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

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Medical and Pharmacy Editor:

PRESCRIPTION: Yes

GENERIC AVAILABLE: Yes

PREPARATIONS: Tablets: 10, 20, 30, and 40 mg; Paxil CR Tablets: 12.5, 25, and 37.5 mg; Suspension: 10 mg/5ml

STORAGE: Tablets should be kept at room temperature, 59-86 F (15- 30 C). The suspension and controlled release tablets should be stored at or below 77 F (25 C).

PRESCRIBED FOR: Paroxetine is used for the management of depression, obsessive-compulsive disorders (OCD), panic disorders, post traumatic stress disorder (PTSD), premenstrual dysphoric disorder (PMDD), and social anxiety disorder.

DOSING: The recommended dose is 20-60 mg daily of immediate release tablets or 12.5-75 mg daily using controlled release tablets. Paroxetine is given as a single daily dose, usually in the morning. As with all anti-depressants, the full effect may not occur until after a few weeks of therapy. Doses for obsessive-compulsive disorders and panic disorders are often higher than those for depression. Doses often are adjusted to find the optimal dose. Elderly patients, debilitated persons, and patients with certain kidney or liver diseases may need lower doses because they metabolize and eliminate paroxetine more slowly and, therefore, are prone to develop high blood levels and toxicity.

DRUG INTERACTIONS: All SSRIs, including paroxetine, should not be taken with any of the monoamine oxidase inhibitor (MAOI) class of antidepressants, for example, isocarboxazid (Marplan), phenelzine (Nardil), tranylcypromine (Parnate), selegiline (Eldepryl, Carbex), and procarbazine (Matulane) or other drugs that inhibit monoamine oxidase such as linezolid (Zyvox) and intravenous methylene blue. Such combinations may lead to confusion, high blood pressure, tremor, hyperactivity, coma, and death. (A period of 14 days without treatment should lapse when switching between paroxetine and MAOIs.) Similar reactions occur when paroxetine is combined with other drugs for example, tryptophan, St. John's wort, meperidine (Demerol), tramadol (Ultram) that increase serotonin in the brain.

Medically Reviewed by a Doctor on 6/7/2013


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