Adult Dosing
Major Depressive Disorder
Immediate-release tabs
- Initial: 20 mg/day PO qam. May increase by 10 mg/day at weekly intervals. Max: 50 mg/day
- Maintenance: 30 mg/day x1 yr
Extended-release tabs
- Initial: 25 mg/day PO qam. May increase by 12.5mg/day at weekly intervals. Max. 62.5 mg/day
- Maintenance: 37.5 mg/day x1 yr
Obsessive Compulsive Disorder
Immediate-release tabs
- Initial: 20 mg/day PO qam. May increase by 10 mg/day at weekly intervals. Max: 60 mg/day
Panic Disorder
Immediate-release tabs
- Initial: 10 mg/day PO qam. May increase by 10 mg/day at weekly intervals up to 40 mg. Max: 60 mg/day
Extended-release tabs
- Initial: 12.5 mg/day PO qam. May increase by 12.5 mg/day at weekly intervals. Max: 75 mg/day
Social Anxiety Disorder
Immediate-release tabs
Extended-release tabs
- Initial: 12.5 mg/day PO qam. May increase by 12.5 mg/day weekly intervals. Max: 37.5 mg/day
Generalized Anxiety Disorder
Immediate-release tabs
- Initial: 20 mg/day PO qam. May increase by 10 mg/day at weekly intervals. Max: 50 mg/day
Post-traumatic Stress Disorder
Immediate-release tabs
- Initial: 20 mg/day PO qam. May increase by 10 mg/day at weekly intervals. Max: 50 mg/day
Premenstrual Dysphoric Disorder
Extended-release tabs
- 12.5 mg/day PO throughout menstrual cycle or during luteal phase of menstrual cycle only; may be increased to 25 mg/day after one week
Vasomotor symptoms associated with menopause (Brisdelle)
- 7.5 mg PO qpm, with or without food
Note: Do not chew or crush tablets. Taper dose gradually to discontinue therapy.
Pediatric Dosing
- Safety and effectiveness in the pediatric population have not been established
[Outline]
Renal Dose Adjustment (Based on CrCl)
- Renal impairment
- <30 mL/min: Start 10 mg PO qd, 12.5 mg ER PO qd. Max: 40 mg/day PO, 50 mg ER/day PO
Hepatic Dose Adjustment
- Severe impairment: Start 10 mg PO qd, 12.5 mg ER PO qd. Max: 40 mg/day PO, 50 mg ER/day PO
See Supplemental Patient Information
- Therapy may increase the risk of suicidality in patients with major depressive disorder or other psychiatric disorders [US Black Box Warning]
- Studies suggested that suicidality risk was not increased in patients >24 yrs and risk decreased in patients >65 yrs [US Black Box Warning]
- During the initial few months of therapy, or at times of dose changes, patients should be closely monitored for clinical worsening, suicidality, or unusual changes in behavior [US Black Box Warning]
- The symptoms such as anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, akathisia (psychomotor restlessness), hypomania, and mania, have been reported in adult and pediatric patients being treated with antidepressants drugs
- Discontinue therapy by tapering the dose in patients with depression or suicidality or severe symptoms
- Family and caregivers should instructed to observe the patient closely during therapy. Paroxetine tablets are not approved for use in pediatric patients [US Black Box Warning]
- Patients with depressive symptoms should be screened to determine risk of bipolar disorder
- Life threatening serotonin syndrome or Neuroleptic Malignant Syndrome (NMS) may occur with SNRIs and SSRIs, including paroxetine treatment, particularly with concomitant use of serotonergic drugs
- Concomitant use of paroxetine with MAOIs intended to treat depression is contraindicated
- Do not use paroxetine with serotonin precursors (such as tryptophan)
- Co-administration of thioridazine and paroxetine may prolong QTc interval, which is associated with serious ventricular arrhythmias
Cautions: Use cautiously in
- Severe renal impairment
- Severe hepatic impairment
- Volume depletion
- Patients <25 yrs
- Elderly/debilitated patients
- History of seizure disorder
- History of mania/hypomania
- Hyponatremia
- Angle-closure glaucoma
- Suicidality history
- Suicidal ideation
- Alcohol use
- Bleeding risk
Supplemental Patient Information
- Do not stop an antidepressant medicine without first consulting to a physician
- Consult doctor for medical advice about side effects
Pregnancy Category:D
Breastfeeding: Probably safe. Due to the low levels of paroxetine in breastmilk, amounts ingested by the infant are small and paroxetine has not been detected in the serum of most infants tested. Paroxetine one of the preferred antidepressants during breastfeeding. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 27 April 2011). Manufacturer advises caution.
US Trade Name(s)
- Brisdelle
- Paxil
- Paxil CR
- Pexeva
US Availability
paroxetine (generic)
- TABS: 10, 20, 30, 40 mg
- ETABS: 12.5, 25, 37.5 mg
Brisdelle
Paxil
- TABS: 10, 20, 30, 40 mg
- SUSP: 10 mg/5 mL
Paxil CR
Pexeva
Canadian Trade Name(s)
Canadian Availability
paroxetine (generic)
Paxil CR
UK Trade Name(s)
UK Availability
paroxetine (generic)
Australian Trade Name(s)
- Aropax
- Extine
- Paxtine
- Pharmacor Paroxo
Australian Availability
paroxetine (generic)
Aropax, Extine, Paxtine, Pharmacor Paroxo
[Outline]
Pricing data from www.DrugStore.com in U.S.A.
- Paxil 20 MG TABS [Bottle] (APOTEX)
30 mg = $125.99
90 mg = $349.96 - PARoxetine HCl 40 MG TABS [Bottle] (ZYDUS PHARMACEUTICALS (USA))
30 mg = $24.99
90 mg = $59.95 - Paxil 30 MG TABS [Bottle] (APOTEX)
30 mg = $129.99
90 mg = $369.97 - Paxil 30 MG TABS [Bottle] (APOTEX)
30 mg = $129.99
90 mg = $369.97 - Pexeva 20 MG TABS [Bottle] (NOVEN THERAPEUTICS)
30 mg = $190.98
90 mg = $528.95 - Paxil CR 12.5 MG TB24 [Bottle] (APOTEX)
30 mg = $120
90 mg = $335.96 - Paxil 10 MG TABS [Bottle] (APOTEX)
30 mg = $116.99
90 mg = $320.98 - Paxil 40 MG TABS [Bottle] (APOTEX)
30 mg = $136.99
90 mg = $384.95 - Paxil 40 MG TABS [Bottle] (APOTEX)
30 mg = $136.99
90 mg = $384.94 - Paxil CR 37.5 MG TB24 [Bottle] (APOTEX)
30 mg = $141.99
90 mg = $411.97 - Pexeva 30 MG TABS [Bottle] (NOVEN THERAPEUTICS)
30 mg = $200.98
90 mg = $584.96 - Pexeva 40 MG TABS [Bottle] (NOVEN THERAPEUTICS)
30 mg = $205.99
90 mg = $572.98 - Paxil CR 25 MG TB24 [Bottle] (APOTEX)
30 mg = $139.98
90 mg = $383.95 - Paxil 10 MG/5ML SUSP [Bottle] (APOTEX)
250 5ml = $189.98
750 5ml = $539.94
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
