Paroxetine
When ATH: N06AB05
Characteristics paroxetine
Colorless, odorless.
Mode of action of paroxetine
Antidepressant.
The use of paroxetine
Depression different etiology, intrusive compulsive disorders, panic disorder.
Contraindications paroxetine
Hypersensitivity and two-week period after discontinuation of MAO inhibitors.
Restrictions on the use of paroxetine
Zakrыtougolynaya glaucoma, prostate adenoma, pregnancy (the appointment is valid only in case of emergency), lactation.
The use of paroxetine during pregnancy and breastfeeding
Category actions result in FDA - C. (The study of reproduction in animals has revealed adverse effects on the fetus, and adequate and well-controlled studies in pregnant women have not held, However, the potential benefits, associated with drugs in pregnant, may justify its use, in spite of the possible risk.)
Side effects of paroxetine
Drowsiness or insomnia, tremor, nervousness, CNS hyperexcitability, impaired concentration, emotional lability, amnesia, dizziness, Parez akkomodacii, mydriasis, sore eyes, noise and ear pain, increase or decrease in blood pressure, fainting, tachycardia or bradycardia, violation of cardiac conduction and peripheral blood circulation, cough, rhinitis, dypnoэ, tachypnea, nausea, decreased appetite, dyspepsia, increase in liver transaminases, stomatitis, arthralgia, arthritis, dizurija, polyuria, urinary incontinence, urinary retention, amenorrhea, dysmenorrhoea, miscarriage, mastitis, abnormal ejaculation, decreased libido and potency, peripheral edema, decrease or increase in body weight, anemia, leukopenia, allergic reactions (itch, hives, chills).
Seldom - thought disorder, akinesia, ataxia, convulsions, hallucinations, giperkineziya, manic or paranoid reactions, delirium, euphoria, grand mal seizures, aggressiveness, nistagmo, stupor, autism, reduced visual acuity, Cataract, conjunctivitis, glaucoma, exophthalmos, angina, myocardial infarction, cerebrovascular accidents, heart rhythm disturbances, eozinofilija, leukocytosis, Lymphocytosis, monocytic, hematuria, nefrourolitiaz, impairment of renal function, dermatitis, uzlovataya эritema, depigmentation.
The interaction of paroxetine
Inductors of microsomal oxidation (phenobarbital, phenytoin) reduce blood concentration and activity, inhibitors (cimetidine) - Increase. Increases in plasma protsiklidina. Incompatible with MAO inhibitors. Co-administration with indirect anticoagulants can cause increased bleeding during the unchanged value of prothrombin time. It enhances the effect of alcohol.
Overdose paroxetine
Symptoms: nausea, vomiting, drowsiness, sinus tachycardia, dilated pupils, etc..
Treatment: symptomatic. To remove part of the stomach nevsosavsheysya drug to induce vomiting or gastric lavage.
Dosage and administration of paroxetine
Inside, in the morning - at 20 mg. With insufficient effects may increase the dose to 10 mg / day with an interval of not less than 1 Sun (the maximum dose - 50 mg / day). Elderly, malnourished patients, as well as kidney function and liver initial dose - 10 mg / day, maximum - 40 mg / day.
Precautions
Before treatment is necessary to clarify, whether there was a history of episodes of mania or seizures. It is recommended to reduce the dose or combined with other antidepressants (nortryptylyn, Amitriptyline, imipramine, desipramine, fluoxetine), phenothiazine derivatives (tioridazin) and Class I antiarrhythmic drugs (propafenone, flekainid, enkainid). Not recommended simultaneous reception of tryptophan. Be wary appoint persons, engaged in potentially hazardous activities, require attention, and rapid mental and motor responses.
The interaction of paroxetine
| Active substance | Description of interaction |
| Amitriptyline | FKV. Against the background of changing paroxetine plasma concentration (monitoring is necessary). |
| Warfarin | FKV. FMR: synergism. Against the background of paroxetine (displace warfarin from protein complex) increases the concentration of the free fraction of blood, enhanced anticoagulant effect and increased risk of bleeding complications. |
| Diazepam | FKV. Displaces (mutually) with binding sites on proteins (competition) and increases the concentration of the free fraction of blood; the combined appointment increases the risk of side effects. |
| Digoxin | FKV. FMR. Against the background of paroxetine (is displaced from the complex with proteins) increases the concentration of the free fraction in plasma and increased risk of adverse events. |
| Imipramine | FKV. Against the background of changing paroxetine plasma concentration (monitoring is necessary). |
| Karvedilol | FKV. Against the background of paroxetine (reduces the activity of CYP2D6), biotransformation slows and increases the blood level of. |
| Linezolid | FMR: synergism. Against the background of paroxetine can cause, as well as other inhibitors of MAO, heavy, sometimes fatal, reaction, including hyperthermia, rigidity, myoclonus, autonomic disorders, extreme agitation, progressing to delirium and to whom; concomitant use is contraindicated. |
| Lorazepam | FMR: synergism. Against the background of paroxetine dampening effect on the central nervous system. |
| Promethazine | FKV. FMR. Inhibits the activity of CYP2D6 isoenzyme, slows (mutually) biotransformation and increases the likelihood of toxic effects; with a joint appointment caution. |
| Selegiline | FMR: synergism. Against the background of paroxetine can cause, as well as other inhibitors of MAO, heavy, sometimes fatal, reaction, including hyperthermia, rigidity, myoclonus, autonomic disorders, extreme agitation, progressing to delirium and to whom; concomitant use is contraindicated. |
| Phenytoin | FKV. FMR: antagonizm. It induces microsomal oxidation, It reduces the concentration in the blood and the antidepressant effect. |
| Phenobarbital | FKV. FMR: antagonizm. It induces microsomal oxidation, It reduces the concentration in the blood and the antidepressant effect. |
| Ethanol | FMR: synergism. Against the background of the effect of paroxetine enhanced deprimiruyuschie. |
