Paroxetine

Uses

Paroxetine tablets, suspension (liquid), and extended-release (long-acting) tablets are used to treat depression, panic disorder (sudden, unexpected attacks of extreme fear and worry about these attacks), and social anxiety disorder (extreme fear of interacting with others or performing in front of others that interferes with normal life). Paroxetine tablets and suspension are also used to treat obsessive-compulsive disorder (bothersome thoughts that won’t go away and the need to perform certain actions over and over), generalized anxiety disorder (GAD; excessive worrying that is difficult to control), and posttraumatic stress disorder (disturbing psychological symptoms that develop after a frightening experience).

Paroxetine extended-release tablets are also used to treat the premenstrual dysphoric disorder (PMDD, physical and psychological symptoms that occur before the onset of the menstrual period each month). Paroxetine capsules (Brisdelle) are used to treat hot flashes (sudden feelings of warmth, especially in the face, neck, and chest) in women who are experiencing menopause (stage of life when menstrual periods become less frequent and stop and women may experience other symptoms and body changes). Paroxetine is in a class of medications called selective serotonin reuptake inhibitors (SSRIs). It treats depression and other mental illnesses by increasing the amount of serotonin, a natural substance in the brain that helps maintain mental balance. There is not enough information available at this time to know how paroxetine works to treat hot flashes.

Side Effects Of Paroxetine

Paroxetine may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• headache
• dizziness
• weakness
• difficulty concentrating
• nervousness
• forgetfulness
• confusion
• sleepiness or feeling ”drugged”
• nausea
• vomiting
• diarrhea
• constipation
• gas
• stomach pain
• heartburn
• changes in the ability to taste food
• decreased appetite
• weight loss or gain
• changes in sex drive or ability
• dry mouth
• sweating
• yawning
• sensitivity to light
• lump or tightness in the throat
• pain in the back, muscles, bones, or anywhere in the body
• tenderness or swelling of joints
• muscle weakness or tightness
• flushing
• sore teeth and gums
• unusual dreams
• painful or irregular menstruation

Some side effects of paroxetine can be serious. If you experience any of the following symptoms or those listed in the IMPORTANT WARNING or SPECIAL PRECAUTIONS sections, call your doctor immediately or get emergency medical treatment:

• seeing things or hearing voices that do not exist (hallucinating)
• fainting
• rapid, pounding, or irregular heartbeat
• chest pain
• difficulty breathing
• seizures
• fever, sweating, confusion, fast or irregular heartbeat, and severe muscle stiffness or twitching
• abnormal bleeding or bruising
• tiny red spots directly under the skin
• peeling or blistering of the skin
• sore throat, fever, chills, cough, and other signs of infection
• uncontrollable shaking of a part of the body
• unsteady walking that may cause falling
• sudden muscle twitching or jerking that you cannot control
• numbness or tingling in your hands, feet, arms, or legs
• difficult, frequent, or painful urination
• swelling, itching, burning, or infection in the vagina
• painful erection that lasts for hours
• sudden nausea, vomiting, weakness, cramping, bloating, swelling, tightness in hands and feet, dizziness, headache, and/or confusion
• hives
• skin rash
• itching
• swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
• hoarseness
• black and tarry stools
• red blood in stools
• bloody vomit
• vomit that looks like coffee grounds
• bone pain
• tenderness, swelling, or bruising of one part of your body
• Paroxetine may decrease appetite and cause weight loss in children. Your child’s doctor will watch his or her growth carefully. Talk to your child’s doctor if you have concerns about your child’s growth or weight while he or she is taking this medication. Talk to your child’s doctor about the risks of giving paroxetine to your child.

Paroxetine may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

Warnings & Precautions

Before taking paroxetine:

• tell your doctor and pharmacist if you are allergic to paroxetine, any other medications, or any of the ingredients in paroxetine tablets, controlled-release tablets, capsules, or suspension. Ask your pharmacist or check the Medication Guide for a list of the ingredients
• tell your doctor if you are taking monoamine oxidase (MAO) inhibitors, including isocarboxazid (Marplan), linezolid (Zyvox), methylene blue, phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), and tranylcypromine (Parnate); if you have stopped taking them within the past 2 weeks; or if you are taking thioridazine or pimozide (Orap). Your doctor will probably tell you not to take paroxetine. If you stop taking paroxetine, you should wait at least 2 weeks before you start to take an MAO inhibitor.
• tell your doctor and pharmacist what other prescription and nonprescription medications and vitamins you are taking or plan to take with paroxetine. Be sure to mention any of the following: anticoagulants (‘blood thinners’) such as warfarin (Coumadin); antidepressants (‘mood elevators’) such as amitriptyline (Elavil), amoxapine (Asendin), clomipramine (Anafranil), desipramine (Norpramin), doxepin (Adapin, Sinequan), imipramine (Tofranil), nortriptyline (Aventyl, Pamelor), protriptyline (Vivactil), and trimipramine (Surmontil); antihistamines; aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin), and naproxen (Aleve, Naprosyn); atomoxetine (Straterra); atazanavir (Reyataz); bromocriptine (Parlodel); bupropion (Wellbutrin); buspirone (Buspar); celecoxib (Celebrex); chlorpromazine (Thorazine); cimetidine (Tagamet); clopidogrel (Plavix); codeine (found in many cough and pain medications); dexamethasone (Decadron); dextromethorphan (found in many cough medications; in Nuedexta); diazepam (Valium); dicloxacillin (Dynapen); digoxin (Lanoxin); dipyridamole (Persantine); diuretics (‘water pills’); fentanyl (Actiq, Duragesic, Fentora); fosamprenavir (Lexiva); haloperidol (Haldol); isoniazid (INH, Nydrazid); lithium (Eskalith, Lithobid); medications for irregular heartbeat such as amiodarone (Cordarone, Pacerone), encainide (Enkaid), flecainide (Tambocor), mexiletine (Mexitil), moricizine (Ethmozine), propafenone (Rythmol), and quinidine (Quinidex; in Nuedexta); medications for mental illness and nausea; medications for migraine headaches such as almotriptan (Axert), eletriptan (Relpax), frovatriptan (Frova), naratriptan (Amerge), rizatriptan (Maxalt), sumatriptan (Imitrex), and zolmitriptan (Zomig); medications for seizures such as phenobarbital and phenytoin (Dilantin); meperidine (Demerol); methadone (Dolophine); metoclopramide (Reglan); metoprolol (Lopressor, Toprol XL); ondansetron (Zofran); other selective serotonin-reuptake inhibitors such as citalopram (Celexa), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), and sertraline (Zoloft); procyclidine (Kemadrin); propoxyphene (Darvon); propranolol (Inderal); ranitidine (Zantac); rifampin (Rifadin, Rimactane); risperidone (Risperdal); ritonavir (Norvir); sibutramine (Meridia); tamoxifen (Nolvadex); terbinafine (Lamisil); theophylline (Theobid, Theo-Dur); ticlopidine (Ticlid); timolol (Blocadren); tramadol (Ultram); trazodone (Desyrel); and venlafaxine (Effexor). Your doctor may need to change the doses of your medications or monitor you carefully for side effects while taking paroxetine.
• you should know that paroxetine products that have different brand names are available and are used to treat different conditions. Do not take more than one product that contains paroxetine at a time.
• tell your doctor what herbal products and nutritional supplements you are taking, especially St. John’s wort and tryptophan.
• tell your doctor if you use or have ever used street drugs or have overused prescription medications if you have recently had a heart attack and if you have a low level of sodium in your blood. Also tell your doctor if you have or have ever had seizures; bleeding from your stomach or esophagus (the tube that connects the mouth and stomach) or liver, kidney, or heart disease.
• tell your doctor if you are pregnant, if you plan to become pregnant, or if you are breastfeeding. If you become pregnant while taking paroxetine, call your doctor immediately. Paroxetine may cause heart defects in the fetus if it is taken during early pregnancy and problems in newborns following delivery if it is taken during the last months of pregnancy.
• talk to your doctor about the risks and benefits of taking paroxetine if you are 65 years of age or older. Older adults should not usually take paroxetine because it is not as safe or effective as other medications that can be used to treat the same condition.
• if you are having surgery, including dental surgery tell the doctor or dentist that you are taking paroxetine.
• you should know that paroxetine may make you drowsy and affect your judgment and thinking. Do not drive a car or operate machinery until you know how this medication affects you.
• ask your doctor about the safe use of alcoholic beverages while you are taking paroxetine.
• you should know that paroxetine may cause angle-closure glaucoma (a condition where the fluid is suddenly blocked and unable to flow out of the eye causing a quick, severe increase in eye pressure which may lead to a loss of vision). Talk to your doctor about having an eye examination before you start taking this medication. If you have nausea, eye pain, changes in vision, such as seeing colored rings around lights, and swelling or redness in or around the eye, call your doctor or get emergency medical treatment right away.

Paroxetine Dosage

Paroxetine comes as a tablet, a suspension (liquid), a controlled-release (long-acting) tablet, and a capsule to take by mouth. The tablets, suspension, and controlled-release tablets are usually taken once daily in the morning or evening, with or without food. The capsules are usually taken once a day at bedtime with or without food. You may want to take paroxetine with food to prevent stomach upset. Take paroxetine at around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take paroxetine exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Shake the liquid well before each use to mix the medication evenly.

Swallow the extended-release and regular tablets whole; do not chew or crush them.

If you are taking paroxetine tablets, suspension, or controlled-release tablets, your doctor may start you on a low dose of paroxetine and gradually increase your dose, not more than once a week.

Paroxetine capsules contain a lower dose of paroxetine than is needed to treat depression and other forms of mental illness. Do not take paroxetine capsules to treat a mental illness. If you think you have depression or another mental illness, talk to your doctor about treatment.

Paroxetine may help control your symptoms but will not cure your condition. It may take several weeks or longer before you feel the full benefit of paroxetine. Continue to take paroxetine even if you feel well. Do not stop taking paroxetine without talking to your doctor. Your doctor may decrease your dose gradually. If you suddenly stop taking paroxetine tablets, suspension, or controlled-release tablets, you may experience withdrawal symptoms such as depression; mood changes; frenzied or abnormally excited mood; irritability; anxiety; confusion; dizziness; headache; tiredness; numbness, or tingling in the arms, legs, hands, or feet; unusual dreams; difficulty falling asleep or staying asleep; nausea; or sweating. Tell your doctor if you experience any of these symptoms when your dose of paroxetine is decreased.

Other

Keep all appointments with your doctor.

Before having any laboratory test (especially those that involve methylene blue), tell your doctor and the laboratory personnel that you are taking paroxetine.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

Source

All information has been provided courtesy of MedLinePlus from the National Library of Medicine and from the FDA.