Follow all directions on your prescription label. Your doctor may occasionally change your dose. Do not take this medicine in larger or smaller amounts or for longer than recommended. Do not crush, chew, or break an extended-release paroxetine tablet. Shake the paroxetine oral suspension liquid well just before you measure a dose. Measure liquid medicine with the dosing syringe provided, or with a special dose-measuring spoon or medicine cup.
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.
Do not stop using paroxetine suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using paroxetine. Irreversible lesions occurred in the reproductive tract of male rats after dosing in toxicity studies for 2 to 52 weeks. Pregnancy Pregnancy Category D. Labor And Delivery The effect of paroxetine on labor and delivery in humans is unknown. Nursing Mothers Like many other drugs, paroxetine is secreted in human milk, and caution should be exercised when PAXIL is administered to a nursing woman.
Clinical Worsening and Suicide Risk. Three placebo-controlled trials in pediatric patients with MDD have been conducted with PAXIL, and the data were not sufficient to support a claim for use in pediatric patients. Anyone considering the use of PAXIL in a child or adolescent must balance the potential risks with the clinical need.
Decreased appetite and weight loss have been observed in association with the use of SSRIs. These include overdoses with paroxetine alone and in combination with other substances. Of these, 48 cases were fatal and of the fatalities, 17 appeared to involve paroxetine alone. Eight fatal cases that documented the amount of paroxetine ingested were generally confounded by the ingestion of other drugs or alcohol or the presence of significant comorbid conditions. Of non-fatal cases with known outcome, most recovered without sequelae.
The largest known ingestion involved 2, mg of paroxetine 33 times the maximum recommended daily dose in a patient who recovered. Commonly reported adverse events associated with paroxetine overdosage include somnolence , coma, nausea, tremor , tachycardia , confusion, vomiting, and dizziness. Other notable signs and symptoms observed with overdoses involving paroxetine alone or with other substances include mydriasis , convulsions including status epilepticus , ventricular dysrhythmias including torsade de pointes , hypertension , aggressive reactions, syncope , hypotension , stupor, bradycardia , dystonia , rhabdomyolysis , symptoms of hepatic dysfunction including hepatic failure, hepatic necrosis , jaundice , hepatitis , and hepatic steatosis , serotonin syndrome, manic reactions, myoclonus , acute renal failure, and urinary retention.
Overdosage Management No specific antidotes for paroxetine are known. Treatment should consist of those general measures employed in the management of overdosage with any drugs effective in the treatment of major depressive disorder.
Ensure an adequate airway, oxygenation , and ventilation. Monitor cardiac rhythm and vital signs. General supportive and symptomatic measures are also recommended. Induction of emesis is not recommended. Due to the large volume of distribution of this drug, forced diuresis , dialysis , hemoperfusion, or exchange transfusion are unlikely to be of benefit. A specific caution involves patients who are taking or have recently taken paroxetine who might ingest excessive quantities of a tricyclic antidepressant.
In managing overdosage, consider the possibility of multiple drug involvement. The physician should consider contacting a poison control center for additional information on the treatment of any overdose. Studies at clinically relevant doses in humans have demonstrated that paroxetine blocks the uptake of serotonin into human platelets.
In vitro studies in animals also suggest that paroxetine is a potent and highly selective inhibitor of neuronal serotonin reuptake and has only very weak effects on norepinephrine and dopamine neuronal reuptake. In vitro radioligand binding studies indicate that paroxetine has little affinity for muscarinic, alpha1-, alpha2-, beta-adrenergic-, dopamine D2 -, 5-HT1-, 5-HT2-, and histamine H1 -receptors; antagonism of muscarinic, histaminergic, and alpha1-adrenergic receptors has been associated with various anticholinergic , sedative , and cardiovascular effects for other psychotropic drugs.
Pharmacokinetics Paroxetine hydrochloride is completely absorbed after oral dosing of a solution of the hydrochloride salt. Paroxetine is extensively metabolized and the metabolites are considered to be inactive. Nonlinearity in pharmacokinetics is observed with increasing doses. Paroxetine metabolism is mediated in part by CYP2D6, and the metabolites are primarily excreted in the urine and to some extent in the feces.
Alcohol As with other psychotropic medicinal products patients should be advised to avoid alcohol use while taking paroxetine. Oral anticoagulants A pharmacodynamic interaction between paroxetine and oral anticoagulants may occur. Concomitant use of paroxetine and oral anticoagulants can lead to an increased anticoagulant activity and haemorrhagic risk. Therefore, paroxetine should be used with caution in patients who are treated with oral anticoagulants.
Caution is advised in patients taking SSRIs, concomitantly with oral anticoagulants, medicinal products known to affect platelet function or increase risk of bleeding e. Pravastatin An interaction between paroxetine and pravastatin has been observed in studies suggesting that co-administration of paroxetine and pravastatin may lead to an increase in blood glucose levels.
The mechanism is unknown. Paroxetine should only be used during pregnancy when strictly indicated. The prescribing physician will need to weigh the option of alternative treatments in women who are pregnant or are planning to become pregnant. Abrupt discontinuation should be avoided during pregnancy see section 4. Neonates should be observed if maternal use of paroxetine continues into the later stages of pregnancy, particularly the third trimester.
The following symptoms may occur in the neonates after maternal paroxetine use in later stages of pregnancy: These symptoms could be due to either serotonergic effects or withdrawal symptoms. Epidemiological data have suggested that the use of SSRIs in pregnancy, particularly in late pregnancy, may have an increased risk of persistent pulmonary hypertension of the newborn PPHN.
The observed risk was approximately 5 cases per pregnancies. In the general population 1 to 2 cases of PPHN per pregnancies occur. Breast-feeding Small amounts of paroxetine are excreted into breast milk. Since no effects are anticipated, breast-feeding can be considered. Fertility Animal data have shown that paroxetine may affect sperm quality see section 5.
In vitro data with human material may suggest some effect on sperm quality, however, human case reports with some SSRIs including paroxetine have shown that an effect on sperm quality appears to be reversible. Impact on human fertility has not been observed so far.
Clinical experience has shown that therapy with paroxetine is not associated with impairment of cognitive or psychomotor function. However, as with all psychoactive drugs, patients should be cautioned about their ability to drive a car and operate machinery.
The prescribing information on paroxetine lists a decreased number of platelets as a very rare side effect of the medication, occurring in 1 out of 10, patients. The most common side effects are dry mouth, constipation, nausea, drowsiness, insomnia, headache, dizziness, yawning and weight gain. You can browse Drugs A-Z for a specific prescription or over-the-counter drug or look up drugs based on your specific condition. This information is for educational purposes only, and not meant to provide medical advice, treatment, or diagnosis.
Remember to always consult your physician or health care provider before starting, stopping, or altering a treatment or health care regimen. To reduce your risk of side effects, your doctor may start you at a low dose and gradually increase your dose. Follow your doctor's instructions carefully. Do not increase your dose or use this drug more often or for longer than prescribed.
Your condition will not improve any faster, and your risk of side effects will increase. Take this medication regularly to get the most benefit from it. To help you remember, take it at the same time each day.
Epidemiological 20mg have suggested that the use of SSRIs in pregnancy, particularly in late pregnancy, may have an increased risk of persistent pulmonary hypertension of the newborn PPHN. It is uncertain whether the hcl of paroxetine and tamoxifen has a significant adverse effect on the efficacy of tamoxifen. Other notable signs and symptoms observed with overdoses involving paroxetine alone or with other substances include mydriasisconvulsions including status epilepticusparoxetine hcl tabs 20mg, ventricular dysrhythmias including torsade de pointeshypertensionaggressive tabs, syncopeparoxetineparoxetine, bradycardiadystoniarhabdomyolysissymptoms of hepatic dysfunction including hepatic failure, hepatic necrosisjaundicehepatitisand hepatic steatosisserotonin syndrome, manic reactions, myoclonusacute renal failure, hcl urinary retention. This includes aspirin, hcl Advil, Motrinnaproxen Aleveparoxetine hcl tabs 20mg, celecoxib Celebrexdiclofenac, indomethacin, meloxicam, and others. Paroxetine affects chemicals in the brain that may be unbalanced in people with depression, anxiety, or other disorders. Patients should be cautioned about the 20mg of serotonin syndrome with the concomitant use of PAXIL and triptans, tramadol, or other serotonergic agents. Close supervision of patients and in particular those at high risk should accompany drug therapy especially in early tab and following dose changes. If, based on clinical need, a decision to treat is nevertheless taken, the patient should be carefully monitored for the appearance of suicidal symptoms. Hyponatraemia Hyponatraemia has been reported rarely, predominantly in the elderly. Saturation of this enzyme at clinical doses appears to account for the nonlinearity of paroxetine kinetics with increasing dose and increasing duration of treatment. A low initial starting dose is recommended to minimise the potential worsening of panic symptomatology, which is generally recognised to occur early in the treatment of this disorder. Take the missed dose as soon as you remember. Caution is advised in patients taking SSRIs paroxetine with oral anticoagulants, medicinal products 20mg to affect platelet function or other medicinal products that may increase tab of bleeding e, paroxetine hcl tabs 20mg.
An overdose of paroxetine can be fatal. These doses are up to 2. As these syndromes may result in potentially life-threatening conditions, treatment with paroxetine should be lopressor panic disorder if such events characterised by clusters of symptoms such as hyperthermia, rigidity, myoclonus, autonomic instability with possible rapid fluctuations of vital signs, mental status changes including confusion, irritability, extreme agitation progressing to tab and coma hcl and supportive symptomatic treatment should be initiated. Do not start or stop taking paroxetine 20mg pregnancy without your doctor's advice. The hyponatraemia generally reverses on discontinuation of paroxetine. Your family or other caregivers should also be alert paroxetine changes in your mood or symptoms. These studies have revealed no evidence of teratogenic effects. Because the MRHD for major depressive disorder is slightly less than that for OCD 50 mg versus 60 mgthe doses used in these carcinogenicity studies were only 2. Also, the long-term safety effects concerning growth, maturation and cognitive and behavioural development, of Paroxetine in this age group have not yet been demonstrated. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or combination is safe, effective or appropriate for any given patient. Concomitant Medication Patients should be advised to inform their physician paroxetine they are taking, or plan to take, any prescription or over-the-counter drugs, since there is a potential for interactions. Teratogenic Effects and Nonteratogenic Effects, paroxetine hcl tabs 20mg. The occurrence of withdrawal hcl is not the same as the drug being addictive or dependence producing, paroxetine hcl tabs 20mg. Cardiac Conditions The usual precautions should be observed 20mg patients with cardiac conditions. Measure liquid medicine with the dosing syringe provided, or tab a special dose-measuring spoon or medicine cup. Keep using the medication as directed and tell your doctor if your symptoms do not improve. Shake the paroxetine oral suspension liquid well just before you measure a dose.
However, other tabs have failed to demonstrate such a 20mg. If you have any questions about the drugs you are taking, check with your doctor, nurse or pharmacist. Hcl initial dosage adjustment is considered necessary when the drug is to be co-administered with known drug metabolising enzyme inducers e. Call your doctor at once if you have: Follow your doctor's directions on how to take this medication. The cause of these deaths is not known. In general, septal defects range 20mg those that are symptomatic and may require surgery to those that are asymptomatic and may resolve spontaneously. These symptoms may also be due to the underlying disease. Caution is advised in patients taking SSRIs, concomitantly with oral anticoagulants, medicinal products known to affect platelet function or increase risk of bleeding e. Other studies do not show a significant statistical association. Labor And Delivery The effect of paroxetine on labor and delivery in humans is unknown. Paroxetine can pass into breast milk and may cause side effects in the nursing baby. Patients with depression should paroxetine treated for a sufficient period of at least 6 months to ensure that they are free from symptoms. Paroxetine affects chemicals in the brain that may be unbalanced in tab with depression, anxiety, paroxetine hcl tabs 20mg, or hcl disorders. Neither Everyday Health nor its licensor assume any responsibility for any paroxetine of healthcare administered with the aid of the information provided.
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