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PAXIL CR is a brand name for Paroxetine, supplied as a tablet (extended-release). The medicine, its uses, side effects and dosage are the same regardless of brand.
Used for: PAXIL CR (paroxetine hydrochloride) is indicated in adults for the symptomatic relief of: Major Depressive Disorder (MDD) Panic Disorder (with or without agoraphobia) Social Phobia (Social Anxiety Disorder) Premenstrual Dysphoric Disorder (PMDD) Long-Term Use of PAXIL CR: PAXIL CR has not been systematically…
Verbatim from this product's HC label. Tap a section to expand.
). 2 CONTRAINDICATIONS PAXIL CR (paroxetine hydrochloride) is contraindicated: Hypersensitivity: In patients who are hypersensitive to this drug or any ingredient in the formulation, including any non-medicinal ingredient, or component of the container.
For a complete listing, see
, Adverse Reactions Following Discontinuation of Treatment). A gradual reduction in the dose rather than abrupt cessation is recommended whenever possible. If intolerable symptoms occur following a decrease in the dose or upon discontinuation of treatment, dose titration should be managed on the basis of the patient’s clinical response (see 8 ADVERSE REACTIONS).
Special Patient Populations For any indication: Pediatrics (<18 years):
Health Canada has not authorized an indication for pediatric use (see 7 WARNINGS AND PRECAUTIONS, Potential Association with Behavioural and Emotional Changes, Including Self-Harm). Geriatrics (> 65 years) or Debilitated: Administration of PAXIL CR to the elderly is associated with increased plasma levels and prolongation of the elimination half-life relative to younger adults (See 10 CLINICAL PHARMACOLOGY).
5 mg/day for elderly patients and debilitated patients. The dose may be increased, if indicated, up to a maximum of 50 mg/day. Renal/Hepatic Insufficiency: PAXIL CR should be used with caution in patients with renal or hepatic impairment.
5 mg/day in patients with clinically significant renal or hepatic impairment. A maximum dose of 50 mg/day should not be exceeded (see 7 WARNINGS AND PRECAUTIONS, Renal and 10 CLINICAL PHARMACOLOGY). g. ventricular and atrial septal defects), associated with the use of paroxetine.
1 Special Populations) and consideration PAXIL CR, paroxetine hydrochloride Page 9 of 66 should be given to switching to other treatment options. Treatment with PAXIL CR should only be continued for an individual patient if the potential benefits outweigh the potential risks.
1 Special Populations). 1 Special Populations). When treating pregnant women with PAXIL CR during the third trimester, the health professional should carefully consider the potential risks and benefits of treatment. The health professional may consider tapering PAXIL CR in the third trimester.
1 Pregnant Women 10/2021 TABLE OF CONTENTS Sections or subsections that are not applicable at the time of authorization are not listed . RECENT MAJOR LABEL CHANGES............................................................................................
2 TABLE OF CONTENTS .............................................................................................................. 2 PART I: HEALTH PROFESSIONAL INFORMATION .....................................................................
5 1 INDICATIONS .............................................................................................................. 1 Pediatrics ..........................................................................................................
2 Geriatrics........................................................................................................... 5 2 CONTRAINDICATIONS .................................................................................................
5 3 SERIOUS WARNINGS AND PRECAUTIONS BOX ............................................................ 6 4 DOSAGE AND ADMINISTRATION................................................................................. 1 Dosing Considerations .......................................................................................
2 Recommended Dose and Dosage Adjustment..................................................... 4 Administration................................................................................................... 5 Missed Dose ......................................................................................................
9 5 OVERDOSAGE ............................................................................................................. 9 6 DOSAGE FORMS, STRENGTHS, COMPOSITION AND PACKAGING ............................... 10 7 WARNINGS AND PRECAUTIONS ................................................................................
PAXIL CR (paroxetine hydrochloride) is contraindicated: Hypersensitivity:
In patients who are hypersensitive to this drug or any ingredient in the formulation, including any non-medicinal ingredient, or component of the container. For a complete listing, see 6 DOSAGE FORMS, STRENGTHS, COMPOSITION AND PACKAGING.
4 Drug-Drug Interactions). 4 Drug-Drug Interactions . Pimozide: In combination with pimozide or within a minimum of 2 weeks of terminating treatment with pimozide. 4 Drug-Drug Interactions).
Not medical advice. Always read the patient information leaflet and follow your prescriber or pharmacist.
Other brands of Paroxetine in Canada.
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Brand names are compiled from public regulatory records for active-ingredient mapping only. Drugvu is not affiliated with any manufacturer. This is not medical advice.
4 Administration PAXIL CR should be administered as a single daily dose, usually in the morning, with or without food. Patients should be cautioned that the PAXIL CR tablet should not be chewed or crushed and should be swallowed whole.
5 Missed Dose If a dose of PAXIL CR is missed at its usual time, it should be taken as soon as possible, unless it is too close to the time of the next dose. The missed dose should be skipped if it is almost time for the next regular dose.
Two doses should not be taken at the same time. 5 OVERDOSAGE The largest known ingestion from which a patient has recovered is 2,000 mg. The smallest known dose of paroxetine alone associated with a fatal outcome is approximately 400 mg.
Symptoms The most commonly reported adverse events subsequent to paroxetine-only overdose include: somnolence, nausea, tremor, dizziness, vomiting, diarrhea, agitation, aggression, anxiety, confused state, headache, fatigue, insomnia, tachycardia, hyperhydrosis, mydriasis, convulsion, paresthesia, serotonin syndrome, fever, blood pressure changes, involuntary muscle contraction and loss of consciousness.
It should be noted that in some cases, patients may have consumed alcohol in addition to taking an overdose of paroxetine. Some of these symptoms may also be seen with clinical use. Events such as coma and ECG changes have also been reported.
Treatment:
The health professional should consider contacting a poison control centre for additional information on the treatment of any overdose. No specific antidote is known. Treatment should consist of those general measures employed in the management of overdose with any antidepressant.
Establish and maintain an airway; ensure adequate oxygenation and ventilation. Induction of emesis is not recommended. Due to the large volume of distribution of PAXIL CR, forced diuresis, dialysis, hemoperfusion and exchange transfusion are unlikely to be of benefit.
Supportive care with frequent monitoring of vital signs and careful observation is indicated. An ECG should be taken and monitoring of cardiac function instituted if there is any evidence of abnormality. PAXIL CR, paroxetine hydrochloride Page 10 of 66 Patient management should be as clinically indicated, or as recommended by the national poisons centre, where available.
In managing overdosage, consider the possibility of multiple drug involvement. A specific caution involves patients taking or recently having taken PAXIL CR who might ingest, by accident or intent, excessive quantities of a tricyclic antidepressant.
In such a case, accumulation of the parent tricyclic and its active metabolite may increase the possibility of clinically significant sequelae and extend the time needed for close medical observation. For management of a suspected drug overdose, contact your regional poison control centre.
5 mg (yellow tablets) and 25 mg (pink tablets) , paroxetine free base. […]
1 Special Populations .......................................................................................... 1 Pregnant Women ....................................................................................... 2 Breast-feeding............................................................................................
3 Pediatrics ................................................................................................... 4 Geriatrics ................................................................................................... 18 8 ADVERSE REACTIONS ................................................................................................
1 Adverse Reaction Overview.............................................................................. 2 Clinical Trial Adverse Reactions ........................................................................ 1 Clinical Trial Adverse Reactions – Pediatrics ................................................
3 Less Common Clinical Trial Adverse Reactions .................................................. 4 Abnormal Laboratory Findings: Hematologic, Clinical Chemistry and Other Quantitative Data ......................................................................................................
5 Post-Market Adverse Reactions........................................................................ 37 9 DRUG INTERACTIONS................................................................................................ 1 Serious Drug Interactions .................................................................................
2 Drug Interactions Overview.............................................................................. 3 Drug-Behavioral Interactions............................................................................ 4 Drug-Drug Interactions ....................................................................................
5 Drug-Food Interactions .................................................................................... 6 Drug-Herb Interactions .................................................................................... 7 Drug-Laboratory Test Interactions ....................................................................
46 10 CLINICAL PHARMACOLOGY ....................................................................................... 1 Mechanism of Action.................................................................................. 2 Pharmacodynamics ....................................................................................
3 Pharmacokinetics....................................................................................... 47 11 STORAGE, STABILITY AND DISPOSAL ......................................................................... 50 12 SPECIAL HANDLING INSTRUCTIONS...........................................................................
50 PART II: SCIENTIFIC INFORMATION ...................................................................................... 51 13 PHARMACEUTICAL INFORMATION............................................................................ 51 14 CLINICAL TRIALS........................................................................................................
1 Clinical Trials by Indication.......................................................................... 52 Major Depressive Disorder ........................................................................................ 52 Panic Disorder (with or without agoraphobia) […]