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paroxetine
generic
Black Box Warnings .
Suicidality
antidepressants incr. suicidality risk in peds and young adult pts in short-term studies; monitor closely for clinical worsening and suicidality; advise families and caregivers of need for close observation and communication w/ prescriber; not approved for peds pts
Adult Dosing .
Dosage forms: CAP: 7.5 mg; TAB: 10 mg, 20 mg, 30 mg, 40 mg; ER TAB: 12.5 mg, 25 mg, 37.5 mg; SUSP: 10 mg per 5 mL
major depressive disorder
- [immediate-release tab or suspension form]
- Dose: 20-50 mg PO qam; Start: 20 mg PO qam, may incr. by 10 mg/day qwk; Max: 50 mg/day; Info: start 10 mg PO qam, max 40 mg/day in elderly pts; do not crush/chew tab; taper dose gradually to D/C
- [extended-release tab form]
- Dose: 25-62.5 mg ER PO qam; Start: 25 mg ER PO qam, may incr. by 12.5 mg/day qwk; Max: 62.5 mg/day ER; Info: start 12.5 mg ER PO qam, max 50 mg/day ER in elderly pts; do not crush/chew ER tab; taper dose gradually to D/C
obsessive-compulsive disorder
- [40 mg PO qam]
- Start: 20 mg PO qam, incr. by 10 mg/day qwk; Max: 60 mg/day; Info: start 10 mg PO qam, max 40 mg/day in elderly pts; do not crush/chew tab; taper dose gradually to D/C
panic disorder
- [immediate-release tab or suspension form]
- Dose: 40 mg PO qam; Start: 10 mg PO qam, incr. by 10 mg/day qwk; Max: 60 mg/day; Info: max 40 mg/day in elderly pts; do not crush/chew tab; taper dose gradually to D/C
- [extended-release tab form]
- Dose: 12.5-75 mg ER PO qam; Start: 12.5 mg ER PO qam, may incr. by 12.5 mg/day qwk; Max: 75 mg/day ER; Info: max 50 mg/day ER in elderly pts; do not crush/chew ER tab; taper dose gradually to D/C
social anxiety disorder
- [immediate-release tab or suspension form]
- Dose: 20 mg PO qam; Start: 20 mg PO qam, may incr. by 10 mg/day qwk; Max: 60 mg/day; Info: start 10 mg PO qam, max 40 mg/day in elderly pts; no proven additional benefit at doses >20 mg/day; do not crush/chew tab; taper dose gradually to D/C
- [extended-release tab form]
- Dose: 12.5-37.5 mg ER PO qam; Start: 12.5 mg ER PO qam, may incr. by 12.5 mg/day qwk; Max: 37.5 mg/day ER; Info: do not crush/chew ER tab; taper dose gradually to D/C
generalized anxiety disorder
- [20 mg PO qam]
- Start: 20 mg PO qam, may incr. by 10 mg/day qwk; Max: 50 mg/day; Info: start 10 mg PO qam, max 40 mg/day in elderly pts; no proven additional benefit at doses >20 mg/day; do not crush/chew tab; taper dose gradually to D/C
post-traumatic stress disorder
- [20 mg PO qam]
- Start: 20 mg PO qam, may incr. by 10 mg/day qwk; Max: 50 mg/day; Info: start 10 mg PO qam, max 40 mg/day in elderly pts; no proven additional benefit at doses >20 mg/day; do not crush/chew tab; taper dose gradually to D/C
premenstrual dysphoric disorder
- [12.5-25 mg ER PO qam]
- Start: 12.5 mg ER PO qam, may incr. to 25 mg ER PO qam after 1wk; Max: 25 mg/day ER; Alt: 12.5-25 mg ER PO qam during luteal phase; Info: do not crush/chew ER tab; taper dose gradually to D/C
vasomotor sx, mod-severe menopausal
- [immediate-release cap form]
- Dose: 7.5 mg PO qhs
- [immediate-release tab or suspension form (off-label)]
- Dose: 10-20 mg PO qd; Start: 10 mg PO qd, may incr. to 20 mg PO qd after at least 1wk; Info: do not crush/chew tab; taper dose gradually to D/C
- [extended-release tab form (off-label)]
- Dose: 12.5-25 mg ER PO qd; Start: 12.5 mg ER PO qd, may incr. to 25 mg ER PO qd after at least 1wk; Info: do not crush/chew ER tab; taper dose gradually to D/C
renal dosing
- [capsule form]
- renal impairment: no adjustment
- HD/PD: not defined
- [immediate-release tab or suspension form]
- CrCl <30: start 10 mg qd, max 40 mg/day
- HD: decr. usual dose by 50%, max 40 mg/day; no supplement after dialysis; PD: decr. usual dose by 50%, max 40 mg/day; no supplement
- [extended-release tab form]
- severe impairment: start 12.5 mg ER qd; Info: max 50 mg/day ER if major depressive disorder or panic disorder use
- HD/PD: not defined
hepatic dosing
- [capsule form]
- hepatic impairment: no adjustment
- [immediate-release tab or suspension form]
- severe impairment: start 10 mg qd, max 40 mg/day
- [extended-release tab form]
- severe impairment: start 12.5 mg ER qd; Info: max 50 mg/day ER if major depressive disorder or panic disorder use
Peds Dosing .
- Dosage forms: TAB: 10 mg, 20 mg, 30 mg, 40 mg; SUSP: 10 mg per 5 mL
obsessive-compulsive disorder (off-label)
- [7-17 yo]
- Dose: 10-60 mg PO qam; Start: 10 mg PO qam, may incr. by 10 mg/day q1-2wk; Max: 60 mg/day; Info: do not crush/chew tab; taper dose gradually to D/C
social anxiety disorder (off-label)
- [8-17 yo]
- Dose: 10-40 mg PO qam; Start: 10 mg PO qam, may incr. by 10 mg/day q1-2wk; Max: 50 mg/day; Info: do not crush/chew tab; taper dose gradually to D/C
renal dosing
- [not defined]
- renal impairment: consider adult renal dosing for guidance
- HD/PD: consider adult renal dosing for guidance
hepatic dosing
- [not defined]
- hepatic impairment: consider adult hepatic dosing for guidance