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Sympathomimetics (eg, amphetamine) Sensitivity of sympathomimetics and risk of serotonin syndrome may be increased. Theophylline Elevated theophylline levels have occurred with paroxetine. Monitor theophylline levels. Tricyclic antidepressants (eg, amitriptyline) Metabolism may be inhibited by paroxetine, increasing plasma levels and adverse reactions.Use dosing cup or spoon to measure and administer dose. Storage/Stability Store paroxetine hydrochloride IR tablets, oral suspension, and CR tablets at or below 77F. Store Pexeva tablets at 59 to 86F.Reduce dose in these patients. Hepatic Function Impairment 2-fold increase in plasma concentrations; dose reduction may be necessary. Elderly Minimum concentrations were 70 to 80 greater. Reduce initial dosage. Indications and Usage Major depressive disorder (MDD panic disorder; social anxiety disorder (except Pexeva ).Tryptophan May cause dizziness, headache, nausea, and sweating. Concomitant use is not recommended. Zolpidem The effect of zolpidem may be increased. Laboratory Test Interactions None well documented. Adverse Reactions Cardiovascular Vasodilation (4 palpitation (3 hypertension, tachycardia (at least 1 vasculitic syndromes (including Henoch-Schönlein purpura ventricular fibrillation, ventricular tachycardia including torsades de pointes (postmarketing).OCD Adults IR PO 20 mg/day initially; recommended dose is 40 mg/day. May increase dose by 10 mg/day at intervals of at least 7 days (max, 60 mg/day). Administer as single daily dose, usually in morning.

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CR PO 12.5 mg/day as a single dose, usually in the morning. May increase dose in increments of 12.5 mg/day at intervals of at least 7 days (max, 75 mg/day). Pmdd Adults CR PO 12.5 mg/day initially, usually in the morning; change doses at intervals of at least 7 days; usual range is 12.5 to 25 mg/day.Hematologic Agranulocytosis, aplastic anemia, bone marrow aplasia, hemolytic anemia, pancytopenia, thrombocytopenia (postmarketing). Hepatic Elevated LFTs, liver necrosis, grossly elevated transaminases associated with severe liver dysfunction (postmarketing). Metabolic-Nutritional Weight gain (at least 1 porphyria (postmarketing).Concomitant use is contraindicated. Procyclidine Reduction of procyclidine dose may be necessary if anticholinergic effects (eg, blurred vision, dry mouth, urinary retention) occur. Protein bound agents Highly protein bound agents may be displaced by paroxetine or paroxetine may be displaced, increasing plasma levels and the risk of adverse reactions.Dosage and Administration GAD/ptsd Adults IR PO 20 mg/day as a single dose with or without food, usually in the morning. May increase dose by 10 mg/day at intervals of 7 days.Elimination 64 of dose excreted in urine (2 as parent compound, 62 as metabolites 36 excreted in feces (mostly as metabolites). The t is 21 h (hydrochloride; IR 33.2 h (mesylate 15 to 20 h (CR).CR PO 25 mg/day as a single dose, usually in the morning (usual dose range, 25 to 62.5 mg/day). May increase dose in increments of 12.5 mg/day at intervals of at least 7 days (max, 62.5 mg/day).T max is 5.2 h (hydrochloride; IR 8.1 h (mesylate 6 to 10 h postdose (CR). Food increased AUC 6 and C max 29, while T max decreased from 6.4 h postdosing to 4.9 h.

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Pregnancy Category D. Lactation Excreted in breast milk. Use with cau.Paxil CR - Tablets, controlled-release 12.5 mg - Tablets, controlled-release 25 mg - Tablets, controlled-release 37.5 mg, paroxetine Mesylate, pexeva - Tablets 10 mg - Tablets 20 mg - Tablets 30 mg - Tablets 40 mg.Pronunciation: par-OX-e-teen, class: ssri, paroxetine Hydrochloride, trade Names, paxil - Tablets 10 mg - Tablets 20 mg - Tablets 30 mg - Tablets 40 mg - Suspension, oral 10 mg per 5 mL.Drug Interactions 5-HT 1 agonists (eg, naratriptan, sumatriptan, zolmitriptan linezolid, lithium, macrolide antibiotics (eg, clarithromycin opioid analgesics (eg, meperidine other ssris, sibutramine, St. John's wort, tramadol, trazodone, tryptophan Risk of serotonin syndrome may be increased.General Advice Administer without regard to meals but with food if GI upset occurs. CR tablets should be swallowed whole. Do not crush, chew, divide, or break tablets. Shake suspension well before measuring dose.Cyproheptadine Pharmacologic effects of paroxetine may be decreased or reversed. Digoxin May decrease digoxin levels. Fosamprenavir, ritonavir Paroxetine plasma levels may be reduced, decreasing the efficacy. Hemostatic agents (eg, aspirin, nsaids, warfarin) Risk of bleeding (eg, GI bleeding) may be increased.Dosage Adjustment in Elderly, Debilitated, or Severe Renal or Hepatic Function Impairment IR PO 10 mg/day initially; do not exceed 40 mg/day. CR PO 12.5 mg/day initially; do not exceed 50 mg/day.

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