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Overview

This article describes possible interactions with paroxetine’s immediate-release (IR) oral tablet. (IR tablets release the medication into your body all at once.) Interactions can cause a drug to have a different effect on the body than expected. Interactions can occur due to medications, alcohol, or certain health conditions.

Paroxetine also comes as an extended-release (ER) tablet that you swallow. (ER tablets release the medication into your body gradually over a few hours.) It’s also available as a suspension, which is a type of liquid mixture that you swallow.

Boxed warning: Risk of suicidal thoughts and behaviors

Paroxetine has a boxed warning for the risk of suicidal thoughts and behaviors. A boxed warning is the most serious warning from the Food and Drug Administration (FDA).

See the end of this article for more information about this warning.

Other drugs and paroxetine

The drugs in the list below may interact with paroxetine oral tablet. This article doesn’t include all drugs that may interact with paroxetine.

Drug classes or drugs that may interact with paroxetine oral tablet include:

  • monoamine oxidase inhibitors (MAOIs):*
    • drug example: phenelzine (Nardil)
    • what might happen: higher risk of serotonin syndrome (a serious condition caused by high levels of serotonin in the body)
  • certain antibiotics:
    • drug example: linezolid (Zyvox)
    • what might happen: higher risk of serotonin syndrome
  • certain antipsychotics:*
    • drug examples: pimozide (Orap), thioridazine (Mellaril)
    • what might happen: higher risk of irregular heart rhythm
  • other antidepressants (paroxetine is an antidepressant drug):
    • drug examples: venlafaxine (Effexor XR), citalopram (Celexa)
    • what might happen: higher risk of serotonin syndrome
  • triptans for migraine:
    • drug examples: sumatriptan (Imigran), eletriptan (Relpax)
    • what might happen: higher risk of serotonin syndrome
  • opioid pain relievers:
    • drug examples: tramadol (ConZip, Ultram), fentanyl (Duragesic, Subsys, Actiq, others), morphine (MS Contin, others)
    • what might happen: higher risk of serotonin syndrome
  • amphetamine or stimulant drugs:
    • drug examples: amphetamine and dextroamphetamine (Adderall, Mydayis), methylphenidate (Ritalin)
    • what might happen: higher risk of serotonin syndrome
  • blood thinners:
    • drug examples: aspirin, warfarin (Jantoven)
    • what might happen: higher risk of bleeding
  • nonsteroidal anti-inflammatory drugs (NSAIDs):
    • drug examples: ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn)
    • what might happen: higher risk of bleeding
  • lithium (Lithobid):
    • what might happen: higher risk of serotonin syndrome
  • buspirone (BuSpar):
    • what might happen: higher risk of serotonin syndrome
  • tamoxifen (Soltamox):
    • what might happen: can make tamoxifen less effective

* You should not take paroxetine oral tablet with these drugs. See the “When to avoid paroxetine” section below.

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When to avoid paroxetine

Certain health conditions or other factors could increase some risks with paroxetine oral tablet. Because of this, doctors may not prescribe paroxetine in these cases. These health conditions or other factors are called contraindications.

Here’s a list of paroxetine contraindications for the oral tablet:

  • Monoamine oxidase inhibitors (MAOIs). If you take an MAOI drug, taking paroxetine oral tablet as well may cause serotonin syndrome. This is a serious side effect caused by high levels of serotonin in your body. You should not take paroxetine after stopping an MAOI until at least 14 days have passed. Examples of MAOIs include certain antidepressants, such as:
    • phenelzine (Nardil)
    • the antibiotic linezolid (Zyvox)
    • a blood disorder treatment called methylene blue (ProvayBlue)
  • Pimozide or thioridazine. Pimozide (Orap) and thioridazine (Mellaril) are antipsychotic drugs. Taking either of these drugs and also taking paroxetine oral tablet may cause dangerous irregular heart rhythms.
  • Past allergic reaction to paroxetine. If you’ve ever had an allergic reaction to paroxetine oral tablet, taking it again may cause another allergic reaction. The same is true if you’ve ever had an allergic reaction to any of paroxetine oral tablet’s ingredients.

Before you start taking paroxetine, tell your doctor if anything listed above relates to you. They can recommend whether you should take paroxetine.

Alcohol and paroxetine

Paroxetine interactions with alcohol are possible. Taking paroxetine oral tablet and drinking alcohol may cause increased side effects such as:

  • sleepiness
  • nausea
  • diarrhea
  • difficulties with sexual health

If you drink alcohol, talk with your doctor about whether it’s safe to consume it while taking paroxetine oral tablet.

Other interactions and paroxetine

Interactions can occur with supplements, foods, vaccines, and some lab tests. Below you can learn whether paroxetine oral tablet has these interactions.

The information below doesn’t include all other interactions possible with paroxetine.

Paroxetine and supplements

Before taking paroxetine oral tablet, tell your doctor and pharmacist about any herbs you take, as well as vitamins and supplements. Doing so may help you avoid interactions.

Paroxetine oral tablet may interact with tryptophan. This supplement is often used for depression, sleep problems, and other conditions.

Taking paroxetine and tryptophan may lead to serotonin syndrome. This is a serious condition caused by high levels of serotonin in your body. Because of this, you should avoid taking paroxetine oral tablet with tryptophan.

If you have questions about other supplement interactions that may affect you, talk with your doctor or pharmacist.

Paroxetine interactions with herbs

Paroxetine oral tablet may interact with St. John’s wort. This herb is often used for depression and other conditions.

Taking paroxetine and St. John’s wort may lead to serotonin syndrome. This is a serious condition caused by high levels of serotonin in your body. Because of this, you should avoid taking paroxetine oral tablet with St. John’s wort.

Ask your doctor or pharmacist before taking any other herbal products while taking paroxetine oral tablet.

Paroxetine interactions with vitamins

Paroxetine oral tablet isn’t known to interact with any vitamins. But this doesn’t mean interactions with vitamins can’t happen or won’t be identified later.

Because of this, ask your doctor or pharmacist before taking any of these products while taking paroxetine oral tablet.

Paroxetine and food

Paroxetine oral tablet isn’t known to interact with foods. But this doesn’t mean interactions with foods can’t happen or won’t be identified later.

Because of this, talk with your doctor or pharmacist about what foods you should avoid while taking paroxetine oral tablet.

Paroxetine and vaccines

Paroxetine oral tablet isn’t known to interact with any vaccines. But this doesn’t mean interactions with vaccines can’t happen or won’t be identified later.

Because of this, talk with your doctor or pharmacist before receiving any vaccines while taking paroxetine oral tablet.

Paroxetine and lab tests

Paroxetine oral tablet isn’t known to interact with lab tests. But this doesn’t mean interactions with lab tests can’t happen or won’t be identified later.

Because of this, talk with your doctor or pharmacist before having any tests while taking paroxetine oral tablet.

Paroxetine and cannabis or CBD

Paroxetine oral tablet isn’t known to interact with cannabis (commonly called marijuana) or cannabis products such as cannabidiol (CBD). But this doesn’t mean interactions can’t happen or won’t be identified later.

As with any drug or supplement, tell your doctor before taking cannabis with paroxetine.

Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.

Questions about paroxetine and interactions

Here you’ll find answers to some common questions about paroxetine and possible interactions.

Are there paroxetine interactions with antibiotics?

Paroxetine doesn’t interact with many antibiotics. In many cases, it’s safe to take paroxetine oral tablet with antibiotics. But you should not take paroxetine oral tablet with an antibiotic called linezolid (Zyvox). Taking paroxetine with this particular antibiotic can raise your risk of serotonin syndrome. This is a serious side effect caused by high levels of serotonin in your body.

If you have questions about taking paroxetine oral tablet with other antibiotics, talk with your doctor or pharmacist.

What pain relievers can I take with paroxetine?

While taking paroxetine oral tablet, it’s generally safe to take acetaminophen (Tylenol) to relieve pain.

Taking an anti-inflammatory pain reliever with paroxetine may raise your risk of bleeding. This includes drugs such as ibuprofen (Advil, Motrin).

Taking an opioid pain reliever with paroxetine may raise your risk of serotonin syndrome. This includes drugs such as morphine (MS Contin, others). Serotonin syndrome is a serious side effect caused by high levels of serotonin in your body.

Talk with your doctor before taking pain relievers with paroxetine oral tablet to be sure they’re safe for you.

Health factors and paroxetine

Certain medical conditions or other health factors may increase the risk of interactions with paroxetine oral tablet. Keep in mind that interactions could lead to side effects or affect how well the drug works. Before taking paroxetine, tell your doctor about your health history. They’ll determine whether paroxetine is right for you.

These health conditions or other factors might interact with paroxetine oral tablet:

Preventing paroxetine interactions

You may be able to help avoid certain interactions with paroxetine oral tablet. Before taking this drug, you may want to discuss possible interactions with your doctor and pharmacist.

Things to consider include:

  • Whether you drink alcohol or use cannabis.
  • Other medications and herbs you take, as well as vitamins and supplements. Your doctor or pharmacist can help you fill out a medication list.
  • What to do if you’re prescribed a new drug while taking paroxetine oral tablet.

Taking paroxetine exactly as prescribed can also help prevent interactions.

What to ask your doctor

If you have questions about paroxetine and possible interactions, talk with your doctor.

Questions you may want to ask your doctor include:

  • Does paroxetine oral tablet interact with my other medications?
  • Does my risk of interactions depend on my dosage of paroxetine oral tablet?
  • I might take medication or have a health factor that interacts with paroxetine oral tablet. If so, will you need to monitor me more closely?

Boxed warning for paroxetine

Paroxetine has a boxed warning for the risk of suicidal thoughts and behaviors. A boxed warning is the most serious warning from the Food and Drug Administration (FDA).

In people under 25 years old, antidepressants such as paroxetine can raise the risk of suicidal thoughts and behaviors. The risk is highest in the first few weeks after starting paroxetine and after any dosage changes. Doctors typically won’t prescribe paroxetine oral tablet for children (younger than 18 years old).

While taking paroxetine, watch for any new or unusual changes in your mood, feelings, thoughts, or behavior. If you experience any, call your doctor right away. It’s helpful to have other people watch for any changes in your mood and behavior as well. You might consider a close friend or family member.

To learn more about this boxed warning, talk with your doctor.

Suicide prevention

If you or someone you know is in crisis and considering suicide or self-harm, please get support:

If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.

If you aren’t in the same household, stay on the phone with them until help arrives.

Disclaimer: Optum Perks has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

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