How to use

Paroxetine should be taken orally, usually once a day. This medication can be taken with or without food, but taking it with a small meal may decrease nausea. The pills may make you either sleepy or more alert so you can take this medication either in the morning or in the evening, depending on the effect it has on you. Follow the instructions of your doctor exactly, even if this differs from the usually recommended dosage.

Take Paroxetine regularly to enjoy its maximum benefits. Try to take it at approximately the same time each day to make sure there is always an even amount of medication in your blood stream. Keep taking this medication, even if you feel well. You should always consult your doctor first before starting or stopping treatment with any medication.

If you have been using Paroxetine for a long time (especially in high doses), you may experience certain withdrawal symtpoms if you suddenly stop taking this medication. Potential withdrawal symptoms are:

• Mood swings
• Headaches
• Tiredness
• Sleep changes
• Feelings of shock

To prevent these side effects, your doctor may decide to gradually wean you off the medication.

Overdose
Potential symtpoms of a Paroxetine overdose include:

• Irregular heartbeat
• Fainting
• Severe dizziness
• Seizures

If you suspect you have taken too much of this medication, you should contact your local poison control center or the emergency medical services immediately.

Missed Dose
If you miss a dose of Paroxetine, take it as soon as you remember. If it is nearly time for your next scheduled dosage, skip the missed dose and just take the next one. Then continue with your normal schedule. Do not attempt to double up on this medication to make up for a missed dosage.

Notes
While taking Paroxetine you should go for regular doctor's check-ups to chart your progress. Make sure you do not miss any of these appointments.

Do not share this medication with others as they may have a condition that is not adequately treated with Paroxetine.

Storage
Store Paroxetine at room temperature between 59 and 86 degrees F (15-30 degrees C) and away from light and moisture. KEEP THIS AND ALL MEDICATIONS OUT OF REACH OF CHILDREN.

Important note
The above information is intended to supplement, not substitute for, the expertise and judgement of your physician, pharmacist or other healthcare professional. It should not be construed that the taking of this medication is safe, appropriate or effective for you.

Precautions

Before taking Paroxetine, let your doctor know of all medical conditions you are suffering from or ever have suffered from. Especially include:

• Any allergies
• Personal or family history of bipolar/manic-depressive disorder
• Personal or family history of suicide attempts
• Liver or kidney problems
• Low sodium in the blood
• Severe loss of body water (dehydration)
• Seizures
• Stomach or intestinal ulcers
• Glaucoma (narrow-angle type)

If you currently have or ever have had any of the above conditions, you may not be able to take Paroxetine or you may need a dosage adjustment.

Paroxetine may make you dizzy or drowsy. Avoid driving or operating heavy machinery until you are sure you can safely perform these activities.

Caution is advised when elderly people are using this medication, as they may be more sensitive to its side effects. People in this age group are also more likely to lose too much salt (hyponatremia), especially if they are taking Paroxetine in combination with diuretics.

Paroxetine is classed as Pregnancy Category D, which means it could potentially harm an unborn baby. It is not recommended to take this medication while pregnant. However, untreated depression is a serious condition and could also harm an unborn child during pregnancy. Discuss the use of this medication with your doctor if you are currently pregnanct, think you may be pregnant or are planning to become pregnant during treatment. If you have been taking Paroxetine during the last 3 months of pregnancy, your baby may rarely develop withdrawal symptoms, such as:

• Feeding or breathing difficulties
• Seizures
• Muscle stiffness
• Constant crying

If you notice any of these symptoms in your newborn, you should notify your doctor immediately.

Paroxetine passes into breast milk and may harm a nursing baby. Discuss the use of this medication with your doctor if you are currently breastfeeding.

Drug Interactions

Before taking Paroxetine, make sure you inform your doctor of all other medication you take, including:

• Sibutramine
• MAO inhibitors (e.g. Furazolidone, Isocarboxazid, Linezolid, Moclobemide, Phenelzine, Procarbazine, Rasagiline, Selegiline and Tranylcypromine) for 2 weeks before, during, or after treatment with this medication
• Pimozide
• Sibutramine
• Thioridazine
• Medication removed from your body by certain liver enzymes (e.g. Aripiprazole, Atomoxetine, Fluoxetine, Phenothiazines, Procyclidine, Risperidone, Tamoxifen, Antiarrhythmics such as Propafenone, Flecainide, TCA antidepressants such as Desipramine, Amitriptyline)
• Cimetidine
• Digoxin
• Fosamprenavir or Ritonavir
• Metoprolol
• Quinidine
• Theophylline
• Tramadol
• Diuretics such as Furosemide)
• Medication that can cause bleeding or bruising (e.g. Aspirin, Antiplatelet medication such as Clopidogrel, NSAIDs such as Ibuprofen, blood thinners such as Heparin and Warfarin)
• Bromocriptine
• Buspirone
• Dextromethorphan
• Lithium
• Meperidine
• Propoxyphene
• Phentermine
• SSRIs
• SNRIs
• Tryptophan
• St. John's wort
• Medication used to treat migraines such as triptans and dihydroergotamine
• Street drugs such as MDMA or ecstasy
• Amphetamine
• Certain antihistamines (e.g. Diphenhydramine)
• Anti-seizure drugs (e.g. Carbamazepine)
• Medicine for sleep or anxiety (e.g. Alprazolam, Diazepam, Zolpidem)
• Muscle relaxants
• Narcotic pain relievers (e.g. Codeine)
• Psychiatric medicines (e.g. Chlorpromazine, Quetiapine, Nortriptyline, Trazodone)
• Cough-and-cold medication containing ingredients that cause drowsiness
• Cimetidine

This is only a partial list of medication that could interact with Paroxetine and other interactions may occur. Inform your doctor of all prescription and non-prescription medication you use, including dietary supplements, herbal pills, vitamins and medication prescribed by other doctors. Do not stop or start taking any medication without discussing it with your doctor first.

The following common side effects of Paroxetine are possible:

• Nausea
• Drowsiness
• Dizziness
• Trouble sleeping
• Loss of appetite
• Weakness
• Tiredness
• Dry mouth
• Sweating
• Yawning
• Headache

If any of the above side effects persist or worsen, notify your doctor promptly.

Inform your doctor immediately if you experience any of the following unlikely but serious side effects

• Unusual or severe mental or mood changes (e.g. agitation, thoughts of suicide)
• Shakiness (tremor)
• Restlessness
• Inability to keep still
• Decreased interest in sex
• Changes in sexual ability
• Blurred vision
• Numbness or tingling

Tell your doctor straightaway if you enocunter any of the following rare but very serious side effects:

• Bloody, black or tarry stools
• Vomit that looks like coffee grounds
• Easy bruising or bleeding
• Fainting
• Fast or irregular heartbeat
• Muscle weakness or spasm
• Seizures
• Change in amount of urine

In rare cases, this medication may cause a very serious condition called Serotonin Syndrome. The risk increases if Generic Paxil (Paroxetine) is used in combination with certain other medications, such as:

• Triptans used to treat migraine headaches (e.g. Sumatriptan, Eletriptan)
• Certain antidepressants including other SSRIs (e.g. Citalopram, Fluoxetine)
• SNRIs (e.g. Duloxetine, Venlafaxine)
• Lithium
• Tramadol
• Tryptophan
• A certain medication to treat obesity (Sibutramine)

Seek immediate medical attention if you develop any of the following symptoms of Serotonin Syndrome:

• Hallucinations
• Unusual restlessness
• Loss of coordination
• Fast heartbeat
• Severe dizziness
• Unexplained fever
• Severe nausea, vomiting or diarrhea
• Twitchy muscles

In unlikely cases, some men may experience a prolonged or painful erection (which lasts more than 4 hours). If this is the case, stop taking this medication immediately and seek emergency medical attention.

In very rare cases, you could experience an allergic reaction to Generic Paxil (Paroxetine). Seek emergency medical attention if you notice any symptoms of a serious allergic reaction, such as:

• Rash
• Itching or swelling (especially of the face, tongue or throat)
• Severe dizziness
• Trouble breathing

This is only a partial list of potential side effects of Generic Paxil (Paroxetine) and others may occur. Notify your doctor straightaway if you experience any other side effects than the ones mentioned above, especially if they are bothersome.