Warnings
What are the risks of taking paroxetine (Paxil)?
Paroxetine can cause serious health problems, especially in certain high-risk patients. Some of the risks of paroxetine use include:
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What should I tell my doctor before starting paroxetine (Paxil)?
Tell your doctor if you have ever had an allergic reaction to paroxetine, any active or inactive ingredients in paroxetine preparations, other SSRIs, or any other medications. Your pharmacy can give you a list of ingredients.
Tell your healthcare provider about all your medical conditions. Paroxetine may not be right for people with certain medical conditions such as low sodium levels, seizures, heart disease, osteoporosis, angle-closure glaucoma, or bleeding problems. Tell your doctor if you or anyone in your family has a history of suicide attempts or bipolar disorder. Also, tell your doctor if you or a family member has ever had a prolonged QT interval (a rare heart condition).
Give your doctor a complete list of all your medications, including prescription drugs, over-the-counter medications, vitamins, dietary supplements, and herbal products, especially St. John’s Wort or tryptophan. This can help avoid serious drug interactions.
Tell your doctor if you are pregnant, could be pregnant, plan to get pregnant, or are breastfeeding. Paroxetine can cause heart defects if taken during early pregnancy and problems in a newborn baby after delivery if taken during the last few months of the pregnancy.
What precautions should I take while on paroxetine (Paxil)?
Keep all appointments with healthcare professionals while on paroxetine. Your doctor may want to see you often, especially when you begin treatment, to evaluate your response to the medication and adjust the dosage.
Paroxetine is available under different brand names to treat different conditions. Do not take more than one paroxetine-containing product at any given time.
Watch out for any unusual mood or behavioral changes. A small number of people, especially those under the age of 24, can experience unexpected mental health changes and suicidality while on paroxetine. Call your doctor immediately if you notice any unusual behaviors or moods.
Paroxetine can make you drowsy. Do not drive, operate heavy machinery, or do anything that requires focus before knowing how this medicine affects you. Remember that alcohol can make drowsiness worse.
Tell your doctor if you become pregnant while on paroxetine. This medicine can be harmful to the baby.
Paroxetine can cause closed-angle glaucoma (increased eye pressure). Your doctor may order an eye examination before you start taking this medication. Call your doctor immediately if you develop symptoms such as eye pain, vision changes, redness and swelling around the eyes, or nausea.
Tell your healthcare professionals you are taking paroxetine before undergoing surgery, including dental surgery.
What are paroxetine (Paxil) interactions?
Taking paroxetine with some other medications can affect how the medications work. Drug interactions can also increase the risk of serious adverse effects. Your physician may choose a different antidepressant for you, change the dose or frequency of one or both medicines, and/or closely monitor you for side effects if there are known interactions between paroxetine and your other medications.
You should not take paroxetine if you are taking or have taken within the last 14 days any monoamine oxidase (MAO) inhibitors. This family of medications includes linezolid (Zyvox), isocarboxazid (Marplan), methylene blue, selegiline (Eldepryl, Emsam, Zelapar), phenelzine (Nardil), and tranylcypromine (Parnate).
Taking paroxetine with the following medications is not recommended:
- Thioridazine
- Pimozide (Orap)
There can also be drug interactions between paroxetine and the following medications:
- Anticoagulants or blood thinners like warfarin (Coumadin) and antiplatelet drugs like clopidogrel (Plavix) and dipyridamole (Persantine)
- Other antidepressants like trazodone (Desyrel), amitriptyline (Elavil), clomipramine (Anafranil), amoxapine (Asendin), desipramine (Norpramin), imipramine (Tofranil), doxepin (Adapin, Sinequan), nortriptyline (Aventyl, Pamelor), trimipramine (Surmontil), and protriptyline (Vivactil)
- Other SSRIs such as Celexa, Prozac, Sarafem, Luvox, Zoloft
- Antihistamines
- Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) (Advil, Motrin, Aleve, Naprosyn)
- ADHD medications like atomoxetine (Strattera)
- Certain HIV medications like atazanavir (Reyataz) and fosamprenavir (Lexiva)
- Diuretics (water pills)
- Certain medications used to treat high blood pressure like timolol (Blocadren), metoprolol (Lopressor, Toprol XL), propranolol (Inderal)
- Painkillers like celecoxib (Celebrex)
- Opioid painkillers like fentanyl (Actiq, Duragesic, Fentora), tramadol (Ultram), methadone (Dolophine), meperidine (Demerol)
- Benzodiazepines like diazepam (Valium)
- Medications used to treat irregular heartbeat (Cordarone, Pacerone, Enkaid, Tambocor, Mexitil, Ethmozine, Rythmol, Quinidex)
- Medications used to treat mental illness
- Medications used to treat nausea, like ondansetron (Zofran)
- Medications for migraine headaches (Axert, Relpax, Frova, Amerge, Maxalt, Imitrex, Zomig)
- Medications used to treat tuberculosis (TB) such as isoniazid (INH, Nydrazid) and rifampin (Rifadin, Rimactane)
- Medications used to treat seizures (Dilantin)
- Chlorpromazine (Thorazine)
- Cimetidine (Tagamet)
- Codeine (found in many cough and pain medications)
- Dextromethorphan (found in many cough medications; in Nuedexta)
- Bromocriptine (Parlodel)
- Dexamethasone (Decadron)
- Digoxin (Lanoxin)
- Dicloxacillin (Dynapen)
- Lithium (Eskalith, Lithobid)
- Haloperidol (Haldol)
- Metoclopramide (Reglan)
- Propoxyphene (Darvon)
- Procyclidine (Kemadrin)
- Risperidone (Risperdal)
- Sibutramine (Meridia)
- Terbinafine (Lamisil)
- Tamoxifen (Nolvadex)
- Ticlopidine (Ticlid)
- Theophylline (Theobid, Theo-Dur)
This list does not describe all possible paroxetine interactions. Give your healthcare professionals a complete list of your medications, including prescription and non-prescription drugs, vitamins and dietary supplements, and herbal products. Also, tell your health care provider if you smoke, drink alcohol, or use illegal drugs because some of these substances can cause serious health complications when used with prescription drugs.
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