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Paroxetine
Generic name: Paroxetine Hydrochloride
Brand Name: Paxil
Indications
Paxil is indicated for the treatment of major depressive disorder.
Dosage and Administration
Paxil Tablets are available for oral administration as 10mg, 20mg, 30mg and 40mg strengths. Paxil is also available as oral suspension as 10 mg/5 mL, in 250 mL bottles.
Normal Dosage:
Paxil should be administered as a single daily dose with or without food, usually in the morning. The recommended initial dose is 20 mg/day. Patients were dosed in a range of 20 to 50 mg/day in the clinical trials demonstrating the effectiveness of Paxil in the treatment of major depressive disorder. As with all drugs effective in the treatment of major depressive disorder, the full effect may be delayed. Some patients not responding to a 20-mg dose may benefit from dose increases, in 10-mg/day increments, up to a maximum of 50 mg/day. Dose changes should occur at intervals of at least 1 week.
Overdose: Overdose symptoms include nausea, vomiting, tremor, seizures, agitation, drowsiness, hyperactivity, and enlarged pupils.
Drug Description
PAXIL (paroxetine hydrochloride) is an orally administered psychotropic drug. It is the hydrochloride salt of a phenylpiperidine compound identified chemically as (-)-trans-4R-(4'-fluorophenyl)-3S-[(3',4'-methylenedioxyphenoxy) methyl] piperidine hydrochloride hemihydrate and has the empirical formula of C19H20FNO3•HCl•½H2O. The molecular weight is 374.8 (329.4 as free base). The structural formula of paroxetine hydrochloride is:
Paroxetine hydrochloride is an odorless, off-white powder, having a melting point range of 120° to 138° C and a solubility of 5.4 mg/mL in water.
Side effects
The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.
- Nausea
- Sexual problems
- Decreased appetite
- Sleepiness (somnolence)
- Difficulty in sleeping (insomnia)
- Dizziness
- Shaking, usually of the hands (tremor)
- Visual disturbances such as blurred vision
- Yawning
- Dry mouth
- Disturbances of the gut such as diarrhoea or constipation
- Sweating
- Weakness or loss of strength (asthenia)
- Weight gain
- Confusion
- Hallucinations
- Abnormal bleeding
- Seizures
- Skin reactions such as rash and itch
- Liver disorders
Precautions
- Use caution when driving, operating machinery, or performing other hazardous activities. May cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities.
- Use alcohol cautiously. Alcohol may reduce the effectiveness of this drug.
- While you are taking this medication you may need to be monitored for worsening symptoms of depression especially at the start of therapy or when doses are changed. Your doctor may want you to monitor for the following symptoms: anxiety, panic attacks, hostility, impulsivity, severe restlessness, and mania (mental and/ or physical hyperactivity). These symptoms may be associated with development of worsening symptoms of depression. Contact your healthcare provider if you develop any new or worsening mental health symptoms during treatment. Do not stop taking medication without first talking to your healthcare provider.
Drug Interactions
- Do not take if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) during the last 2 weeks. Serious, and sometimes fatal, reactions have occurred when these medicines have been used together. Also, do not take paroxetine if you are taking thioridazine (Mellaril). Dangerous, even fatal irregular heartbeats may occur if these medicines are taken together. You must wait 5 weeks after stopping this medication before taking thioridazine (Mellaril).
- Before taking this medication, tell your doctor if you are taking any of the following medicines:
- a benzodiazepine such as diazepam (Valium), alprazolam (Xanax), chlordiazepoxide (Librium), clorazepate (Tranxene), temazepam (Restoril), triazolam (Halcion), and others
- a tricyclic antidepressant such as amitriptyline (Elavil), imipramine (Tofranil), doxepin (Sinequan), nortriptyline (Pamelor), and others
- a phenothiazine such as chlorpromazine (Thorazine), fluphenazine (Prolixin), mesoridazine (Serentil), perphenazine (Trilafon), prochlorperazine (Compazine), and others
- almotriptan (Axert), frovatriptan (Frova), sumatriptan (Imitrex), naratriptan (Amerge), rizatriptan (Maxalt), or zolmitriptan (Zomig)
- carbamazepine (Tegretol) or phenytoin (Dilantin)
- lithium (Lithobid, Eskalith, others)
- theophylline (Theobid, Theolair, Theochron, Elixophyllin, and others)
- warfarin (Coumadin)
- digoxin (Lanoxin)
- cimetidine (Tagamet, Tagamet HB)
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