However, there is substantial evidence from placebo-controlled maintenance trials in adults with depression that the use of antidepressants can delay the recurrence of depression. All patients being treated with antidepressants for any indication should be monitored appropriately and observed closely for clinical worsening, suicidality, and unusual changes in behavior, especially during the initial few months of a course of drug therapy, or at times of dose changes, either increases or decreases.

The following symptoms, 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 for major depressive disorder as well as for other indications, both psychiatric and nonpsychiatric. Consideration should be given to changing the therapeutic regimen, including possibly discontinuing the medication, in patients whose depression is persistently worse, or who are experiencing emergent suicidality or symptoms that might be precursors to worsening depression or suicidality, especially if these symptoms are severe, abrupt in onset, or were not part of the patient's presenting symptoms.

Families and caregivers of patients being treated with antidepressants for major depressive disorder or other indications, both psychiatric and nonpsychiatric, should be alerted about the need to monitor patients for the emergence of agitation, irritability, unusual changes in behavior, and the other symptoms described above, as well as the emergence of suicidality, and to report such symptoms immediately to healthcare providers.

Such monitoring should include daily observation by families and caregivers. Prescriptions for PAXIL CR should be written for the smallest quantity of tablets consistent with good patient management, in order to reduce the risk of overdose. Screening Patients For Bipolar Disorder A major depressive episode may be the initial presentation of bipolar disorder. Whether any of the symptoms described above represent such a conversion is unknown.

However, prior to initiating treatment with an antidepressant, patients with depressive symptoms should be adequately screened to determine if they are at risk for bipolar disorder; such screening should include a detailed psychiatric history, including a family history of suicide, bipolar disorder, and depression. Serotonin Syndrome The development of a potentially life-threatening serotonin syndrome has been reported with SNRIs and SSRIs, including PAXIL CR, alone but particularly with concomitant use of other serotonergic drugs including triptans, tricyclic antidepressants , fentanyl, lithium , tramadol, tryptophan , buspirone, and St.

John's Wort and with drugs that impair metabolism of serotonin in particular, MAOIs, both those intended to treat psychiatric disorders and also others, such as linezolid and intravenous methylene blue. Serotonin syndrome symptoms may include mental status changes e. Patients should be monitored for the emergence of serotonin syndrome.

No reports involved the administration of methylene blue by other routes such as oral tablets or local tissue injection or at lower doses. John's Wort is clinically warranted, be aware of a potential increased risk for serotonin syndrome, particularly during treatment initiation and dose increases. Treatment with PAXIL CR and any concomitant serotonergic agents should be discontinued immediately if the above events occur and supportive symptomatic treatment should be initiated.

Angle-Closure Glaucoma The pupillary dilation that occurs following use of many antidepressant drugs including Paxil may trigger an angle closure attack in a patient with anatomically narrow angles who does not have a patent iridectomy. Potential Interaction With Thioridazine Thioridazine administration alone produces prolongation of the QTc interval, which is associated with serious ventricular arrhythmias, such as torsade de pointes—type arrhythmias, and sudden death.

This effect appears to be dose related. An in vivo study suggests that drugs which inhibit CYP2D6, such as paroxetine, will elevate plasma levels of thioridazine. Usage In Pregnancy Teratogenic Effects Epidemiological studies have shown that infants exposed to paroxetine in the first trimester of pregnancy have an increased risk of congenital malformations, particularly cardiovascular malformations.

The findings from these studies are summarized below: No increase in the risk of overall congenital malformations was seen in the paroxetine-exposed infants. The cardiac malformations in the paroxetine-exposed infants were primarily ventricular septal defects VSDs and atrial septal defects ASDs. Septal defects range in severity from those that resolve spontaneously to those which require surgery.

This study showed a trend towards an increased risk for cardiovascular malformations for paroxetine risk of 1. Of the 12 paroxetine-exposed infants with cardiovascular malformations, 9 had VSDs. In one study the OR was 2. Other studies have found varying results as to whether there was an increased risk of overall, cardiovascular, or specific congenital malformations.

While subject to limitations, this meta-analysis suggested an increased occurrence of cardiovascular malformations prevalence odds ratio [POR] 1. It was not possible in this meta-analysis to determine the extent to which the observed prevalence of cardiovascular malformations might have contributed to that of overall malformations, nor was it possible to determine whether any specific types of cardiovascular malformations might have contributed to the observed prevalence of all cardiovascular malformations.

If a patient becomes pregnant while taking paroxetine, she should be advised of the potential harm to the fetus. For women who intend to become pregnant or are in their first trimester of pregnancy, paroxetine should only be initiated after consideration of the other available treatment options. These studies have revealed no evidence of teratogenic effects. However, in rats, there was an increase in pup deaths during the first 4 days of lactation when dosing occurred during the last trimester of gestation and continued throughout lactation.

The no-effect dose for rat pup mortality was not determined. In the US - Call your doctor for medical advice about side effects. In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at List Paxil CR side effects by likelihood and severity.

Precautions Before taking paroxetine, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details. Before using this medication , tell your doctor or pharmacist your medical history, especially of: This drug may make you dizzy or drowsy or cause blurred vision.

Do not drive, use machinery, or do any activity that requires alertness or clear vision until you are sure you can perform such activities safely. Before having surgery, tell your doctor or dentist about all the products you use including prescription drugs , nonprescription drugs, and herbal products. Older adults may be more sensitive to the side effects of this drug, especially bleeding or loss of coordination. Older adults may also be more likely to develop a type of salt imbalance hyponatremia , especially if they are also taking " water pills " diuretics.

Loss of coordination can increase the risk of falling. Children may be more sensitive to the side effects of this drug, especially loss of appetite and weight loss. Monitor weight and height in children who are taking this drug.

This medication is not recommended for use during pregnancy. Instead, ask your doctor if a different medication would be right for you.

If you are planning pregnancy, become pregnant, or think you may be pregnant, tell your doctor right away. This drug passes into breast milk.

Consult your doctor before breast -feeding. What should I know regarding pregnancy, nursing and administering Paxil CR to children or the elderly? Interactions Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

Some products that may interact with this drug include: Aspirin can increase the risk of bleeding when used with this medication. However, if your doctor has directed you to take low-dose aspirin for heart attack or stroke prevention usually at dosages of milligrams a day , you should continue taking it unless your doctor instructs you otherwise. Ask your doctor or pharmacist for more details. This medication can slow down the removal of other medications from your body, which may affect how they work.

Taking MAO inhibitors with this medication may cause a serious possibly fatal drug interaction. Avoid taking MAO inhibitors isocarboxazid , linezolid , methylene blue, moclobemide, phenelzine , procarbazine , rasagiline , safinamide, selegiline, tranylcypromine during treatment with this medication. Most MAO inhibitors should also not be taken for two weeks before and after treatment with this medication. Ask your doctor when to start or stop taking this medication.

It is used to treat social anxiety problems. It is used to treat mood problems caused by monthly periods. It may be given to you for other reasons. If you have an allergy to paroxetine or any other part of this medicine.

If you are allergic to any drugs like this one, any other drugs, foods, or other substances. Tell your doctor about the allergy and what signs you had, like rash; hives; itching; shortness of breath; wheezing; cough; swelling of face, lips, tongue, or throat; or any other signs. If you are taking any of these drugs: Linezolid, methylene blue, pimozide, or thioridazine. If you have taken certain drugs used for low mood depression like isocarboxazid, phenelzine, or tranylcypromine or drugs used for Parkinson's disease like selegiline or rasagiline in the last 14 days.

Taking Paxil CR within 14 days of those drugs can cause very bad high blood pressure. This is not a list of all drugs or health problems that interact with this medicine. You must check to make sure that it is safe for you to take Paxil CR with all of your drugs and health problems.

Do not start, stop, or change the dose of any drug without checking with your doctor. Tell all of your health care providers that you take this medicine. This includes your doctors, nurses, pharmacists, and dentists. Avoid driving and doing other tasks or actions that call for you to be alert or have clear eyesight until you see how Paxil CR affects you. Do not stop taking this medicine all of a sudden without calling your doctor.

You may have a greater risk of side effects. If you need to stop Paxil CR, you will want to slowly stop it as ordered by your doctor. Avoid drinking alcohol while taking this medicine. Talk with your doctor before you use other drugs and natural products that slow your actions. It may take several weeks to see the full effects.

This medicine may affect how much of some other drugs are in your body. If you are taking other drugs, talk with your doctor. You may need to have your blood work checked more closely while taking Paxil CR with your other drugs.

This medicine may raise the chance of a broken bone.

PAXIL CR 25 (Paxil CR 25 mg)

Pediatric Use, for adverse events reported upon discontinuation of treatment with paroxetine in pediatric patients. It was not possible in this meta-analysis to determine the extent to which the observed prevalence of cardiovascular malformations might have contributed to that of overall malformations, paxil was it possible to determine whether any specific types of cardiovascular malformations might have contributed to the observed prevalence of all cardiovascular malformations. Patients may wish to be examined to determine whether they are indicação to angle closure, and have a prophylactic procedure e. Case reports and epidemiological studies case-control and cohort design have demonstrated an association between 25mg of drugs that 25mg with serotonin reuptake and the occurrence of gastrointestinal bleeding. This medicine may affect growth in children and teens in some cases. In the US - Call your doctor for medical advice about side effects. 25mg Medications Patients should be advised to indicação their physician if they are taking, paxil cr 25mg indicação, or plan to take, any paxil or over-the-counter drugs, since there is a potential for interactions. Loss of coordination can increase the risk of falling. This drug may make you dizzy or drowsy or cause blurred vision, paxil cr 25mg indicação. It is used to treat social anxiety indicação. To gain the most benefit, do not miss doses. Clinical Worsening and Suicide Risk. A few paxil of acute angle closure glaucoma associated with therapy with immediate-release paroxetine have been reported in the literature.

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All patients being treated with antidepressants for any indication should be monitored appropriately and observed closely for clinical worsening, suicidality, and unusual changes in behavior, especially during the initial few months of a course of drug therapy, or at times of dose changes, either increases or decreases. Discontinuation of PAXIL CR should be considered in patients with symptomatic hyponatremia and appropriate medical paxil should be instituted. They may need indicação growth checks. Follow your doctor's instructions 25mg. The risk increases if you are also taking other drugs that increase serotonin, so tell your doctor or pharmacist of all the drugs you take see Drug Interactions section. Drugs That Interfere With Hemostasis e. You may need to have your blood work checked more closely while taking Paxil CR with your other drugs. If you are taking any of these drugs: Reported clinical findings have included respiratory distress, paxil cr 25mg indicação, cyanosisapneaseizures, temperature instability, feeding difficulty, vomiting, hypoglycemiahypotoniahypertoniahyperreflexia, tremor, jitteriness, irritability, and constant crying, paxil cr 25mg indicação. This medicine may affect growth in children and teens in paxil cases. Signs indicação symptoms of hyponatremia include headache, difficulty concentrating, memory impairment, confusion, weakness, and unsteadinesswhich may lead to falls. Rarely, males may have a painful or prolonged erection lasting 4 or more hours. Linezolid, paxil cr 25mg indicação, methylene blue, 25mg, or thioridazine. This medicine may affect sperm in men. Other studies do not show a significant statistical association.

Indicação adults may also be more likely to develop a type of salt imbalance hyponatremia 25mg, especially if they are also taking " water pills " diuretics, paxil cr 25mg indicação. Paxil c First 25mg, Inc. Storage Store at room temperature away from light and moisture. Get medical help right away if you develop some of the following symptoms: This document does not contain all possible drug interactions. List Paxil CR side effects by likelihood and severity, paxil cr 25mg indicação. Side Effects See also Warning section. Some people may have a indicação chance of eye problems with this medicine. Be sure to tell your doctor and pharmacist about all the products you use including prescription drugsnonprescription drugs, and herbal products, paxil cr 25mg indicação. If you have an allergy to paroxetine paxil any other part of this medicine. Evaluation of electrocardiograms of patients who received immediate-release paroxetine hydrochloride in double-blind, placebo-controlled trials, however, did not indicate that paroxetine lexapro 10mg ingredients associated with the development of paxil ECG abnormalities. You must check to make sure that it is safe for you to take Paxil CR with all of your 25mg and health problems. For women who intend to become pregnant or are in paxil first trimester of pregnancy, paroxetine should only be initiated after 25mg of the other available indicação options. Indicação who discontinued antidepressant medication during pregnancy showed a significant increase in relapse of their major depression compared to those women who remained on antidepressant medication throughout pregnancy. This medicine may affect growth in children and teens in some cases. These studies have revealed no evidence of teratogenic effects.

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