Paxil - Generic Name: paroxetine (pa ROX a teen)

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Product Code: Paxil - Generic Name: paroxetine (pa ROX a teen)
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WHAT IS PAXIL? 

Paxil (paroxetine) is an antidepressant in a group of drugs called selective serotonin reuptake inhibitors (SSRIs). Paxil affects chemicals in the brain that may become unbalanced.

Paxil is used to treat depression, obsessive-compulsive disorder, anxiety disorders, post-traumatic stress disorder (PTSD), and premenstrual dysphoric disorder (PMDD).

Paxil may also be used for purposes not listed in this medication guide.

Important information Paxil

Do not take Paxil together with pimozide (Orap), thioridazine (Mellaril), linezolid (Zyvox), methylene blue (Urolene Blue), or a monoamine oxidase inhibitor (MAOI) such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate). A dangerous drug interaction could occur, leading to serious side effects.

Before you take Paxil, tell your doctor if you have liver or kidney disease, a bleeding or blood clotting disorder, seizures, glaucoma, bipolar disorder, or a history of drug abuse or suicidal thoughts. 

There are many other drugs that can interact with Paxil. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Paxil may cause harm to an unborn baby. Tell your doctor right away if you become pregnant while taking Paxil.

Paxil may cause heart defects or serious lung problems in a newborn if you take the medication during pregnancy. However, you may have a relapse of depression if you stop taking your antidepressant during pregnancy.

Do not start or stop taking Paxil during pregnancy without your doctor's advice.

You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Before taking Paxil

Do not take Paxil together with pimozide (Orap), thioridazine (Mellaril), linezolid (Zyvox), methylene blue (Urolene Blue), or a monoamine oxidase inhibitor (MAOI) such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate). A dangerous drug interaction could occur, leading to serious side effects. You must wait at least 14 days after stopping an MAO inhibitor before you can take Paxil. After you stop taking Paxil, you must wait at least 14 days before you start taking an MAOI.

Tell your doctor about all other antidepressants you take, especially Celexa, Cymbalta, Desyrel, Effexor, Lexapro, Luvox, Oleptro, Prozac, Sarafem, Symbyax, Viibryd, or Zoloft.

To make sure you can safely take Paxil, tell your doctor if you have any of these other conditions:

  • liver or kidney disease;

  • a bleeding or blood clotting disorder;

  • seizures or epilepsy;

  • narrrow-angle glaucoma; or

  • bipolar disorder (manic depression), or a history of drug abuse or suicidal thoughts.

You may have thoughts about suicide while taking an antidepressant, especially if you are younger than 24 years old. Tell your doctor if you have worsening depression or suicidal thoughts during the first several weeks of treatment, or whenever your dose is changed.

Your family or other caregivers should also be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

FDA pregnancy category D. Paxil may cause heart defects or serious lung problems in a newborn if you take the medication during pregnancy. However, you may have a relapse of depression if you stop taking your antidepressant during pregnancy. Tell your doctor right away if you become pregnant while taking Paxil. Do not start or stop taking Paxil during pregnancy without your doctor's advice. Paroxetine can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby. 

How should I take Paxil?

Take Paxil exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results.

Do not crush, chew, or break a Paxil CR extended-release tablet. Swallow it whole. Breaking or opening the pill may cause too much of the drug to be released at one time. Shake the Paxil oral suspension (liquid) well just before you measure a dose. Measure the liquid with a special dose measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose measuring device, ask your pharmacist for one. It may take up to 4 weeks before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve after 4 weeks of treatment.

You may have withdrawal symptoms (such as agitation, dizziness, numbness or tingling, ringing in your ears, confusion, or behavior changes) after you stop taking Paxil. Do not stop taking this medication suddenly without first talking to your doctor.

Store Paxil at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of Paxil can be fatal. Overdose symptoms may include extreme drowsiness, vomiting, tremor, confusion, decreased urination, blurred vision, rapid heartbeat, aggression, seizures, and coma.

What should I avoid while taking Paxil?

Drinking alcohol can increase some of the side effects of Paxil. This medication may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. 

Paxil side effects

Get emergency medical help if you have any of these signs of an allergic reaction to Paxil: skin rash or hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have a serious side effect such as:

  • unusual bone pain or tenderness, swelling or bruising;

  • easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), coughing up blood;

  • agitation, hallucinations, fever, fast heart rate, overactive reflexes, nausea, vomiting, diarrhea, feeling unsteady, loss of coordination, fainting;

  • very stiff (rigid) muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, overactive reflexes, feeling like you might pass out;

  • headache, trouble concentrating, memory problems, weakness, confusion, hallucinations, fainting, seizure, shallow breathing or breathing that stops; or

  • severe skin reaction -- fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Less serious Paxil side effects may include:

  • mild headache, drowsiness, dizziness, sleep problems (insomnia), feeling restless or nervous;

  • mild nausea, constipation, weight changes;

  • decreased sex drive, impotence, or difficulty having an orgasm; or

  • dry mouth, yawning, or ringing in your ears.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Paxil side effects (in more detail)

What other drugs will affect Paxil?

Cold or allergy medicine, sedatives, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures or anxiety can add to sleepiness caused by Paxil. Tell your doctor if you regularly use any of these medicines, or any other antidepressant.

Ask your doctor before taking a nonsteroidal anti-inflammatory drug (NSAID) for pain, arthritis, fever, or swelling. This includes aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn, Naprelan, Treximet), celecoxib (Celebrex), diclofenac (Cataflam, Voltaren), indomethacin (Indocin), meloxicam (Mobic), and others. Taking an NSAID with Paxil may cause you to bruise or bleed easily.

Many drugs can interact with Paxil. Below is just a partial list. Tell your doctor if you are using:

  • a blood thinner such as warfarin (Coumadin, Jantoven);

  • cimetidine (Tagamet);

  • fentanyl (Abstral, Actiq, Duragesic, Fentora, Onsolis);

  • fosamprenavir (Lexiva) or ritonavir (Norvir, Kaletra);

  • St. John's wort;

  • tamoxifen (Nolvadex, Soltamox);

  • theophylline (Elixophyllin, Theo-24, Theochron, Uniphyl);

  • tramadol (Ultram, Ultracet);

  • tryptophan (also called L-tryptophan);

  • heart medication such as digoxin (digitalis, Lanoxin), quinidine (Quin-G), procainamide (Pronestyl), disopyramide (Norpace), flecaininde (Tambocor), mexiletine (Mexitil), propafenone, (Rythmol), and others;

  • any other antidepressant such as amitriptyline (Elavil, Vanatrip, Limbitrol), citalopram (Celexa), desipramine (Norpramin), doxepin (Sinequan), fluoxetine (Prozac, Sarafem, Symbyax), nortriptyline (Pamelor), sertraline (Zoloft), and others;

  • medicine to treat psychiatric disorders, such as chlorpromazine (Thorazine), fluphenazine (Permitil, Prolixin), haloperidol (Haldol), lithium (Lithobid, Eskalith), perphenazine (Trilafon), or risperidone (Risperdal); or

  • almotriptan (Axert), frovatriptan (Frova), sumatriptan (Imitrex, Treximet), naratriptan (Amerge), rizatriptan (Maxalt), or zolmitriptan (Zomig).

This list is not complete and other drugs may interact with Paxil. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

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