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Buy Paroxetine (Paxil, Paxil CR) online Product Name: Paroxetine

Generics: Paroxetine

Common Brand Names: Paxil

Pharmaceutical Category: Antidepressants / Anti Anxiety

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There is an additional general information about this medication active ingredient paroxetine:

Pharmacological action

Paroxetine is an antidepressant, selective serotonin reuptake inhibitor. This medication has a bicyclic structure distinct from the structures of other known antidepressants. Paroxetine has antidepressant and anxiolytic effects when expressed enough incentive (activated) effect.
Antidepressant (thymoleptic) action is related to the ability of paroxetine selectively block the reuptake of serotonin presynaptic membrane than is caused by increase of free content of this neurotransmitter in the synaptic cleft and enhancement of its activity in the CNS.
Effect on the m-cholinergic receptors, alpha- and beta-adrenergic receptors is only slightly which determines the extremely weak intensity of the side effects.

Pharmacokinetics

After oral administration Paroxetine is well absorbed from the gastrointestinal tract. Ingestion did not affect absorption. Css is set to the 7-14 day since the start of therapy. The major metabolites of paroxetine are polar and conjugated products of oxidation and methylation. Due to the low pharmacological activity of metabolites their impact on therapeutic efficacy is unlikely.
T1/2 on average is 16-24 hours. Less than 2% excreted in the urine in unchanged form, the rest - in the form of metabolites or urine (64%), or bile.
Excretion of paroxetine is biphasic.
With long-term continuous using of this drug pharmacokinetic parameters do not change.

Why is Paroxetine prescribed?

Endogenous, neurotic and reactive depression.

Dosage and administration

When Paroxetine administered orally an initial dose is 10-20 mg / day. If necessary, depending on the evidence, the dose was increased to 40-60 mg / day. Increasing the dose spend gradually on 10 mg with intervals of 1 week. Frequency of admission is 1 time / day. The treatment of long-term. Treatment's efficacy is assessed after 6-8 weeks.
For elderly and debilitated patients, as well as renal impairment and hepatic the initial dose is 10 mg / day, the maximum dose is 40 mg / day.

Paroxetine side effects

CNS: rarely (when used in doses more than 20 mg) - drowsiness, tremor, fatigue, insomnia.
Digestive system: rarely (when used in doses more than 20 mg) - nausea, dry mouth, and in some cases constipation. Other: rarely (when used in doses more than 20 mg) - increased sweating, ejaculation disorders.

Paroxetine contraindications

Simultaneous treatment with MAO inhibitors, and the period up to 14 days after their withdrawal, hypersensitivity to paroxetine.

Restrictions for using

Angle-closure glaucoma, prostate adenoma, pregnancy (the appointment is permissible only if absolutely necessary) and breastfeeding.

Using during pregnancy and breastfeeding

Category effects on the fetus by FDA - C.

Special instructions

Stop taking of Paroxetine should be gradually reducing the dose to avoid withdrawal syndrome, which manifests itself dizziness, nausea, vomiting, insomnia, confusion, increased sweating.
There is contraindicated drinking alcohol during the treatment with paroxetine.
Be wary of over 14 days after taking of MAO inhibitors, gradually increasing the dose. MAO inhibitors should not be administered within 2 weeks after complete withdrawal of paroxetine.
Simultaneous administration with drugs that inhibit the metabolism of liver enzymes, Paroxetine should be used in the smallest recommended doses.
In simultaneous use with drugs that induce the metabolism of enzymes it does not required any changes in the initial doses of paroxetine.
Be wary of using paroxetine with lithium therapy (recommended to monitor the lithium concentration in blood plasma) and oral anticoagulants.
There was not found carcinogenic and mutagenic properties of paroxetine in experimental studies.
Use Paroxetine with caution in patients whose activities are connected with the necessity of high concentration of attention and quickness of psychomotor reactions.

Paroxetine drug interactions

Simultaneous administration of Paroxetine with:
  • paroxetine may increase the plasma concentrations of any drugs metabolized with the participation of CYP2D6 isoenzyme of cytochrome P450 (antidepressants, antipsychotics derivatives of phenothiazine antiarrhythmic drugs of class IC);
  • medications inducing or inhibiting protein metabolism, there may be changes in the metabolism and pharmacokinetic parameters of paroxetine;
  • enhances the action of alprazolam due to the decrease of its metabolism due to inhibition of CYP3A isozymes of cytochrome P450 under the influence of Paroxetine;
  • warfarin, oral anticoagulants may increase bleeding time in unaltered prothrombin time;
  • dextromethorphan, dihydroergotamine described cases of serotonin syndrome;
  • interferon it is possible to change the antidepressant action of paroxetine;
  • tryptophan can cause the development of serotonin syndrome which manifests itself agitation, anxiety, disorders of the gastrointestinal tract, including diarrhea;
  • perphenazine increases the side effects of the CNS by inhibiting the metabolism of perphenazine under the influence of paroxetine;
  • increased plasma concentration of tricyclic antidepressants, the risk of serotonin syndrome.
  • cimetidine increases the concentration of paroxetine in plasma.

    Paroxetine in case of emergency / overdose

    Symptoms: nausea, vomiting, drowsiness, sinus tachycardia, dilated pupils, etc.
    Treatment: symptomatic; to remove from the stomach not absorbed part of this drug it is necessary to induce vomiting or gastric lavage.

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