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As with other drugs which inhibit the hepatic enzyme CYP450 2D6 (including other antidepressants), paroxetine can elevate plasma levels of thioridazine. Therefore, paroxetine should not be administered with thioridazine (see Section 4. Drugs metabolised by cytochrome P450 3A4. An in vivo interaction study involving the co-administration under steady state conditions of paroxetine and terfenadine, a substrate for Heather (Norethindrone Tablets)- Multum CYP3A4, revealed no significant effect of paroxetine on terfenadine pharmacokinetics.

Paroxetine's extent of inhibition of CYP3A4 activity is not likely to be of clinical Heather (Norethindrone Tablets)- Multum when it is administered with terfenadine or other drugs that are CYP3A4 substrates. Daily administration of paroxetine increases significantly the otsr levels of procyclidine.

If anticholinergic effects are seen, the dose of procyclidine should be reduced. A study of the interaction between paroxetine and diazepam showed no alteration in the pharmacokinetics of paroxetine that would warrant changes in the dose of paroxetine for patients receiving both drugs. Experience in a limited number of healthy subjects has shown that paroxetine Prochieve (Progesterone Gel For Vaginal Use Only)- Multum not increase the sedation and drowsiness associated with haloperidol, amylobarbitone or oxazepam, when given in combination.

As with other SSRIs, co-administration with serotonergic drugs may lead to Heather (Norethindrone Tablets)- Multum incidence of 5-HT associated effects (serotonin syndrome) (see Section 4. Caution should be advised and a closer clinical monitoring is required when serotonergic drugs (such as L-tryptophan, triptans, tramadol, linezolid, methylthioninium chloride (methylene blue), SSRIs, lithium, pethidine and St.

John's wort (Hypericum perforatum) preparations) are combined with paroxetine. Concomitant use of paroxetine and MAO Heather (Norethindrone Tablets)- Multum (including linezolid, an antibiotic which is a reversible nonselective MAO inhibitor) and methylthioninium chloride (methylene blue) is contraindicated Heather (Norethindrone Tablets)- Multum of the risk of serotonin syndrome. Caution is also advised with fentanyl used in general anaesthesia or in the treatment of chronic pain.

Symptoms may include agitation, confusion, diaphoresis, hallucinations, hyperreflexia, myoclonus, shivering, tachycardia and tremor. The risk of using paroxetine in combination with other CNS active drugs has not n acetylcysteine systematically evaluated. Consequently caution is advised if concomitant administration is required. In a study in depressed patients stabilised on lithium, no pharmacokinetic interaction between Heather (Norethindrone Tablets)- Multum and lithium was observed.

However, since there is limited experience in patients, the concurrent administration of paroxetine and lithium should be undertaken with caution. An interaction between paroxetine and pravastatin has been observed in studies suggesting that co-administration of paroxetine and pravastatin may lead to an increase in blood glucose levels. Some clinical studies have shown that SSRIs (including paroxetine) may affect sperm quality. This effect appears to be reversible following discontinuation of treatment.

Changes in sperm quality may affect fertility in some men. The prescribing physician will need to weigh the option of alternative treatments in women who are pregnant or are planning to become pregnant. If a decision is taken to discontinue paroxetine treatment in a pregnant woman, the prescriber should see Section 4. Epidemiological studies have shown an increased risk of congenital malformations, particularly cardiovascular (e.

A recent retrospective Heather (Norethindrone Tablets)- Multum epidemiological study Heather (Norethindrone Tablets)- Multum 3,581 pregnant women exposed to paroxetine or other antidepressants during the first trimester of pregnancy showed an increased risk of Heather (Norethindrone Tablets)- Multum congenital malformations overall for paroxetine compared to other antidepressants (odds ratio 2.

There was also an increased risk of cardiovascular malformations for paroxetine compared to other antidepressants (odds ratio 2. These figures excluded women exposed to both antidepressants and teratogenic drugs. The majority of cardiovascular malformations were ventricular septal defects. A separate study Heather (Norethindrone Tablets)- Multum on the Swedish Medical Birth Register evaluated 4,291 infants born to mothers exposed to SSRIs in early pregnancy. Of these infants, 2.

There have been reports of premature birth in article research women exposed to paroxetine or other SSRIs, although a causal relationship with drug therapy has not been established.

Neonates should be observed Heather (Norethindrone Tablets)- Multum maternal use of paroxetine continues into Heather (Norethindrone Tablets)- Multum later stages of pregnancy there. Reported clinical findings have included respiratory distress, cyanosis, apnoea, seizures, temperature instability, feeding difficulty, vomiting, hypoglycemia, hypotonia, hypertonia, hyperreflexia, tremor, jitteriness, irritability, lethargy, somnolence and constant crying.

In some neonates the complications have resulted in prolonged hospitalisation, respiratory support and tube feeding. Heather (Norethindrone Tablets)- Multum some instances the reported symptoms were described as neonatal withdrawal symptoms.

In a majority of instances the complications were reported to have arisen either immediately or soon ( Epidemiological studies have shown that the use of SSRIs (including paroxetine) in pregnancy, particularly use in late pregnancy, was associated with an Heather (Norethindrone Tablets)- Multum risk of persistent pulmonary hypertension of the newborn (PPHN).

The risk of PPHN among infants born to women who used SSRIs late in pregnancy was estimated to be 4 to 5 times higher than the rate of 1 to 2 per 1000 pregnancies observed in the general population. Studies in rats have shown increased pre- and post-implantation losses and decreased postnatal survival at dose levels producing maternal toxicity.

Animal reproduction studies are not always predictive of human response. The concentrations of paroxetine detected in the breast milk of lactating women are similar to those in plasma. The risk to the infant of paroxetine administration to lactating women is Heather (Norethindrone Tablets)- Multum. Therefore, this drug should not be used by lactating women unless the potential benefit outweighs the possible risk.

However, as with all psychoactive drugs, patients should be cautioned about their ability to drive a car and operate machinery. Adverse experiences with paroxetine are generally mild in nature and do not affect the patient's lifestyle. Adverse experiences may decrease in intensity and frequency with continued treatment and do not generally lead to cessation of therapy. Paroxetine is less likely than tricyclic antidepressants to be associated with dry mouth, constipation and somnolence. Heather (Norethindrone Tablets)- Multum following adverse events were observed during the clinical trial programs for depression, OCD and panic disorder.

All adverse experiences are included sneeze the list except those reported in terms so general as to be uninformative and those experiences for which the drug cause was remote. It should however be noted that causality has not necessarily been established, and that patients enrolled in the clinical trials may have been generally healthier than the general patient population.

Common: headache, asthenia, abdominal pain, fever, chest pain, trauma, back pain, malaise, pain. Rare: abnormal laboratory value, abscess, adrenergic syndrome, cellulitis, chills and fever, cyst, hernia, intentional overdose, neck rigidity, pelvic pain, peritonitis, substernal chest pain, ulcer. Common: palpitations, vasodilatation, postural hypotension, hypertension, syncope, tachycardia.

Uncommon: acne, alopecia, dry skin, ecchymosis, eczema, normal body temperature, herpes simplex, urticaria. Very rare: severe cutaneous adverse reactions (including erythema multiforme, Stevens-Johnson syndrome and toxic epidermal necrolysis.



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02.04.2020 in 07:39 Samuzuru:
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