Dosage ; 20mg OD (Morning) (max.50mg daily but 40mg in elderly).
| Brand Name | Manufacturer Name | Distributor | Drug Strength | Packaging | Formulation | Formulation Strength | Price |
|---|---|---|---|---|---|---|---|
| Adco-paroxetine | Adcock ingram E.A. | Adcock ingram E.A. | 20mg | 30 | Tablet | per tablet | KES 2,625.00 |
| Seroxat | GlaxoSmithkline | GlaxoSmithKline | 20mg | 30 | Tablet | per tablet | KES 3,623.70 |
| Paroxetin | Metro | 20mg | 30s | Tablet | per tablet | KES 800.00 |
| Mode Of Action | Combined serotonin (5-HT) and noradrenaline (NA) re-uptake inhibitor e.g. Duloxetine |
|---|---|
| Drug Indication | Depression; obsessive-compulsive disorders; panic disorders with / without agoraphobia. |
| Precautions | Renal impairment; hepatic impairment; diabetes; epilepsy; extra-pyramidal reactions; discontinue if seizure develop; elderly; withdraw gradually; ECT therapy. |
| Contra-Indications | Safety in pregnancy, lactation and children has not been established; severe renal failure; manic phase of depression; within 14 days of MAOI administration; avoid MAOI 5 weeks after discontinuation of paroxetine (concurrent use results in confusion, agitation, restlessness, GI symptoms, hyperpyretic episodes, severe convulsions, hypertensive crises, the serotonin syndrome, or death); hypersensitivity to paroxetine and related drugs. |
| Side Effects | Headache; GI disturbances; dry mouth; Extrapyramidal symptoms; galactorrhoea; hyponatreamia; possible seizures; rash; asthenia; palpitation; vasodilatation; insomnia; drowsiness; nervousness; anxiety; tremor. |
| Dosage | 20mg OD (Morning) (max.50mg daily but 40mg in elderly). |
| Special Information | Less sedative than tricylics |
| Pregnancy Category | Category B2 |
| Pregnancy Category Description | Drugs which have been taken by only a small number of pregnant women and women of child-bearing age with no any established rise in the frequency of malformations or other direct or indirect detrimental effects on the foetus having been noted. Studies in animals are inadequate or lacking but available data show no evi-dence of an increased occurrence of foetal damage. Studies in animals are inadequate or lacking but available data show no evi-dence of an increased occurrence of foetal damage. |
| Drug Category | DRUGS ACTING ON CNS |
| Drug Sub-Category | Antidepressants, anxiolytics
Dosing: Adult Major depressive disorder: Oral: PaxilŽ, PexevaŽ: Initial: 20 mg once daily, preferably in the morning; increase if needed by 10 mg/day increments at intervals of at least 1 week; maximum dose: 50 mg/day Paxil CRŽ: Initial: 25 mg once daily; increase if needed by 12.5 mg/day increments at intervals of at least 1 week; maximum dose: 62.5 mg/day Generalized anxiety disorder (PaxilŽ, PexevaŽ): Oral: Initial: 20 mg once daily, preferably in the morning (if dose is increased, adjust in increments of 10 mg/day at 1-week intervals); doses of 20-50 mg/day were used in clinical trials, however, no greater benefit was seen with doses >20 mg. Obsessive-compulsive disorder (PaxilŽ, PexevaŽ): Oral: Initial: 20 mg once daily, preferably in the morning; increase if needed by 10 mg/day increments at intervals of at least 1 week; recommended dose: 40 mg/day; range: 20-60 mg/day; maximum dose: 60 mg/day Panic disorder: Oral: PaxilŽ, PexevaŽ: Initial: 10 mg once daily, preferably in the morning; increase if needed by 10 mg/day increments at intervals of at least 1 week; recommended dose: 40 mg/day; range: 10-60 mg/day; maximum dose: 60 mg/day Paxil CRŽ: Initial: 12.5 mg once daily; increase if needed by 12.5 mg/day at intervals of at least 1 week; maximum dose: 75 mg/day Premenstrual dysphoric disorder (Paxil CRŽ): Oral: Initial: 12.5 mg once daily in the morning; may be increased to 25 mg/day; dosing changes should occur at intervals of at least 1 week. May be given daily throughout the menstrual cycle or limited to the luteal phase. Post-traumatic stress disorder (PaxilŽ): Oral: Initial: 20 mg once daily, preferably in the morning; increase if needed by 10 mg/day increments at intervals of at least 1 week; range: 20-50 mg. Limited data suggest doses of 40 mg/day were not more efficacious than 20 mg/day. Social anxiety disorder: Oral: PaxilŽ: Initial: 20 mg once daily, preferably in the morning; recommended dose: 20 mg/day; range: 20-60 mg/day; doses >20 mg may not have additional benefit Paxil CRŽ: Initial: 12.5 mg once daily, preferably in the morning; may be increased by 12.5 mg/day at intervals of at least 1 week; maximum dose: 37.5 mg/day Menopause-associated vasomotor symptoms (unlabeled use, Paxil CRŽ): Oral: 12.5-25 mg/day Note: Upon discontinuation of paroxetine therapy, gradually taper dose: PaxilŽ, PexevaŽ: 10 mg/day at weekly intervals; when 20 mg/day dose is reached, continue for 1 week before treatment is discontinued. Some patients may need to be titrated to 10 mg/day for 1 week before discontinuation. Paxil CRŽ: Patients receiving 37.5 mg/day in clinical trials had their dose decreased by 12.5 mg/day to a dose of 25 mg/day and remained at a dose of 25 mg/day for 1 week before treatment was discontinued. Dosing: Pediatric Depression (unlabeled use; not recommended by FDA): Oral: Initial: 10 mg/day and adjusted upward on an individual basis to 20 mg/day Obsessive-compulsive disorder (unlabeled use): Oral: Initial: 10 mg/day and titrate up as necessary to 60 mg/day Self-injurious behavior (unlabeled use): Oral: 20 mg/day Social anxiety disorder (unlabeled use): Oral: 2.5-15 mg/day Dosing: Geriatric Major depressive disorder, obsessive compulsive disorder, panic attack, social anxiety disorder: PaxilŽ, PexevaŽ: Oral: Initial: 10 mg/day; increase if needed by 10 mg/day increments at intervals of at least 1 week; maximum dose: 40 mg/day Paxil CRŽ: Initial: 12.5 mg/day; increase if needed by 12.5 mg/day increments at intervals of at least 1 week; maximum dose: 50 mg/day Note: Upon discontinuation of paroxetine therapy, gradually taper dose: PaxilŽ, PexevaŽ: 10 mg/day at weekly intervals; when 20 mg/day dose is reached, continue for 1 week before treatment is discontinued. Some patients may need to be titrated to 10 mg/day for 1 week before discontinuation. Paxil CRŽ: Patients receiving 37.5 mg/day in clinical trials had their dose decreased by 12.5 mg/day to a dose of 25 mg/day and remained at a dose of 25 mg/day for 1 week before treatment was discontinued. Dosing: Renal Impairment Clcr <30 mL/minute: Mean plasma concentrations ~4 times that seen in normal function. Clcr 30-60 mL/minute: Plasma concentrations 2 times that seen in normal function. PaxilŽ, PexevaŽ: Adults: Initial: 10 mg/day; increase if needed by 10 mg/day increments at intervals of at least 1 week; maximum dose: 40 mg/day Paxil CRŽ: Initial: 12.5 mg/day; increase if needed by 12.5 mg/day increments at intervals of at least 1 week; maximum dose: 50 mg/day Dosing: Hepatic Impairment In hepatic dysfunction, plasma concentration is 2 times that seen in normal function. PaxilŽ, PexevaŽ: Initial: 10 mg/day; increase if needed by 10 mg/day increments at intervals of at least 1 week; maximum dose: 40 mg/day Paxil CRŽ: Initial: 12.5 mg/day; increase if needed by 12.5 mg/day increments at intervals of at least 1 week; maximum dose: 50 mg/day |