paroxetine, Paxil, Paxil CR, Pexeva (cont.)

Pharmacy Author:

Omudhome Ogbru, PharmD

Omudhome Ogbru, PharmD

Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

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Medical and Pharmacy Editor:

Jay W. Marks, MD

Jay W. Marks, MD

Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

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Paroxetine may increase the effect of the blood thinner, warfarin (Coumadin), leading to excessive bleeding. Therefore, warfarin therapy should be monitored more frequently in patients who are also taking paroxetine. Combining SSRIs such as paroxetine with aspirin, nonsteroidal anti-inflammatory drugs or other drugs that affect bleeding may increase the likelihood of upper gastrointestinal bleeding. Phenytoin (Dilantin) and phenobarbital may decrease the amount of paroxetine in the body and possibly reduce its effectiveness.

PREGNANCY: Use of paroxetine during pregnancy may result in congenital heart defects. Paroxetine should not be administered to pregnant women unless the need justifies the risk.

NURSING MOTHERS: Paroxetine is secreted in breast milk. Mothers who are taking paroxetine should consider not breastfeeding.

SIDE EFFECTS: Paroxetine can cause nausea, headaches, anxiety, insomnia, drowsiness, constipation, weakness, dry mouth, sweating, diarrhea and loss of appetite. Increased blood pressure can occur, and blood pressure should be monitored during treatment. Seizures have been reported. Sexual dysfunction has been associated with paroxetine. Some patients may experience withdrawal reactions upon stopping paroxetine. Symptoms of withdrawal include anxiety, nausea, nervousness, and insomnia. The dose of paroxetine should be gradually reduced when therapy is discontinued.

Antidepressants increased the risk of suicidal thinking and behavior (suicidality) in short-term studies in children and adolescents with depression and other psychiatric disorders. Anyone considering the use of paroxetine or any other antidepressant in a child or adolescent must balance this risk with the clinical need. Patients who are started on therapy should be closely observed for clinical worsening, suicidality, or unusual changes in behavior.

Reference: FDA Prescribing Information

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