Paroxetine Disease Interactions
There are 11 disease interactions with paroxetine.
- Depression
- Bone fractures
- Renal dysfunction
- Hyponatremia
- Glaucoma
- Liver disease
- Mania
- Platelet function
- Seizure disorders
- SIADH
- Weight loss
SSRI antidepressants (applies to paroxetine) depression
Major Potential Hazard, Moderate plausibility. Applicable conditions: Psychosis
Adult and pediatric patients with depression and other psychiatric disorders may experience worsening of their symptoms and may have the emergence of suicidal thoughts and behavior. Patients should be monitored appropriately and observed closely for worsening of their symptoms, suicidality or changes in their behavior, especially during the first few months of treatment, and at times of dose changes. Families and caregivers should be advised of the need for close observation and communication with the treating physician. Discontinuing the medication should be considered if symptoms are persistently worse, or abrupt in onset. It may be prudent to refrain from dispensing large quantities of medication to these patients.
Paroxetine (applies to paroxetine) bone fractures
Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Osteoporosis
Some epidemiological studies have reported association between antidepressant treatment and bone fractures. The extent of this risk is unknown. Treatment with paroxetine should be administered with caution in patients with decreased bone mineral density that present unexplained bone pain, tenderness, swelling or bruising.
Paroxetine (applies to paroxetine) renal dysfunction
Moderate Potential Hazard, High plausibility.
Paroxetine may accumulate in renal dysfunction. The mean plasma concentration of paroxetine in patients with creatinine clearance below 30 mL/min has been shown to be approximately four times greater than that in normal patients. Therapy with paroxetine should be administered cautiously in patients with renal impairment. A reduction in the daily dosage is recommended if renal function is severely impaired.
SSRI (applies to paroxetine) hyponatremia
Moderate Potential Hazard, Moderate plausibility.
Treatment with SSRI antidepressants can cause hyponatremia. Caution should be used when treating patients with hyponatremia or at greater risk of hyponatremia such as the elderly, patients taking diuretics or who are volume depleted.
SSRIs (applies to paroxetine) glaucoma
Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Glaucoma (Narrow Angle)
Some SSRI antidepressants such as fluoxetine, paroxetine and sertraline may have an effect on pupil size causing dilation. This effect can potentially narrow the eye angle resulting in increased intraocular pressure and angle closure glaucoma, especially in predisposed patients. These drugs should be used with caution in patients with angle-closure glaucoma or history of glaucoma.
SSRIs (applies to paroxetine) liver disease
Moderate Potential Hazard, High plausibility.
Selective serotonin reuptake inhibitors (SSRIs) are primarily metabolized by the liver. The plasma concentrations of SSRIs and their metabolites may be increased and the half-lives prolonged in patients with impaired hepatic function. Dosage adjustments may be necessary in accordance with the individual product package labeling.
SSRIs (applies to paroxetine) mania
Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Bipolar Disorder, Depression
Selective serotonin reuptake inhibitors (SSRIs), like other antidepressants, may occasionally cause or activate mania or hypomania. The reported incidence ranged from 0.1% to 2% in premarketing testing of several SSRIs. Patients with bipolar disorder are generally more likely to experience mania from antidepressants. Therapy with SSRIs should be administered cautiously in patients with a history of mania or bipolar disorder. Prior to initiating treatment, it is recommended to adequately screen patients for bipolar disorder, including a family history of suicide, bipolar disorder, and depression.
SSRIs (applies to paroxetine) platelet function
Moderate Potential Hazard, High plausibility. Applicable conditions: Vitamin K Deficiency, Thrombocytopenia, Thrombocytopathy, Coagulation Defect, Bleeding
The use of selective serotonin reuptake inhibitors (SSRIs) has been associated with altered platelet function. Petechiae, purpura, ecchymosis, increased bleeding times, epistaxis and gastrointestinal hemorrhage have been reported. Therapy with SSRIs should be administered cautiously in patients with severe active bleeding or a hemorrhagic diathesis.
SSRIs (applies to paroxetine) seizure disorders
Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Seizures
Selective serotonin reuptake inhibitors (SSRIs) may trigger seizures in approximately 0.2% of patients, and some of them are not recommended in patients with unstable epilepsy. Therapy with SSRIs should be administered cautiously in patients with seizure disorders.
SSRIs (applies to paroxetine) SIADH
Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Hyponatremia, Dehydration
The use of selective serotonin reuptake inhibitors (SSRIs) has rarely been associated with hyponatremia, sometimes secondary to development of the syndrome of inappropriate secretion of antidiuretic hormone (SIADH). These events have generally been reversible following discontinuation of SSRI therapy and/or medical intervention. SSRI-related hyponatremia may be more common in elderly female patients and those who are volume-depleted or receiving concomitant diuretic therapy. Caution may be warranted when SSRI therapy is administered in these patients and patients with preexisting hyponatremia or SIADH. Serum electrolytes, especially sodium as well as BUN and plasma creatinine, should be monitored regularly.
SSRIs (applies to paroxetine) weight loss
Minor Potential Hazard, Moderate plausibility. Applicable conditions: Weight Loss/Failure to Thrive, Anorexia/Feeding Problems, Malnourished
The use of selective serotonin reuptake inhibitors (SSRIs) may occasionally cause significant weight loss, which may be undesirable in patients suffering from anorexia, malnutrition or excessive weight loss. Anorexia may occur in approximately 5% to 10% of patients. Weight change should be monitored during therapy if an SSRI is used in these patients.
Paroxetine drug interactions
There are 505 drug interactions with paroxetine.
Paroxetine alcohol/food interactions
There is 1 alcohol/food interaction with paroxetine.
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Drug Interaction Classification
Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. | |
No interaction information available. |
Further information
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