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PAROXETINE 30MG TABLETS

Active substance(s): PAROXETINE HYDROCHLORIDE ANHYDROUS

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Paroxetine 20mg and 30mg tablets
(paroxetine hydrochloride anhydrous)
Read all of this leaflet carefully before you start taking this
medicine because it contains important information for
you.
· Keep this leaflet. You may need to read it again.
· If you have any further questions, ask your doctor or
pharmacist.
· This medicine has been prescribed for you only. Do
not pass it on to others. It may harm them, even if their
signs of illness are the same as yours.
· If you get any side effects, talk to your doctor or
pharmacist. This includes any possible side effects not
listed in this leaflet. See section 4.
Eight important things you need to know about paroxetine
• Like all medicines, Paroxetine can have unwanted
effects. It is therefore important that you and your doctor
weigh up the benefits against the possible unwanted effects
before starting treatment.
• Paroxetine is not for use in children and adolescents
under 18.
• Paroxetine won’t work straight away. Some people taking
antidepressants feel worse before feeling better. Your doctor
should ask to see you again, a couple of weeks after you
first start treatment. Tell your doctor if you haven’t started
feeling better. See section 3, How to take.
• Some people who are depressed or anxious think of
harming or killing themselves. If you start to feel worse,
or think of harming or killing yourself, see your doctor or
go to a hospital straight away. See section 2, Thoughts of
suicide.
• Don’t stop taking paroxetine without talking to your
doctor. If you stop taking paroxetine suddenly or miss a
dose, you may get withdrawal effects. See section 3, If you
stop taking the tablets.
• If you feel restless and feel like you can’t sit or stand
still, tell your doctor. Increasing the dose of paroxetine
may make these feelings worse. See section 4, Possible side
effects.
• Taking some other medicines with paroxetine can cause
problems. See Taking other medicines.
• If you are pregnant or planning to get pregnant, talk to
your doctor. See section 2, Pregnancy and breastfeeding.

What is in this leaflet
What Paroxetine tablets are and what they are
1 
used for
What you need to know before you take
2 
Paroxetine tablets
3 How to take Paroxetine tablets
4 Possible side effects
5 How to store Paroxetine tablets
6 Contents of the pack and other information
1 
What Paroxetine tablets are and what they are

used for

Paroxetine is one of a type of antidepressants known as Selective
Serotonin Re-uptake Inhibitors (SSRIs). Low levels of the hormone
serotonin are thought to be a cause of depression and other related
conditions. Paroxetine works by bringing the levels of serotonin back to
normal. Paroxetine is used in adults to treat:
• depression
• obsessive compulsive disorder
• panic disorder with or without agoraphobia (fear of open spaces or
new situations)
• social anxiety disorders/social phobias
• post traumatic stress disorder
• anxiety disorders.

2 
What you need to know before you take

Paroxetine tablets

Do not take Paroxetine tablets if you are:




allergic (hypersensitive) to paroxetine or any of the other
ingredients (see section 6)
taking medicines called pimozide or monoamine oxidase
inhibitors (MAOls, including moclobemide), or have taken them at
any time within the last two weeks
taking a tranquilliser called thioridazine.

• Warnings and precautions
Check with your doctor or pharmacist before taking
Paroxetine tablets if you:
• suffer from eye, kidney, liver or heart problems
• suffer from epilepsy or have a history of fits
• have episodes of mania (overactive behaviour or thoughts)
• are having electro-convulsive therapy (ECT)
• have a history of bleeding disorders
• suffer from diabetes
• are on a low sodium diet
• have glaucoma (pressure in the eye)

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During treatment, talk to your doctor, pharmacist or nurse if
you:
• develop symptoms such as confusion, restlessness, sweating,
shaking, shivering, hallucinations (strange visions or sounds),
sudden jerks of the muscles or a fast heartbeat, since these
symptoms could be a sign of “serotonin syndrome”
Thoughts of suicide and worsening of your depression or anxiety
disorder
If you are depressed and/or have anxiety disorders, you can sometimes
have thoughts of harming or killing yourself. These may be increased
when first starting antidepressants, since these medicines take time to
work, (usually about two weeks but sometimes longer).
You may be more likely to think like this if you:
• have previously had thoughts about killing or harming yourself.
• are a young adult. Information from clinical trials has shown an
increased risk of suicidal behaviour in young adults (less than 25
years old) with psychiatric conditions who were treated with an
antidepressant.
If you have thoughts of harming or killing yourself at any time, contact
your doctor or go to a hospital straight away.
You may find it helpful to tell a relative or close friend that you are
depressed or have an anxiety disorder, and ask them to read this leaflet.
You might ask them to tell you if they think your depression or anxiety is
getting worse, or if they are worried about changes in your behaviour.
Children and adolescents
Paroxetine should not be used for children and adolescents under 18
years. Also, patients under 18 have an increased risk of side effects
such as suicide attempt, suicidal thoughts and hostility (predominantly
aggression, oppositional behaviour and anger) when they take
Paroxetine. If your doctor has prescribed Paroxetine for you (or your
child) and you want to discuss this, please go back to your doctor. You
should inform your doctor if any of the symptoms listed above develop
or worsen when you (or your child) are taking Paroxetine. Also, the
long-term safety effects concerning growth, maturation and cognitive
and behavioural development of Paroxetine in this age group have not
yet been demonstrated. In studies of Paroxetine in under 18s, common
side effects that affected less than 1 in 10 children/adolescents were: an
increase in suicidal thoughts and suicide attempts, deliberately harming
themselves, being hostile, aggressive or unfriendly, lack of appetite,
shaking, abnormal sweating, hyperactivity (having too much energy),
agitation, changing emotions (including crying and changes in mood)
and unusual bruising or bleeding (such as nose bleeds). These studies
also showed that the same symptoms affected children and adolescents
taking sugar pills (placebo) instead of Paroxetine, although these
were seen less often. Some patients in these studies of under 18s had
withdrawal effects when they stopped taking Paroxetine. These effects
were mostly similar to those seen in adults after stopping Paroxetine
(see Section 3, ). In addition, patients under 18 also commonly (affecting
less than 1 in 10) experienced stomach ache, feeling nervous and
changing emotions (including crying, changes in mood, trying to hurt
themselves, thoughts of suicide and attempting suicide).

Other medicines and Paroxetine tablets
Tell your doctor, pharmacist or nurse if you are taking or
have recently taken any other medicines, including medicines
obtained without a prescription. Especially:











 onoamine oxidase inhibitors (MAOls, including moclobemide), or
m
have taken them at any time within the last two weeks
thioridazine (a tranquilliser)
fentanyl or pethidine (for severe pain)
tramadol (a painkiller)
medicines called triptans, such as sumatriptan (to treat migraine)
other antidepressants including other Selective Serotonin Reuptake
Inhibitors (SSRls)
drugs to treat some psychiatric conditions such as lithium,
perphenazine
St John’s Wort, (a herbal remedy for depression)
linezolid (an antibiotic)
methylene blue (used to treat high levels of methaemoglobin in
the blood)

Concomitant use of above-mentioned medicinal products may lead to
‘serotonin syndrome’ (see “Warnings and precautions”).
Other drugs taken with Paroxetine that may cause unwanted effects
include:
• aspirin, ibuprofen or other medicines called NSAIDs (non-steroidal
anti-inflammatory drugs) such as celecoxib, etodolac, meloxicam
and refecoxib (for pain and inflammation)
• other antidepressants including, tryptophan and tricyclic
antidepressants like clomipramine, nortriptyline and desipramine
• drugs to treat some psychiatric conditions such as clozapine,
risperidone, pimozide
• sodium valproate, phenobarbital, phenytoin or carbamazepine (to
treat epilepsy)
• atomoxetine (to treat attention deficit hyperactivity disorder
(ADHD))
• procyclidine (to relieve tremor, especially in Parkinson’s Disease)
• warfarin or other anticoagulants (to thin the blood)
• propafenone, flecainide (to treat an irregular heartbeat)
• tamoxifen (used in breast cancer)
• fosamprenivir/ritonavir (used in HIV)
• metoprolol (for high blood pressure and heart problems)
• rifampicin (to treat tuberculosis (TB) and leprosy)

Continued over page

Paroxetine tablets with food, drink and alcohol:
Do not drink alcohol while you are taking Paroxetine tablets. Alcohol
may make your symptoms or side effects worse

Pregnancy and breast-feeding

If you are pregnant or breast-feeding, think you may be pregnant or are
planning to have a baby ask your doctor or pharmacist for advice before
taking this medicine.
Pregnancy
If you are already taking Paroxetine and have just found out that you are
pregnant you should talk to your doctor immediately. This is because
some studies have suggested an increase in the risk of heart defects
in babies whose mothers received paroxetine in the first few months
of pregnancy. These studies found that less than 2 in 100 babies (2%)
whose mothers received paroxetine in early pregnancy had a heart
defect, compared with the normal rate of 1 in 100 babies (1%) seen in
the general population. You and your doctor may decide that it is better
for you to gradually stop taking paroxetine while you are pregnant.
However, depending on your circumstances, your doctor may suggest
that it is better for you to keep taking paroxetine.
When taken during pregnancy, particularly in the last 3 months of
pregnancy, medicines like paroxetine may increase the risk of a serious
condition in babies, called persistent pulmonary hypertension of the
newborn (PPHN). PPHN increases blood pressure in the blood vessels in
the lungs. This may result in abnormal blood flow to the lungs and heart
and the baby cannot get enough oxygen into their bloodstream. These
symptoms usually begin during the first 24 hours after birth and include
not being able to sleep or feed properly, breathing faster, a blue-ish
skin or being too hot or cold, being sick, crying a lot, stiff or floppy
muscles, lethargy, tremors, jitters or fits. If your baby has any of these
symptoms when it is born and you are concerned, contact your doctor
or midwife who will be able to advise you.
Fertility
Paroxetine has been shown to reduce the quality of sperm in animal
studies. Theoretically, this could affect fertility, but impact on human
fertility has not been observed as yet

Driving and using machines

Paroxetine may cause dizziness, confusion or changes in eyesight. If you
are affected by these side effects, do not drive or use machinery.

Paroxetine tablets contain soya lecithin.

Paroxetine contain soya lecithin. If you are allergic to peanut or soya, do
not use this medicine.

3 
How to take Paroxetine tablets

Always take paroxetine exactly as your doctor has told you.
Check with your doctor, pharmacist or nurse if you are not sure.
Take your tablets in the morning with food. Swallow them with a
drink of water. The white tablets can be cut in half.
Do not chew.
Doses:
Your doctor will advise you what dose to take when you first start taking
paroxetine.
• Adults
- Depression: 20mg a day to a maximum of 50mg
- Obsessive compulsive disorder: 20mg a day to a maximum of
60mg
- Panic disorder: 10mg a day to a maximum of 60mg
- Social anxiety disorder: 20mg a day to a maximum of 50mg
- Post traumatic stress disorder: 20mg a day to a maximum of
50mg
- Anxiety disorder: 20mg a day to a maximum of 50mg
• Elderly
 The maximum dose for people over 65 is 40mg per day.
• Children and adolescents

Not recommended for use in children aged under 18 years.
• Patients with liver or kidney disease
If you have trouble with your liver or kidneys, your doctor may
decide that you should have a lower dose. If you have severe liver
or kidney disease, the maximum dose is 20mg per day.

If you take more than you should

If you (or someone else) swallow a lot of tablets at the same time, or you
think a child may have swallowed any, contact your nearest hospital
casualty department or tell your doctor immediately. Signs of overdose
include being sick, dilated pupils, fever, blood pressure changes,
headache, involuntary muscle contractions, agitation, anxiety and rapid
heart beat.

If you forget to take the tablets

Do not take a double dose to make up for a forgotten dose. If you
do forget a dose, and you remember before you go to bed, take it
straight away, then take the next dose at the right time. If you only
remember during the night, or the next day, leave out the missed
dose.

If you stop taking the tablets

Do not stop treatment early because your doctor will help you to
reduce your dose slowly over a number of weeks or months. This should
help reduce the chance of withdrawal effects such as dizziness or a
feeling of unsteadiness, tingling, electric shock sensations, burning
sensations, sleep disturbances, intense dreams, restlessness, anxiety,
feeling sick, shaking, confusion, sweating, headache, diarrhoea, irregular
heartbeat, emotional instability, irritability or changes in vision.
Talk to your doctor before you stop taking the tablets and follow their
advice.

What to do if you are feeling no better

Paroxetine will not relieve your symptoms straight away. All
antidepressants take time to work. Some people will start to feel better
within a couple of weeks, but for others it may take a little longer. Some
people taking antidepressants feel worse before feeling better. If you
don’t start to feel better after a couple of weeks, go back to your doctor
who will advise you. Your doctor should ask to see you again a couple
of weeks after you start treatment. Tell your doctor then if you haven’t
started to feel better.

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4 
Possible side effects

Like all medicines, this medicine can cause side effects, but not
everybody gets them.
Contact your doctor at once if you experience any of the following:
• an allergic reaction: red and lumpy skin rash, severe skin rash with
flushing, fever, blisters or ulcers, swelling of the eyelids, face, lips,
mouth or tongue, itching or difficulty breathing or swallowing
• unusual bruising or bleeding, including vomiting blood or passing
blood in your stools
• not being able to pass water
• seizures (fits)
• akathisia (restlessness, and feeling like you can’t sit or stand still),
low blood sodium (causing tiredness, weakness, confusion and
achy, stiff or uncoordinated muscles)
• serotonin syndrome (confusion, restlessness, sweating, shaking,
shivering, hallucinations (strange visions or sounds), sudden jerks of
the muscles or a fast heartbeat.
Tell your doctor if you notice any of the following side effects or
notice any other effects not listed:
• Very common: may affect more than 1 in 10 people
- c hanges in sex drive or function (lack of orgasm, abnormal
erection and ejaculation in men), impaired concentration.
• Common: may affect up to 1 in 10 people
- dry mouth, diarrhoea, constipation, being sick
- lack of appetite, weight gain, increase in blood cholesterol levels
- difficulty sleeping, abnormal dreams/nightmares, feeling sleepy,
dizziness, headache
- shakes (tremors), feeling agitated
- blurred vision, yawning
• Uncommon: may affect up to 1 in 100 people
- increase or decrease in blood pressure
- irregular or fast heartbeat
- lack of movement, stiffness, shaking
- abnormal movements of the mouth and tongue
- abnormal dilated pupils
- increase in the need to pass urine
• Rare: may affect up to 1 in 1,000 people
- abnormal production of breast milk in men and women
- slow heartbeat
- effects on the liver showing up in liver function tests
- panic attacks, overactive behaviour or thoughts (mania), feeling
detached from yourself (depersonalisation), feeling anxious,
restless leg syndrome (RLS)
- joint or muscle pain.
• Very rare: may affect up to 1 in 10,000 people
- yellowing of the skin or whites of the eyes
- fluid or water retention which may cause swelling of the arms or
legs
- sensitivity to sunlight
- acute glaucoma (eye pain and blurred vision)
- painful erection of the penis that won’t go away
• Not known: frequency cannot be estimated from the available data
- bone fractures, ringing in the ears, suicidal ideation and suicidal
behaviour (see section 2), aggression.

Reporting of side effects

If you get any side effects, talk to your doctor, pharmacist or nurse. This
includes any possible side effects not listed in this leaflet. You can also
report side effects directly via the Yellow Card Scheme at:
www.mhra.gov.uk/yellowcard
By reporting side effects you can help provide more information on the
safety of this medicine.


5 
How to store Paroxetine tablets

Keep this medicine out of the sight and reach of children. No special
precautions for storage.
Do not use this medicine after the expiry date stated on the label. The
expiry date refers to the last day of that month.
Do not throw away any medicine via wastewater or household waste.
Ask your pharmacist how to throw away medicines you no longer use.
These measures will help protect the enviroment.


6 Contents of the pack and other information
What Paroxetine tablets contain




The active substance (the ingredient that makes the tablet work)
is paroxetine hydrochloride anhydrous. Each tablet contains either
22.22mg or 33.33mg of the active ingredient (equivalent to 20mg
or 30mg of paroxetine).
The other ingredients are magnesium stearate, sodium starch
glycollate (Type A), mannitol DC (E421), cellulose microcrystalline,
and polymethacrylate. 20mg tablets also contain opadry AMB
white (polyvinyl alcohol-part hydrolysed, titanium dioxide (E171),
talc, lecithin soya (E322), and xanthan gum (E415)). 30mg tablets
also contain opadry AMB blue (polyvinyl alcohol-part hydrolysed,
titanium dioxide (E171), talc, FD&C blue #2 / indigo carmine lake
(E132), lecithin soya (E322), xanthan gum (E415), FD&C yellow #6 /
sunset yellow (E110) and quinoline yellow lake (E104)).

What Paroxetine tablets look like and contents of the pack
Paroxetine 20mg tablets are white and Paroxetine 30mg tablets are
blue, circular film-coated tablets.
Pack sizes are 30 tablets.
Marketing Authorisation Holder
Actavis, Barnstaple, EX32 8NS, UK.
Manufacturer
Balkanpharma – Dupnitsa AD
3 Samokovsko Shosse Str., Dupnitsa 2600, Bulgaria
Wasdell Packaging Ltd, Units 6, 7, 8 Euro Way,
Blagrove, Swindon, Wiltshire, SN5 8YW
Date of revision: June 2016

Actavis, Barnstaple, EX32 8NS, UK

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Source: Medicines and Healthcare Products Regulatory Agency

Disclaimer: Every effort has been made to ensure that the information provided here is accurate, up-to-date and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. This information has been compiled for use by healthcare practitioners and consumers in the United States. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective or appropriate for any given patient. If you have questions about the substances you are taking, check with your doctor, nurse or pharmacist.

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