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Brand
name : Paxil
Pronounced: PACKS-ill
Generic name: Paroxetine hydrochloride
Other brand name: Paxil CR Why is Paxil prescribed?
Paxil relieves a variety of emotional problems. It can be prescribed
for serious, continuing depression that interferes with your ability
to function. Symptoms of this type of depression often include changes
in appetite and sleep patterns, a persistent low mood, loss of interest
in people and activities, decreased sex drive, feelings of guilt or
worthlessness, suicidal thoughts, difficulty concentrating, and slowed
thinking.
Paxil is also used to treat obsessive-compulsive disorder (OCD), a
disease marked by unwanted, but stubbornly persistent thoughts, or
unreasonable rituals you feel compelled to repeat.
In addition, Paxil is prescribed for panic disorder, a crippling emotional
problem characterized by sudden attacks of at least four of the following
symptoms: palpitations, sweating, shaking, numbness, chills or hot
flashes, shortness of breath, a feeling of choking, chest pain, nausea
or abdominal distress, dizziness or faintness, feelings of unreality
or detachment, fear of losing control, or fear of dying.
Paxil can be prescribed for generalized anxiety disorder, a disease
marked by excessive anxiety and worry that persists for at least 6
months and can't be easily controlled. True cases of generalized anxiety
disorder are accompanied by at least three of the following symptoms:
restlessness or a keyed-up or on-edge feeling, a tendency to tire easily,
difficulty concentrating or spells when the mind goes blank, irritability,
muscle tension, or sleep disturbance.
Paxil can be used in the treatment of social anxiety disorder (also
known as social phobia), a condition marked by shyness or stage fright
so intense that it interferes with an individual's work and social
life.
Paxil is also prescribed for post-traumatic stress disorder--a crippling
condition that sometimes develops in reaction to a disastrous or horrifying
experience. Symptoms, which stubbornly refuse to abate, include unwanted
memories and dreams, intense distress when confronted with reminders
of the event, a general numbing of interest and enjoyment, jumpiness,
irritability, poor sleep, and loss of concentration.
Paxil CR, the controlled-release version, is prescribed for major
depression, panic disorder, social anxiety disorder, and severe premenstrual
symptoms classified as premenstrual dysphoric disorder.
Paxil belongs to the class of drugs known as selective serotonin reuptake
inhibitors (SSRIs). Serotonin is one of the chemical messengers believed
to govern moods. Ordinarily, it is quickly reabsorbed after its release
at the junctures between nerves. Reuptake inhibitors such as Paxil
slow this process, thereby boosting the levels of serotonin available
in the brain. Most important fact about Paxil
Your symptoms may seem to improve within 1 to 4 weeks after beginning
treatment with Paxil. Even if you feel better, continue to take Paxil
as long as your doctor tells you to do so. How should you take Paxil?
Paxil is taken once a day, with or without food, usually in the morning.
Inform your doctor if you are taking or plan to take any prescription
or over-the-counter drugs, since they may interact unfavorably with
Paxil. Shake the oral suspension well before using. Paxil CR should
be swallowed whole; it should not be chewed or crushed.
If you miss a dose...
Skip the forgotten dose and go back to your regular schedule with
the next dose. Do not take a double dose to make up for the one you
missed.
--Storage instructions...
Paxil tablets and suspension can be stored at room temperature.
Paxil side effects
Side effects cannot be anticipated. If any develop or change in intensity,
inform your doctor as soon as possible. Only your doctor can determine
whether it is safe for you to continue taking this medication.
During the first 4 to 6 weeks, you may find some side effects less
troublesome (nausea and dizziness, for example) than others (dry mouth,
drowsiness, and weakness).
* Side effects may include:
Abnormal ejaculation, abnormal orgasm, constipation, decreased appetite, decreased
sex drive, diarrhea, dizziness, drowsiness, dry mouth, gas, impotence, male
and female genital disorders, nausea, nervousness, sleeplessness, sweating,
tremor, weakness, vertigo
Why should Paxil not be prescribed?
Dangerous and even fatal reactions are possible when Paxil is combined
with thioridazine (Mellaril) or drugs classified as monoamine oxidase
(MAO) inhibitors, such as the antidepressants Nardil and Parnate. Never
take Paxil with any of these medications, or within 2 weeks of starting
or stopping use of an MAO inhibitor. You'll also need to avoid Paxil
if it gives you an allergic reaction. Special warnings about Paxil
Paxil should be used cautiously by people with a history of manic
disorders and those with high pressure in the eyes (glaucoma).If you
have a history of seizures, make sure your doctor knows about it. Paxil
should be used with caution in this situation. If you develop seizures
once therapy has begun, the drug should be discontinued.In clinical studies,
antidepressants increased the risk of suicidal thinking and behavior
in children and adolescents with depression and
other psychiatric disorders. Anyone considering the use of Paxil or
any other antidepressant in a child or adolescent must balance this
risk with the clinical need. Paxil has not been studied in children
or adolescents and is not approved for treating anyone less than 18
years old.Additionally, the progression of major depression is associated
with a worsening of symptoms and/or the emergence of suicidal thinking
or
behavior in both adults and children, whether or not they are taking
antidepressants. Individuals being treated with Paxil and their caregivers
should watch for any change in symptoms or any new symptoms that appear
suddenly--especially agitation, anxiety, hostility, panic, restlessness,
extreme hyperactivity, and suicidal thinking or behavior--and report
them to the doctor immediately. Be especially observant at the beginning
of treatment or whenever there is a change in dose.
If you have a disease or condition that affects your metabolism or
blood circulation, make sure your doctor is aware of it. Paxil should
be used cautiously in this situation.
Paxil may impair your judgment, thinking, or motor skills. Do not
drive, operate dangerous machinery, or participate in any hazardous
activity that requires full mental alertness until you are sure the
medication is not affecting you in this way.
Antidepressants such as Paxil could potentially cause stomach bleeding,
especially when combined with nonsteroidal anti-inflammatory drugs
(NSAIDs) such as aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve),
and ketoprofen (Orudis KT). Consult your doctor before combining Paxil
with NSAIDs or blood-thinning drugs.
It's best to avoid an abrupt discontinuation of Paxil therapy. It
can lead to symptoms such as dizziness, abnormal dreams, and tingling
sensations. To prevent such problems, your doctor will reduce your
dose gradually.
Possible food and drug interactions when taking Paxil
Remember that Paxil must never be combined with Mellaril or MAO inhibitors
such as Nardil and Parnate, or taken within 2 weeks of starting or
stopping an MAO inhibitor.
If Paxil is taken with certain other drugs, the effects of either
could be increased, decreased, or altered. It is especially important
to check with your doctor before combining Paxil with any of the following:
Alcohol
Antidepressants such as Elavil, Tofranil, Norpramin, Pamelor, Prozac
Aspirin
Cimetidine (Tagamet)
Diazepam (Valium)
Digoxin (Lanoxin)
Flecainide (Tambocor)
Lithium (Eskalith)
Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen
(Advil, Motrin), naproxen (Aleve), and ketoprofen (Orudis KT)
Phenobarbital
Phenytoin (Dilantin)
Procyclidine (Kemadrin)
Propafenone (Rythmol)
Propranolol (Inderal, Inderide)
Quinidine (Quinaglute)
Sumatriptan (Imitrex)
Theophylline (Theo-24, Uniphyl)
Tryptophan
Warfarin (Coumadin) Special information if you are pregnant or breastfeeding
The effects of Paxil during pregnancy have not been adequately studied.
There have been reports of serious complications in newborns who were
exposed to Paxil late in the last 3 months of pregnancy. If you are
pregnant or plan to become pregnant, inform your doctor immediately.
Paxil appears in breast milk and could affect a nursing infant. If
Paxil is essential to your health, your doctor may advise you to discontinue
breastfeeding until your treatment with Paxil is finished. Recommended dosage for Paxil
The following dosages are for adults. The safety and effectiveness
of Paxil have not been studied in children or adolescents.
DEPRESSION
Overdosage
Any medication taken in excess can have serious consequences. If you
suspect an overdose, seek medical attention immediately.
* The symptoms of Paxil overdose may include:
Coma, dizziness, drowsiness, facial flushing, nausea, sweating, tremor, vomiting
What is the most important information I should know about Paxil?
You may have an increased risk of suicidal thoughts or behavior at the start of treatment with an antidepressant medication, especially if you are a child or young adult. Talk with your doctor about this risk. While you are taking Paxil you will need to be monitored for worsening symptoms of depression and/ or suicidal thoughts during the first weeks of treatment, or whenever your dose is changed. In addition to you watching for changes in your own symptoms, your family or other caregivers should 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.
Contact your doctor promptly if you have any of the following side effects, especially if they are new symptoms or if they get worse: mood changes, anxiety, panic attacks, trouble sleeping, irritability, agitation, aggressiveness, severe restlessness, mania (mental and/ or physical hyperactivity), thoughts of suicide or hurting yourself.
Do not use this medication if you are pregnant. It could cause harm to the unborn baby. Use an effective form of birth control, and tell your doctor if you become pregnant during treatment.
Do not take Paxil together with pimozide (Orap), thioridazine (Mellaril), or a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate). You must wait at least 14 days after stopping an MAOI before you can take Paxil. You must wait 5 weeks after stopping Paxil before you can take thioridazine (Mellaril).
What is Paxil?
Paxil is an antidepressant in a group of drugs called selective serotonin reuptake inhibitors (SSRIs). Paxil affects chemicals in the brain that may become unbalanced and cause depression, panic, anxiety, or obsessive-compulsive symptoms.
Paxil is used to treat depression, obsessive-compulsive disorder, panic disorder, anxiety disorders, post-traumatic stress disorder (PTSD), and premenstrual dysphoric disorder (PMDD).
Paxil may also be used for purposes other than those listed in this medication guide.
What should I discuss with my healthcare provider before taking Paxil?
You may have an increased risk of suicidal thoughts or behavior at the start of treatment with an antidepressant medication, especially if you are a child or young adult. Talk with your doctor about this risk. While you are taking Paxil you will need to be monitored for worsening symptoms of depression and/ or suicidal thoughts during the first weeks of treatment, or whenever your dose is changed. In addition to you watching for changes in your own symptoms, your family or other caregivers should 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.
Do not use Paxil if you are using any of the following drugs:
pimozide (Orap);
thioridazine (Mellaril); or
an MAO inhibitor such as isocarboxazid (Marplan), tranylcypromine (Parnate), phenelzine (Nardil), or selegiline (Eldepryl, Emsam).
Serious and sometimes fatal reactions can occur when these medicines are taken with Paxil. You must wait at least 14 days after stopping an MAO inhibitor before you can take Paxil. You must wait 5 weeks after stopping Paxil before you can take thioridazine (Mellaril).
Before taking Paxil, tell your doctor if you have:
liver or kidney disease;
seizures or epilepsy;
bipolar disorder (manic depression); or
a history of drug abuse or suicidal thoughts.
If you have any of these conditions, you may not be able to use Paxil, or you may need a dosage adjustment or special tests during treatment.
FDA pregnancy category D. This medication can cause harm to an unborn baby. Do not use Paxil if you are pregnant. Tell your doctor if you become pregnant during treatment. Use an effective form of birth control while you are using this medication.
Paxil 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 this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Your doctor may occasionally change your dose to make sure you get the best results from the medication.
Try to take the medicine at the same time each day.
Do not crush, chew, or break a controlled-release tablet. Swallow the pill whole. It is specially made to release medicine slowly in the body. Breaking the pill would cause too much of the drug to be released at one time.
Shake the liquid form of Paxil well just before you measure a dose. To be sure you get the correct dose, measure the liquid with a marked 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 4 weeks or more for you to start feeling better. Do not stop using Paxil without first talking to your doctor. You may have unpleasant side effects if you stop taking this medication suddenly.
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. However, if it is almost time for the next regularly scheduled dose, skip the missed dose and take the next one as directed. Do not take extra medicine to make up the missed dose.
What happens if I overdose?
Seek emergency medical attention if you think you have taken too much of this medication. Symptoms of a Paxil overdose may include nausea, vomiting, tremor, sweating, decreased urination, blurred vision, rapid heartbeat, confusion, aggression, fainting, seizures, and coma.
What should I avoid while taking Paxil?
Do not take Paxil together with pimozide (Orap), thioridazine (Mellaril), isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate).
Avoid drinking alcohol, which can increase some of the side effects of Paxil.
Avoid using other medicines that make you sleepy (such as cold medicine, other pain medication, muscle relaxants). They can add to sleepiness caused by Paxil.
Paxil can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.
What are the possible side effects of Paxil?
Get emergency medical help if you have any of these signs of an allergic reaction: skin rash or hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Contact your doctor promptly if you have any of the following side effects, especially if they are new symptoms or if they get worse: mood changes, anxiety, panic attacks, trouble sleeping, irritability, agitation, aggressiveness, severe restlessness, mania (mental and/ or physical hyperactivity), thoughts of suicide or hurting yourself.
Call your doctor at once if you have any of these serious side effects:
seizure (convulsions);
tremors, shivering, muscle stiffness or twitching;
problems with balance or coordination; or
agitation, confusion, sweating, fast heartbeat.
Other less serious side effects are more likely to occur, such as:
feeling nervous, restless, or unable to sit still;
drowsiness, dizziness, weakness;
sleep problems (insomnia);
nausea, constipation, loss of appetite;
weight changes;
decreased sex drive, impotence, or difficulty having an orgasm; or
dry mouth, yawning, or ringing in your ears.
Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.
What other drugs will affect Paxil?
Talk to your doctor before taking any medicine for pain, arthritis, fever, or swelling. This includes aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), diclofenac (Voltaren), indomethacin, piroxicam (Feldene), nabumetone (Relafen), etodolac (Lodine), and others. Taking any of these drugs with Paxil may cause you to bruise or bleed easily.
Before taking Paxil, tell your doctor if you are using any of the following medicines:
tryptophan (also called L-tryptophan);
risperidone (Risperdal);
tramadol (Ultram);
St. John's wort;
cimetidine (Tagamet);
lithium (Lithobid, Eskalith);
atomoxetine (Strattera);
a blood thinner such as warfarin (Coumadin);
any other antidepressants such as amitriptyline (Elavil), citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), imipramine (Tofranil), nortriptyline (Pamelor), or sertraline (Zoloft);
a phenothiazine such as prochlorperazine (Compazine), chlorpromazine (Thorazine), fluphenazine (Prolixin), mesoridazine (Serentil), perphenazine (Trilafon), and others;
almotriptan (Axert), frovatriptan (Frova), sumatriptan (Imitrex), naratriptan (Amerge), rizatriptan (Maxalt), or zolmitriptan (Zomig); or
heart rhythm medication such as flecainide (Tambocor), propafenone (Rhythmol), and others.
If you are using any of these drugs, you may not be able to use Paxil, or you may need dosage adjustments or special tests during treatment.
There may be other drugs not listed that can affect Paxil. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.
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