Skip to Content

Paroxetine Dosage

Applies to the following strength(s): 12.5 mg ; 25 mg ; 37.5 mg ; 10 mg ; 20 mg ; 30 mg ; 40 mg ; 10 mg/5 mL ; mesylate 10 mg ; mesylate 20 mg ; mesylate 30 mg ; mesylate 40 mg ; 7.5 mg

The information at Drugs.com is not a substitute for medical advice. ALWAYS consult your doctor or pharmacist.

Usual Adult Dose for Depression

Immediate-release tablets and suspension:
Initial dose: 20 mg orally once a day
Maintenance dose: 20 to 50 mg orally once a day
Maximum dose: 50 mg orally once a day

Controlled-release tablets:
Initial dose: 25 mg orally once a day
Maintenance dose: 25 to 62.5 mg orally once a day
Maximum dose: 62.5 mg orally once a day

Duration: Acute episodes of major depressive disorder require several months or longer of sustained pharmacologic therapy; systemic evaluation has shown that efficacy was maintained for up to one year.

Comments:
-Immediate-release oral formulations: The daily dose may be increased in 10 mg increments at weekly intervals, according to clinical response and tolerability
-Extended-release oral formulations: The daily dose may be increased in 12.5 mg increments at weekly intervals, according to clinical response and tolerability
-Efficacy of up to one year was demonstrated with a daily dose averaging 30 mg for the immediate-release formulations and 37.5 mg for the controlled-release formulation

Use: Treatment of Major Depressive Disorder

Usual Adult Dose for Social Anxiety Disorder

Immediate-release tablets and suspension:
Initial dose: 20 mg orally once a day
Maintenance dose: 20 to 60 mg orally once a day
Maximum dose: 60 mg orally once a day

Controlled-release tablets:
Initial dose: 12.5 mg orally once a day
Maintenance dose: 12.5 to 37.5 mg orally once a day

Duration: Efficacy has been demonstrated for up to 12 weeks; being a chronic condition, continuation of treatment beyond this time may be considered in responding patients

Comments:
-Immediate-release oral formulations: The daily dose may be increased in 10 mg increments at weekly intervals, according to clinical response and tolerability
-Extended-release oral formulations: The daily dose may be increased in 12.5 mg increments at weekly intervals, according to clinical response and tolerability

Usual Adult Dose for Panic Disorder

Immediate-release tablets and suspension:
Initial dose: 10 mg orally once a day
Maintenance dose: 10 to 40 mg orally once a day
Maximum dose: 60 mg orally once a day

Controlled-release oral tablets:
Initial dose: 12.5 mg orally once a day
Maintenance dose: 12.5 to 75 mg orally once a day
Maximum dose: 75 mg orally once a day

Duration: Efficacy has been demonstrated for up to 12 weeks; being a chronic condition, continuation of treatment beyond this time may be considered in responding patients

Comments:
-Immediate-release oral formulations: The daily dose may be increased in 10 mg increments at weekly intervals, according to clinical response and tolerability
-Extended-release oral formulations: The daily dose may be increased in 12.5 mg increments at weekly intervals, according to clinical response and tolerability
-The target dose is 40 mg once a day

Usual Adult Dose for Premenstrual Dysphoric Disorder

Controlled-release tablets:
Continuous regimen:
Initial dose: 12.5 mg orally once a day during the menstrual cycle
Maintenance dose: 25 mg orally once a day during the menstrual cycle

Cyclic regimen:
Initial dose: 12.5 mg orally once a day, starting 14 days prior to the anticipated start of menstruation through to the first full day of menses, and repeated with each new cycle
Maintenance dose: 12.5 to 25 mg orally once a day

Duration: Efficacy has been demonstrated for up to 3 menstrual cycles; continuation of treatment beyond this time may be considered in responding patients

Comments:
-The daily dose may be increased in 12.5 mg increments at weekly intervals, according to clinical response and tolerability

Usual Adult Dose for Obsessive Compulsive Disorder

Immediate-release tablets and suspension:
Initial dose: 20 mg orally once a day
Maintenance dose: 20 to 60 mg orally once a day
Maximum dose: 60 mg orally once a day
Duration: Efficacy has been demonstrated for up to 6 months; being a chronic condition, continuation of treatment beyond this time may be considered in responding patients

Comments:
-The daily dose may be increased in 10 mg increments at weekly intervals, according to clinical response and tolerability
-The target dose is 40 mg once a day

Usual Adult Dose for Post Traumatic Stress Disorder

Immediate-release tablets and suspension:
Initial dose: 20 mg orally once a day
Maintenance dose: 20 to 50 mg orally once a day
Maximum dose: 50 mg orally once a day
Duration:
-Generalized Anxiety Disorder: Efficacy has been demonstrated for up to 24 weeks in patients responding to treatment during an 8 week treatment phase
-Posttraumatic Stress Disorder: Efficacy has been demonstrated for up to 12 weeks; being a chronic condition, continuation of treatment beyond this time may be considered in responding patients

Comments:
-The daily dose may be increased in 10 mg increments at weekly intervals, according to clinical response and tolerability

Usual Adult Dose for Generalized Anxiety Disorder

Immediate-release tablets and suspension:
Initial dose: 20 mg orally once a day
Maintenance dose: 20 to 50 mg orally once a day
Maximum dose: 50 mg orally once a day
Duration:
-Generalized Anxiety Disorder: Efficacy has been demonstrated for up to 24 weeks in patients responding to treatment during an 8 week treatment phase
-Posttraumatic Stress Disorder: Efficacy has been demonstrated for up to 12 weeks; being a chronic condition, continuation of treatment beyond this time may be considered in responding patients

Comments:
-The daily dose may be increased in 10 mg increments at weekly intervals, according to clinical response and tolerability

Usual Adult Dose for Postmenopausal Symptoms

Recommended dose: 7.5 mg orally once a day

Use: Treatment of moderate to severe vasomotor symptoms associated with menopause (Brisdelle (R))

Usual Geriatric Dose for Obsessive Compulsive Disorder

Immediate-release tablets and suspension:
Initial dose: 10 mg orally once a day
Maintenance dose: 10 to 40 mg orally once a day
Maximum dose: 40 mg orally once a day
Duration:
-Generalized Anxiety Disorder: Efficacy has been demonstrated for up to 24 weeks in patients responding to treatment during an 8 week acute treatment phase
-Obsessive Compulsive Disorder: Efficacy has been demonstrated for up to 6 months; being a chronic condition, continuation of treatment beyond this time may be considered in responding patients
-Posttraumatic Stress Disorder and Social Anxiety Disorder: Efficacy has been demonstrated for up to 12 weeks being a chronic condition, continuation of treatment beyond this time may be considered in responding patients

Comments:
-The daily dose may be increased in 10 mg increments at weekly intervals, according to clinical response and tolerability

Usual Geriatric Dose for Post Traumatic Stress Disorder

Immediate-release tablets and suspension:
Initial dose: 10 mg orally once a day
Maintenance dose: 10 to 40 mg orally once a day
Maximum dose: 40 mg orally once a day
Duration:
-Generalized Anxiety Disorder: Efficacy has been demonstrated for up to 24 weeks in patients responding to treatment during an 8 week acute treatment phase
-Obsessive Compulsive Disorder: Efficacy has been demonstrated for up to 6 months; being a chronic condition, continuation of treatment beyond this time may be considered in responding patients
-Posttraumatic Stress Disorder and Social Anxiety Disorder: Efficacy has been demonstrated for up to 12 weeks being a chronic condition, continuation of treatment beyond this time may be considered in responding patients

Comments:
-The daily dose may be increased in 10 mg increments at weekly intervals, according to clinical response and tolerability

Usual Geriatric Dose for Social Anxiety Disorder

Immediate-release tablets and suspension:
Initial dose: 10 mg orally once a day
Maintenance dose: 10 to 40 mg orally once a day
Maximum dose: 40 mg orally once a day
Duration:
-Generalized Anxiety Disorder: Efficacy has been demonstrated for up to 24 weeks in patients responding to treatment during an 8 week acute treatment phase
-Obsessive Compulsive Disorder: Efficacy has been demonstrated for up to 6 months; being a chronic condition, continuation of treatment beyond this time may be considered in responding patients
-Posttraumatic Stress Disorder and Social Anxiety Disorder: Efficacy has been demonstrated for up to 12 weeks being a chronic condition, continuation of treatment beyond this time may be considered in responding patients

Comments:
-The daily dose may be increased in 10 mg increments at weekly intervals, according to clinical response and tolerability

Usual Geriatric Dose for Generalized Anxiety Disorder

Immediate-release tablets and suspension:
Initial dose: 10 mg orally once a day
Maintenance dose: 10 to 40 mg orally once a day
Maximum dose: 40 mg orally once a day
Duration:
-Generalized Anxiety Disorder: Efficacy has been demonstrated for up to 24 weeks in patients responding to treatment during an 8 week acute treatment phase
-Obsessive Compulsive Disorder: Efficacy has been demonstrated for up to 6 months; being a chronic condition, continuation of treatment beyond this time may be considered in responding patients
-Posttraumatic Stress Disorder and Social Anxiety Disorder: Efficacy has been demonstrated for up to 12 weeks being a chronic condition, continuation of treatment beyond this time may be considered in responding patients

Comments:
-The daily dose may be increased in 10 mg increments at weekly intervals, according to clinical response and tolerability

Usual Geriatric Dose for Depression

Immediate-release tablets and suspension:
Initial dose: 10 mg orally once a day
Maintenance dose: 10 to 40 mg orally once a day
Maximum dose: 40 mg orally once a day

Controlled-release tablets:
Initial dose: 12.5 mg orally once a day
Maintenance dose: 12.5 to 50 mg orally once a day
Maximum dose: 50 mg orally once a day

Duration:
-Major Depressive Disorder: Acute episodes require several months or longer of sustained pharmacologic therapy; systemic evaluation has shown that efficacy was maintained for up to one year
-Panic Disorder: Efficacy has been demonstrated for up to 12 weeks; being a chronic condition, continuation of treatment may be considered in responding patients

Comments:
-Immediate-release oral formulations: The daily dose may be increased in 10 mg increments at weekly intervals, according to clinical response and tolerability
-Controlled-release oral formulations: The daily dose may be increased in 12.5 mg increments at weekly intervals, according to clinical response and tolerability
-Efficacy of up to one year was demonstrated with a daily dose averaging 30 mg for the immediate-release formulation and 37.5 mg for the controlled-release formulation

Uses: Treatment of Major Depressive Disorder and Panic Disorder

Usual Geriatric Dose for Panic Disorder

Immediate-release tablets and suspension:
Initial dose: 10 mg orally once a day
Maintenance dose: 10 to 40 mg orally once a day
Maximum dose: 40 mg orally once a day

Controlled-release tablets:
Initial dose: 12.5 mg orally once a day
Maintenance dose: 12.5 to 50 mg orally once a day
Maximum dose: 50 mg orally once a day

Duration:
-Major Depressive Disorder: Acute episodes require several months or longer of sustained pharmacologic therapy; systemic evaluation has shown that efficacy was maintained for up to one year
-Panic Disorder: Efficacy has been demonstrated for up to 12 weeks; being a chronic condition, continuation of treatment may be considered in responding patients

Comments:
-Immediate-release oral formulations: The daily dose may be increased in 10 mg increments at weekly intervals, according to clinical response and tolerability
-Controlled-release oral formulations: The daily dose may be increased in 12.5 mg increments at weekly intervals, according to clinical response and tolerability
-Efficacy of up to one year was demonstrated with a daily dose averaging 30 mg for the immediate-release formulation and 37.5 mg for the controlled-release formulation

Uses: Treatment of Major Depressive Disorder and Panic Disorder

Renal Dose Adjustments

Brisdelle (R): No adjustment recommended

CrCl less than 30 mL/min:
Immediate-release tablets and suspension:
Initial dose: 10 mg orally once a day
Maintenance dose: 10 to 40 mg orally once a day
Maximum dose: 40 mg orally once a day

Controlled-release tablets:
Initial dose: 12.5 mg orally once a day
Maintenance dose: 12.5 to 50 mg orally once a day
Maximum dose: 50 mg orally once a day

Liver Dose Adjustments

Brisdelle (R): No adjustment recommended

Severe liver dysfunction:
Immediate-release tablets and suspension:
Initial dose: 10 mg orally once a day
Maintenance dose: 10 to 40 mg orally once a day
Maximum dose: 40 mg orally once a day

Controlled-release tablets:
Initial dose: 12.5 mg orally once a day
Maintenance dose: 12.5 to 50 mg orally once a day
Maximum dose: 50 mg orally once a day

Dose Adjustments

Dosage adjustments should be made to maintain the patient on the lowest effective dosage

Switching from:
-MAOI to paroxetine therapy: At least 14 days should elapse
-Paroxetine to MAOI therapy: At least 14 days should elapse

Doses at the lower end of the range should be considered when used concomitantly with drugs metabolized by CYP450 2D6; subsequent dosage adjustments should be made according to patient response and tolerability.

Treatment withdrawal:
-A gradual dose reduction is recommended instead of abrupt cessation where possible
-If intolerable symptoms occur, it is recommended to consider resuming the previously prescribed dose and to decrease the dose at a more gradual rate

Precautions

US BOXED WARNING:
Suicidality and antidepressant drugs:
-Antidepressants increased the risk compared to placebo of suicidal thinking and behavior (suicidality) in children, adolescents, and young adults in short-term studies of major depressive disorder (MDD) and other psychiatric disorders.
-Anyone considering the use of this drug or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need.
-Short-term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults beyond age 24; there was a reduction in risk with antidepressants compared to placebo in adults aged 65 and older
-Depression and certain other psychiatric disorders are themselves associated with increases in the risk of suicide
-Patients of all ages who are started on antidepressant therapy should be monitored appropriately and observed closely for clinical worsening, suicidality, or unusual changes in behaviors. Families and caregivers should be advised of the need for close observation and communication with the prescriber.
-This drug is not approved for use in pediatric patients.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available; however, due to its extensive distribution, paroxetine is not expected to be dialyzable.

Other Comments

Administration advice:
-The dose may be taken with or without food, usually in the morning; extended release tablets should be swallowed whole and not chewed or crushed.
-Brisdelle (R) should be administered at bedtime
-The bottle containing paroxetine oral suspension should be shaken before drawing up the dose

Storage requirements:
-Paroxetine oral suspension should be stored at temperatures at or below 25 C (77 F)

General:
-The need for ongoing treatment should be regularly reviewed
-It is unknown whether the dose of antidepressant required to induce remission in major depressive disorder is the same as that needed to maintain and/or sustain euthymia
-Symptoms of premenstrual dysphoric disorder has been reported to worsen with age, until relieved at the onset of menopause

Monitoring:
-Hepatic: Liver function
-Metabolic: Hyponatremia
-Nervous system: Serotonin syndrome
-Psychiatric: Emergence or worsening of depression, suicidal thoughts or behavior, and/or any unusual changes in mood or behavior
-Renal: Renal function

Patient advice:
-Tell your healthcare provider about all of the medicines that you take, including prescription and non-prescription medicines
-This medicine may increase the risk of suicidal thoughts and behavior. Be alert for the emergence or worsening of symptoms of depression, any unusual changes in mood or behavior, or the emergence of suicidal thoughts, behavior, or thoughts about self-harm. Report any behavior of concern to your healthcare provider as soon as possible.
-This medicine may cause impaired judgment, thinking, or motor skills; do not drive a car or operate dangerous machinery until you know how this drug affects you.
-Concomitant ingestion of alcohol is not advised.

Hide