How to take Paroxetine (Paxil)?
Ensure to read and understand the Patient Information Leaflet provided by your pharmacist before you start using Paroxetine (Paxil). If there are any doubts ask your doctor or pharmacist.

Take Paroxetine (Paxil) tablet with a glass of water with or without food as per your doctor's advice. Usually it is recommended to take once a day in the morning. If you have nausea, take this medicine with food. If Paroxetine makes you drowsy during the day, talk to your doctor about switching the dose to bedtime.

Your dosage will be decided upon your medical condition, age, laboratory tests, your response to the medication and other medications that you are taking. Take Paroxetine exactly as it was prescribed for you. Do not take in doses which are either larger or for longer than what is recommended by your doctor.Inform your doctor about any medications that you are taking including prescription medications, over the counter medications, vitamins, supplements and herbal remedies.In order to reduce the side effects your doctor may start Paroxetine at a low dosage and gradually will increase the dosage over time. Take Paroxetine exactly as it was prescribed for you. Do not take in doses which are either larger or for longer than what is recommended by your doctor. Make sure to take Paroxetine regularly to get the most benefit from it.

If you are prescribed Paroxetine (Paxil) for premenstrual problems, you may have been asked to take every day for a month or just for 2 weeks prior to your period through the first full day of your period.

Paroxetine (Paxil) needs to be continued even if you feel well. It should not be discontinued without consulting your doctor. Sometimes your condition may get worse when you stop the medication abruptly. It may also cause mood swings, tiredness, headache, sleep changes, brief feelings similar to that of electric shock. In order to stop this medication your doctor may decrease your dosage gradually. If you develop any new symptoms keep your doctor well informed.

To feel the benefit of this medication it may take a couple of weeks.

Precautions
Prior to taking Paroxetine (Paxil) inform your doctor if you have

• any allergies to Paroxetine (Paxil) or any other allergies
• low sodium in the blood
• seizures
• intestinal ulcers / bleeding (peptic ulcer disease)
• liver disease
• kidney disease
• bleeding problems
• personal or family history of glaucoma
• personal or family history of bipolar / manic disorder
• personal or family history of suicide attempts

Paroxetine (Paxil) may make you dizzy, confused or disoriented. Consumption of alcohol or marijuana can increase the risk of drowsiness. Do not operate machinery, drive a car or do anything that require alertness until you can do it safely. Understand how this medication affects you. Do not take any alcoholic beverages.

If you are having surgery prior to your surgery, inform your doctor or the dentist of all the products (prescription, non- prescription medications, herbal products, vitamin and supplements) you are taking.

Older adult patients may be more sensitive to the side effects of this drug. They may experience

• bleeding
• salt imbalance
• loss of coordination

Older adults have a higher risk of falling due to loss of coordination.

Loss of appetite and weight loss often seen in children as a side effect among those who are taking Duloxetine. Children may be more sensitive to side effects of this medication. Need to monitor weight and height in children who are taking Paroxetine.

If you are pregnant, you must take Paroxetine (Paxil) only if it's absolutely necessary. Unborn baby may be harmed by Paroxetine. If the mother has been taking Paroxetine during the last 3 months of the pregnancy the babies may rarely develop withdrawal symptoms such as breathing or feeding difficulties, muscle stiffness, seizures or constant crying. Consult your doctor immediately if you notice these symptoms in your new born. If you are planning a pregnancy, become pregnant or think you may be pregnant discuss with your doctor the risks and the benefits involved.

Nursing mothers must discuss with the doctor if it is safe to feed the baby while taking Paroxetine as it passes into breast milk and may have undesirable effects on a nursing infant.

Side Effects
Your doctor prescribed this medicine after carefully analyzing the benefits over the risks involved. Most people do not experience any serious side effects.

• dry mouth
• dizziness
• nausea
• drowsiness
• loss of appetite
• unusual sweating
• blurred vision
• trouble sleeping
• yawning
• weakness

Inform your doctor immediately if you experience any of the serious side effects mentioned below.

• low libido
• shaking (tremor)
• easy bruising / bleeding
• changes in sexual ability

A serious allergy reaction is extremely rare with Paroxetine. In case you show the following symptoms get to the emergency clinic

• itching
• fainting
• black stools
• swelling in the face, throat, tongue, throat
• rash - itching
• vomit that looks like coffee grounds
• irregular / fast heartbeat
• eye pain / swelling/ vision changes/ widened pupils

Interactions
Inform your doctor about any medications that you are taking including prescription medications, over the counter medications, vitamins, supplements and herbal remedies. Do not start, stop and change the dosage of any medicine without your doctor's permission.

Some of the medications which cause drowsiness may interact with Paroxetine (Paxil) is

• blood thinners (warfarin)
• antiplatelet drugs (clopidogrel)
• NSAIDS (ibruprofen)

Paroxetine when taken with aspirin the risk of bleeding is increased. If your doctor has prescribed a low dosage aspirin in order to prevent a heart attack or a stroke you should continue taking it unless your doctor advices you otherwise.

Paroxetine taken together with MAO inhibitors can cause serious drug interaction. You need to avoid MAO inhibitors (linezolid, rasagiline, phenelzine, procabazine, methylene blue, isocarboxazid, safinamide, tranylcypromine) during the time of treatment.

Most MAO shouldn't be taken for two weeks before and after treatment with Paroxetine.