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, fluoxetine, fluvoxamine, paroxetine, sertraline, or citalopram is clinically warranted, appropriate observation of the patient is advised.

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Tell your doctor and pharmacist if you are allergic to paroxetineany other medicationsor any of the ingredients in paroxetine tabletscontrolled-release tabletscapsulesor suspensionAsk your pharmacist or check the Medication Guide for a list of the ingredients tell your doctor if you are taking monoamine oxidaseMAOinhibitorsincluding isocarboxazidMarplanlinezolidZyvoxmethylene bluephenelzineNardilselegilineEldeprylEmsamZelaparand tranylcypromineParnateif you have stopped taking them within the past 2 weeksor if you are taking thioridazine or pimozideOrapYour doctor will probably tell you not to take paroxetineIf you stop taking paroxetineyou should wait at least 2 weeks before you start to take an MAO inhibitortell your doctor and pharmacist what other prescription and nonprescription medications and vitamins you are taking or plan to takeBe sure to mention any of the followinganticoagulantsblood thinnerssuch as warfarinCoumadinantidepressantsmood elevatorssuch as amitriptylineElavilamoxapineAsendinclomipramineAnafranildesipramineNorpramindoxepinAdapinSinequanimipramineTofranilnortriptylineAventylPamelorprotriptylineVivactiland trimipramineSurmontilantihistaminesaspirin and other nonsteroidal anti-inflammatory drugsNSAIDssuch as ibuprofenAdvilMotrinand naproxenAleveNaprosynatomoxetineStraterraatazanavirReyatazbromocriptineParlodelbupropionWellbutrinbuspironeBusparcelecoxibCelebrexchlorpromazineThorazinecimetidineTagametclopidogrelPlavixcodeinefound in many cough and pain medicationsdexamethasoneDecadrondextromethorphanfound in many cough medicationsin NuedextadiazepamValiumdicloxacillinDynapendigoxinLanoxindipyridamolePersantinediureticswater pillsfentanylActiqDuragesicFentorafosamprenavirLexivahaloperidolHaldolisoniazidINHNydrazidlithiumEskalithLithobidmedications for irregular heartbeat such as amiodaroneCordaronePaceroneencainideEnkaidflecainideTambocormexiletineMexitilmoricizineEthmozinepropafenoneRythmoland quinidineQuinidexin Nuedextamedications for mental illness and nauseamedications for migraine headaches such as almotriptanAxerteletriptanRelpaxfrovatriptanFrovanaratriptanAmergerizatriptanMaxaltsumatriptanImitrexand zolmitriptanZomigmedications for seizures such as phenobarbital and phenytoinDilantinmeperidineDemerolmethadoneDolophinemetoclopramideReglanmetoprololLopressorToprol XLondansetronZofranother selective serotonin-reuptake inhibitors such as citalopramCelexafluoxetineProzacSarafemfluvoxamineLuvoxand sertralineZoloftprocyclidineKemadrinpropoxypheneDarvonpropranololInderalranitidineZantacrifampinRifadinRimactanerisperidoneRisperdalritonavirNorvirsibutramineMeridiatamoxifenNolvadexterbinafineLamisiltheophyllineTheobidTheo-DurticlopidineTiclidtimololBlocadrentramadolUltramtrazodoneDesyreland venlafaxineEffexorYour doctor may need to change the doses of your medications or monitor you carefully for side effectsyou should know that paroxetine products that have different brand names are available and are used to treat different conditionsDo not take more than one product that contains paroxetine at a timetell your doctor what herbal products and nutritional supplements you are takingespecially StJohn’s wort and tryptophantell your doctor if you use or have ever used street drugs or have overused prescription medicationsif you have recently had a heart attackand if you have a low level of sodium in your bloodAlso tell your doctor if you have or have ever had seizuresbleeding from your stomach or esophagustube that connects the mouth and stomachor liverkidneyor heart diseasetell your doctor if you are pregnantif you plan to become pregnantor if you are breast-feedingIf you become pregnant while taking paroxetinecall your doctor immediatelyParoxetine 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 pregnancyif you are having surgeryincluding dental surgery tell the doctor or dentist that you are taking paroxetineyou should know that paroxetine may make you drowsy and affect your judgment and thinkingDo not drive a car or operate machinery until you know how this medication affects youask your doctor about the safe use of alcoholic beverages while you are taking paroxetineyou should know that paroxetine may cause angle-closure glaucomaa condition where the fluid is suddenly blocked and unable to flow out of the eye causing a quicksevere increase in eye pressure which may lead to a loss of visionTalk to your doctor about having an eye examination before you start taking this medicationIf you have nauseaeye painchanges in visionsuch as seeing colored rings around lightsand swelling or redness in or around the eyecall your doctor or get emergency medical treatment right away.

Risk of complications such as feeding difficultiesirritabilityand respiratory problems reported in neonates exposed to SNRIs/SSRIs late in third trimester.

Severe nervous system reactionvery stiffrigidmuscleshigh feversweatingconfusionfast or uneven heartbeatstremorsfaintingor.

AGenerally acceptableControlled studies in pregnant women show no evidence of fetal risk.

Paxil CR12.5 mg PO qDay initiallymay increase at 1 week intervals not to exceed 25 mg/day.

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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.

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