Paroxetine Disease Interactions

There are 7 disease interactions with paroxetine:

Paroxetine (Includes Paroxetine) ↔ Renal Dysfunction

Moderate Potential Hazard, High plausibility

Applies to: Renal Dysfunction

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.

References

  1. Doyle GD, Laher M, Kelly JG, Byrne MM, Clarkson A, Zussman BD "The pharmacokinetics of paroxetine in renal impairment." Acta Psychiatr Scand Suppl 350 (1989): 89-90
  2. Kaye CM, Haddock RE, Langley PF, Mellows G, Tasker TC, Zussman BD, Greb WH "A review of the metabolism and pharmacokinetics of paroxetine in man." Acta Psychiatr Scand Suppl 350 (1989): 60-75
  3. "Product Information. Paxil (paroxetine)." GlaxoSmithKline, Research Triangle Park, NC.

Ssris (Includes Paroxetine) ↔ Liver Disease

Moderate Potential Hazard, High plausibility

Applies to: Liver Disease

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.

References

  1. Guthrie SK "Sertraline: a new specific serotonin reuptake blocker." DICP 25 (1991): 952-61
  2. "Product Information. Celexa (citalopram)." Forest Pharmaceuticals, St. Louis, MO.
  3. Finley PR "Selective serotonin reuptake inhibitors: pharmacologic profiles and potential therapeutic distinctions." Ann Pharmacother 28 (1994): 1359-69
View all 17 references

Ssris (Includes Paroxetine) ↔ Mania

Moderate Potential Hazard, Moderate plausibility

Applies to: Mania, Bipolar Disorder

Selective serotonin reuptake inhibitors (SSRIs), like other antidepressants, may occasionally cause 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.

References

  1. Peet M "Induction of mania with selective serotonin re-uptake inhibitors and tricyclic antidepressants." Br J Psychiatry 164 (1994): 549-50
  2. "Product Information. Zoloft (sertraline)." Roerig Division, New York, NY.
  3. Guthrie SK "Sertraline: a new specific serotonin reuptake blocker." DICP 25 (1991): 952-61
View all 27 references

Ssris (Includes Paroxetine) ↔ Platelet Function

Moderate Potential Hazard, High plausibility

Applies to: 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.

References

  1. Hergovich N, Aigner M, Eichler HG, Entlicher J, Drucker C, Jilma B "Paroxetine decreases platelet serotonin storage and platelet function in human beings." Clin Pharmacol Ther 68 (2000): 435-42
  2. "Product Information. Zoloft (sertraline)." Roerig Division, New York, NY.
  3. Skop BP, Brown TM "Potential vascular and bleeding complications of treatment with selective serotonin reuptake inhibitors." Psychosomatics 37 (1996): 12-6
View all 18 references

Ssris (Includes Paroxetine) ↔ Seizure Disorders

Moderate Potential Hazard, Moderate plausibility

Applies to: Seizures

Selective serotonin reuptake inhibitors (SSRIs) may trigger seizures in approximately 0.2% of patients. Therapy with SSRIs should be administered cautiously in patients with seizure disorders.

References

  1. Marshall RD, Printz D, Cardenas D, Abbate L, Liebowitz MR "Adverse events in PTSD patients taking fluoxetine." Am J Psychiatry 152 (1995): 1238-9
  2. Hargrave R, Martinez D, Bernstein AJ "Fluoxetine-induced seizures." Psychosomatics 33 (1992): 236-9
  3. "Product Information. Lexapro (escitalopram)." Forest Pharmaceuticals, St. Louis, MO.
View all 21 references

Ssris (Includes Paroxetine) ↔ Siadh

Moderate Potential Hazard, Moderate plausibility

Applies to: SIADH, 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.

References

  1. Schattner A, Skurnik Y "Fluoxetine-induced SIADH." J Am Geriatr Soc 44 (1996): 1413
  2. Kessler J, Samuels SC "Sertraline and hyponatremia." N Engl J Med 335 (1996): 524
  3. Baliga RR, McHardy KC "Syndrome of inappropriate antidiuretic hormone secretion due to fluvoxamine therapy [published erratum appears in Br J Clin Pract 1993 May-Jun;47(3):119]." Br J Clin Pract 47 (1993): 62-3
View all 30 references

Ssris (Includes Paroxetine) ↔ Weight Loss

Minor Potential Hazard, Moderate plausibility

Applies to: 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.

References

  1. "Product Information. Celexa (citalopram)." Forest Pharmaceuticals, St. Louis, MO.
  2. Fernstrom MH, Massoudi M, Kupfer DJ "Fluvoxamine and weight loss." Biol Psychiatry 24 (1988): 948-9
  3. Wagner W, Plekkenpol B, Gray TE, Vlaskamp H, Essers H "Review of fluvoxamine safety database." Drugs 43 Suppl 2 (1992): 48-53;disc. 53-4
View all 11 references

You should also know about...

paroxetine drug Interactions

There are 851 drug interactions with paroxetine

paroxetine alcohol/food Interactions

There is 1 alcohol/food interaction with paroxetine

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.

Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor 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.

Do not stop taking any medications without consulting your healthcare provider.

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