Anxiety/OCD:
Indications for: PEXEVA
Panic disorder (PD). Obsessive-compulsive disorder (OCD). Generalized anxiety disorder (GAD).
Adult Dosage:
Give once daily, usually in the AM; adjust by 10mg/day at 1-week intervals. PD: initially 10mg/day; max 60mg/day. OCD: initially 20mg/day; max 60mg/day. GAD: initially 20mg/day; max 50mg/day. Elderly, severe renal or severe hepatic impairment: initially 10mg/day; max 40mg/day.
Children Dosage:
Not established.
PEXEVA Contraindications:
Concomitant pimozide, thioridazine. During or within 14 days of MAOIs (including linezolid, IV methylene blue).
Boxed Warning:
Suicidal thoughts and behaviors.
PEXEVA Warnings/Precautions:
Increased risk of suicidal thoughts and behavior in children and young adults; monitor all patients for clinical worsening or unusual changes. Monitor for serotonin syndrome; discontinue and treat if occurs. Screen for bipolar disorder, mania, or hypomania. Seizure disorder. Risk for bleeding events. Angle-closure glaucoma. Avoid in untreated anatomically narrow angles. Volume-depleted. Hyponatremia (esp. in elderly). Bone fracture risk. Sexual dysfunction. Write ℞ for the smallest practical amount. Avoid abrupt cessation; reduce dose gradually. Reevaluate periodically. Renal and/or hepatic impairment. Elderly. Labor & delivery. Pregnancy (during 3rd trimester; see full labeling for effects on neonates). Nursing mothers.
PEXEVA Classification:
SSRI.
PEXEVA Interactions:
See Contraindications. Do not start MAOI until at least 2 weeks after discontinuing paroxetine. Increased risk of serotonin syndrome with other serotonergic drugs (eg, other SSRIs, SNRIs, triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, meperidine, methadone, tryptophan, buspirone, amphetamines, St. John's Wort) or with drugs that impair serotonin metabolism (eg, MAOIs, linezolid, IV methylene blue). Potentiation with other protein bound drugs. Increased risk of bleeding with aspirin, NSAIDs, clopidogrel, heparin, warfarin, or others that affect coagulation. May affect, or be affected by, drugs metabolized by CYP2D6 (eg, propafenone, flecainide, atomoxetine, desipramine, dextromethorphan, metoprolol, nebivolol, perphenazine, tolterodine, venlafaxine, risperidone). May reduce effects of tamoxifen; consider alternative antidepressant. Antagonized by fosamprenavir/ritonavir.
Adverse Reactions:
Asthenia, sweating, nausea, decreased appetite, dry mouth, constipation, somnolence, dizziness, insomnia, tremor, nervousness, libido decreased, female genital disorders, impotence, ejaculatory disturbance, other male genital disorders, orgasmic disturbance, infection; discontinuation syndrome.
Drug Elimination:
Renal (64%), fecal (36%). Half-life: 15–20 hours.
Generic Drug Availability:
NO
How Supplied:
Tabs—30
Mood disorders:
Indications for: PEXEVA
Major Depressive Disorder (MDD).
Adult Dosage:
Give once daily, usually in the AM; adjust by 10mg/day at 1-week intervals. Initially 20mg/day; max 50mg/day. Elderly, severe renal or severe hepatic impairment: initially 10mg/day; max 40mg/day.
Children Dosage:
Not established.
PEXEVA Contraindications:
Concomitant pimozide, thioridazine. During or within 14 days of MAOIs (including linezolid, IV methylene blue).
Boxed Warning:
Suicidal thoughts and behaviors.
PEXEVA Warnings/Precautions:
Increased risk of suicidal thoughts and behavior in children and young adults; monitor all patients for clinical worsening or unusual changes. Monitor for serotonin syndrome; discontinue and treat if occurs. Screen for bipolar disorder, mania, or hypomania. Seizure disorder. Risk for bleeding events. Angle-closure glaucoma. Avoid in untreated anatomically narrow angles. Volume-depleted. Hyponatremia (esp. in elderly). Bone fracture risk. Sexual dysfunction. Write ℞ for the smallest practical amount. Avoid abrupt cessation; reduce dose gradually. Reevaluate periodically. Renal and/or hepatic impairment. Elderly. Labor & delivery. Pregnancy (during 3rd trimester; see full labeling for effects on neonates). Nursing mothers.
PEXEVA Classification:
SSRI.
PEXEVA Interactions:
See Contraindications. Do not start MAOI until at least 2 weeks after discontinuing paroxetine. Increased risk of serotonin syndrome with other serotonergic drugs (eg, other SSRIs, SNRIs, triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, meperidine, methadone, tryptophan, buspirone, amphetamines, St. John's Wort) or with drugs that impair serotonin metabolism (eg, MAOIs, linezolid, IV methylene blue). Potentiation with other protein bound drugs. Increased risk of bleeding with aspirin, NSAIDs, clopidogrel, heparin, warfarin, or others that affect coagulation. May affect, or be affected by, drugs metabolized by CYP2D6 (eg, propafenone, flecainide, atomoxetine, desipramine, dextromethorphan, metoprolol, nebivolol, perphenazine, tolterodine, venlafaxine, risperidone). May reduce effects of tamoxifen; consider alternative antidepressant. Antagonized by fosamprenavir/ritonavir.
Adverse Reactions:
Asthenia, sweating, nausea, decreased appetite, dry mouth, constipation, somnolence, dizziness, insomnia, tremor, nervousness, libido decreased, female genital disorders, impotence, ejaculatory disturbance, other male genital disorders, orgasmic disturbance, infection; discontinuation syndrome.
Drug Elimination:
Renal (64%), fecal (36%). Half-life: 15–20 hours.
Generic Drug Availability:
NO
How Supplied:
Tabs—30
