Drug Interaction Report

Using FLUoxetine together with PARoxetine may significantly increase the blood levels and effects of both medications. This may increase the risk and/or severity of side effects such as cognitive and motor impairment, insomnia, drowsiness, seizures, abnormal bleeding, sexual dysfunction (e.G., delayed ejaculation, decreased libido, impotence), and a rare but serious condition called the serotonin syndrome. Symptoms of serotonin syndrome may include confusion, hallucination, seizures, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. You should seek immediate medical attention if you experience these symptoms during treatment. Talk to your doctor if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Alcohol can increase the nervous system side effects of FLUoxetine such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with FLUoxetine. Do not use more than the recommended dose of FLUoxetine, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. Talk to your doctor or pharmacist if you have any questions or concerns.

Alcohol can increase the nervous system side effects of PARoxetine such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with PARoxetine. Do not use more than the recommended dose of PARoxetine, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. Talk to your doctor or pharmacist if you have any questions or concerns.

The recommended maximum number of medicines in the 'SSRI antidepressants' category to be taken concurrently is usually one. Your list includes two medicines belonging to the 'SSRI antidepressants' category:

• fluoxetine
• Paxil CR (paroxetine)

Note: In certain circumstances, the benefits of taking this combination of drugs may outweigh any risks. Always consult your healthcare provider before making changes to your medications or dosage.