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Paxil (paroxetine)

Indications

Paxil is indicated for the treatment of:

• Major Depressive Disorder (MDD)
• Obsessive Compulsive Disorder (OCD)
• Panic Disorder (PD)
• Social Anxiety Disorder (SAD)
• Generalized Anxiety Disorder (GAD)
• Posttraumatic Stress Disorder (PTSD)

Dosage and Administration

• Take Paxil by mouth, as directed by your healthcare provider, usually once daily in the morning. If this tablet makes you sleepy during the day, ask your healthcare provider about taking it in the evening.
• Swallow the tablets whole.
• Take Paxil tablets with or without food. Taking it with food may help reduce nausea.
• Take this medication regularly at the same time each day for the best results.
• Follow your healthcare provider’s instructions on whether to take it every day or only for the 2 weeks before your period through the first full day of your period. This implies when you are taking Paxil for premenstrual problems.
• Keep taking Paxil even if you feel well. 
• Do not increase your dose or take this tablet more often than prescribed.
• Do not stop taking this tablet suddenly, as this can cause withdrawal symptoms.

Mechanism of Action

Paroxetine, the active ingredient in Paxil, is a selective serotonin reuptake inhibitor (SSRI). It works by increasing the levels of serotonin, a natural substance in the brain that helps maintain mental balance.

Contraindications of Paxil

This tablet should not be used if you are:

• Using monoamine oxidase inhibitors (MAOIs) or taking an MAOI within the last 14 days.
• Using Pimozide or Thioridazine along with Paxil tablets.
• Known hypersensitivity to Paroxetine or any of the inactive ingredients in Paxil.

Side Effects of Paxil

Common Side Effects:

• Nausea
• Headache
• Dizziness
• Dry mouth
• Loss of appetite
• Sexual side effects
• Numbness or tingling

Serious Side Effects:

• Serotonin Syndrome
• Embryofetal and Neonatal Toxicity
• Increased Risk of Bleeding
• Activation of Mania/Hypomania
• Seizures
• Angle-Closure Glaucoma

Precautions

• Serotonin Syndrome: Paxil can cause serotonin syndrome, especially when taken with other serotonergic drugs (e.g., SSRIs, SNRIs, triptans). If you experience symptoms, stop taking this tablet and seek medical attention immediately.
• Embryofetal and Neonatal Toxicity: This tablet can harm an unborn baby. There is an increased risk of heart defects if taken during the first trimester and persistent pulmonary hypertension if taken late in pregnancy.
• Increased Risk of Bleeding: Taking Paxil with aspirin, NSAIDs, other antiplatelet drugs, warfarin, and other anticoagulants can increase bleeding risk.
• Activation of Mania/Hypomania: Paxil may trigger mania or hypomania in patients with bipolar disorder. Screen for bipolar disorder before starting treatment.
• Seizures: Use this tablet with caution if you have a seizure disorder.
• Angle-Closure Glaucoma: Paxil can cause angle-closure glaucoma in patients with untreated anatomically narrow angles.

Storage Instructions

Store these tablets between 15°C and 30°C (59°F and 86°F).

References

https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/020031s077lbl.pdf  

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