Select therapeutic use:
  • Anxiety/OCD
  • Mood disorders

Anxiety/OCD:

Indications for PAXIL:

Panic disorder. Social anxiety disorder. Obsessive-compulsive disorder (OCD). Generalized anxiety disorder (GAD). Posttraumatic stress disorder (PTSD).

Adult:

Give once daily, usually in the AM, adjust by 10mg/day at 1-week intervals. Panic disorder: initially 10mg/day; usual 40mg/day; max 60mg/day. Social anxiety disorder: 20mg/day; max 60mg/day. OCD: initially 20mg/day, usual 40mg/day; max 60mg/day. GAD or PTSD: 20mg/day; max 50mg/day. Elderly, debilitated, severe renal or hepatic impairment: initially 10mg/day; max 40mg/day.

Children:

Not established.

Contraindications:

Concomitant pimozide, thioridazine. During or within 14 days of MAOIs (including linezolid, IV methylene blue).

Boxed Warning:

Suicidal thoughts and behaviors.

Warnings/Precautions:

Increased risk of suicidal thoughts and behavior in children, adolescents, and young adults; monitor all patients for clinical worsening or unusual changes. Monitor for serotonin syndrome; discontinue and treat if occurs. Screen for bipolar disorder. History of seizures (discontinue if occurs), mania/hypomania. Cardiac disease. Angle-closure glaucoma. Write ℞ for smallest practical amount. Avoid abrupt cessation; reduce dose gradually. Reevaluate periodically. Elderly. Neonates. Pregnancy (Cat.D); avoid use. Nursing mothers.

Pharmacologic Class:

SSRI.

Interactions:

See Contraindications. Do not start MAOI until at least 2 weeks after discontinuing paroxetine. Increased risk of serotonin syndrome with other serotonergic drugs (eg, triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, tryptophan, buspirone, amphetamines, St. John's Wort) or with drugs that impair serotonin metabolism (eg, MAOIs, linezolid, IV methylene blue). Avoid alcohol. Potentiation with other protein bound drugs. Increased risk of bleeding with NSAIDs, aspirin, clopidogrel, warfarin, or others that affect coagulation. May affect, or be affected by, drugs metabolized by CYP2D6 (eg, propafenone, flecainide, atomoxetine, desipramine, dextromethorphan, metoprolol, nebivolol, perphenazine, tolterodine, venlafaxine, risperidone). May reduce effects of tamoxifen; consider alternative antidepressant. Monitor digoxin, phenytoin, phenobarbital, theophylline, warfarin. Antagonized by fosamprenavir/ritonavir. Hormonal contraceptives and PMDD treatment: see full labeling.

Adverse Reactions:

Abnormal ejaculation, headache, nausea, somnolence, diarrhea, asthenia, dizziness, sweating, constipation, decreased appetite, insomnia, decreased libido, tremor, akathisia, dry mouth, female genital disorders, abnormal vision, impotence, hyponatremia, abnormal bleeding, others; serious discontinuation symptoms (monitor).

How Supplied:

CR—30; Tabs—30; Susp—250mL

Pricing for PAXIL

20mg tablet (Qty: 30)
Appx. price $11
GoodRx

Mood disorders:

Indications for PAXIL:

Major Depressive Disorder (MDD).

Adult:

Give once daily, usually in the AM, adjust by 10mg/day at 1-week intervals. Initially 20mg/day; max 50mg/day. Elderly, debilitated, severe hepatic or renal impairment: initially 10mg/day; max 40mg/day.

Children:

Not established.

Contraindications:

Concomitant pimozide, thioridazine. During or within 14 days of MAOIs (including linezolid, IV methylene blue).

Boxed Warning:

Suicidal thoughts and behaviors.

Warnings/Precautions:

Increased risk of suicidal thoughts and behavior in children, adolescents, and young adults; monitor all patients for clinical worsening or unusual changes. Monitor for serotonin syndrome; discontinue and treat if occurs. Screen for bipolar disorder. History of seizures (discontinue if occurs), mania/hypomania. Cardiac disease. Angle-closure glaucoma. Write ℞ for smallest practical amount. Avoid abrupt cessation; reduce dose gradually. Reevaluate periodically. Elderly. Neonates. Pregnancy (Cat.D); avoid use. Nursing mothers.

Pharmacologic Class:

SSRI.

Interactions:

See Contraindications. Do not start MAOI until at least 2 weeks after discontinuing paroxetine. Increased risk of serotonin syndrome with other serotonergic drugs (eg, triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, tryptophan, buspirone, amphetamines, St. John's Wort) or with drugs that impair serotonin metabolism (eg, MAOIs, linezolid, IV methylene blue). Avoid alcohol. Potentiation with other protein bound drugs. Increased risk of bleeding with NSAIDs, aspirin, clopidogrel, warfarin, or others that affect coagulation. May affect, or be affected by, drugs metabolized by CYP2D6 (eg, propafenone, flecainide, atomoxetine, desipramine, dextromethorphan, metoprolol, nebivolol, perphenazine, tolterodine, venlafaxine, risperidone). May reduce effects of tamoxifen; consider alternative antidepressant. Monitor digoxin, phenytoin, phenobarbital, theophylline, warfarin. Antagonized by fosamprenavir/ritonavir. Hormonal contraceptives and PMDD treatment: see full labeling.

Adverse Reactions:

Abnormal ejaculation, headache, nausea, somnolence, diarrhea, asthenia, dizziness, sweating, constipation, decreased appetite, insomnia, decreased libido, tremor, akathisia, dry mouth, female genital disorders, abnormal vision, impotence, hyponatremia, abnormal bleeding, others; serious discontinuation symptoms (monitor).

How Supplied:

CR—30; Tabs—30; Susp—250mL

Pricing for PAXIL

20mg tablet (Qty: 30)
Appx. price $11
GoodRx