Warnings for special population
Pregnancy
This medicine is not recommended for use in pregnant women unless absolutely necessary. The risks and benefits should be discussed with the doctor before taking this medicine.
Breast-feeding
This medicine is not recommended for use in breastfeeding women unless necessary. The risks and benefits should be discussed with the doctor before taking this medicine.
General warnings
Suicidal thinking and behavior
Use of this medicine may cause suicidal thought and change the behavior of the user. This risk is increasingly high in young patients. It is recommended to screen the patient for such behavior before starting the treatment. Any change in behavior and thought process after taking this medicine should be reported to the doctor immediately.
Serotonin syndrome
Use of this medicine with other medicines to treat depression may cause nausea, agitation, seizures and hallucinations (symptoms of serotonin syndrome)
Neuroleptic malignant syndrome
Use of this medicine may cause Neuroleptic malignant syndrome characterized by high fever, muscle stiffness, extreme changes in blood pressure, excessive sweating and salivation. The use of this medicine should be stopped as soon as these side effects are experienced.
Hypertension
Use of this medicine is associated with a sharp increase in blood pressure levels. Regular monitoring of blood pressure levels is necessary while receiving this medicine. Appropriate dose adjustments or replacement with a suitable alternative may be required in some cases based on the clinical condition.
Bleeding disorders
Use of this medicine may cause unusual bleeding and bruising and hence should be used with caution in patients suffering from bleeding disorders. Use of medicines that are known to cause gastrointestinal bleeding, (example: aspirin, paracetamol, ibuprofen etc), should be avoided while taking paroxetine.
Glaucoma
This medicine should be used with caution in patients suffering from angle closure glaucoma. The symptoms of this disease may worsen upon using paroxetine and hence caution is advised.
Seizure disorder
This medicine should be used with caution in patients with a known history of seizures due to the increased risk of worsening of the patient's condition.
Manic episodes
Use of this medicine may cause agitation and aggressive behavior in some patients. The patient should be screened for bipolar disorder before starting the treatment course with this medicine.
Heart disease
This medicine should be used with caution in patients suffering from a heart or blood vessel disorder. Appropriate dose adjustments or replacement with a suitable alternative may be required in some cases based on the clinical condition.
Hyponatremia
This medicine may cause hyponatremia in some patients. This risk is especially high in the elderly population and in patients who are volume-depleted or taking diuretics. Close monitoring of blood pressure and sodium levels is recommended for such patients. Appropriate dose adjustments or replacement with a suitable alternative may be required in some cases based on the clinical condition.
Bone fractures
Use of this medicine has been associated with an increase in the incidence of bone fractures. Report any incidence of bone pain to the doctor while taking paroxetine.
Driving or Operating machinery
This medicine may cause dizziness or drowsiness in some patients. It is advised that you do not perform any activities that require high mental alertness like driving a vehicle or operating machinery if you experience any of these symptoms during treatment with this medicine.
Sexual dysfunction
Use of this medicine may cause sexual dysfunction. These dysfunctions may include a decrease in libido, erectile disorders, or painful orgasm.
Withdrawal symptoms
This medicine may cause withdrawal symptoms if the usage is stopped abruptly. This risk is especially higher after prolonged usage of this medicine. The treatment should be withdrawn gradually under the close supervision of your doctor. Do not stop the use of this medicine without consulting your doctor.
Pediatric use
This medicine is not recommended for use in patients below 18 years of age since the safety and efficacy of use are not clinically established.
Use in elderly
This medicine should be used with extreme caution in the elderly population due to the increased risk of unusual adverse effects.