Paroxetine
SSRI, Antidepressant
Paroxetine
Paxil
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Interactions
Pharmacogenomic + mechanism interactions
Pharmacogenomic guideline recommendationsCPIC and Dutch Pharmacogenetics Working Group clinical guidelines
CPIC rec 8094697 [Strong]: Initiate therapy with recommended starting dose CPIC pair-level A (CYP2D6, CYP2C19, CYP2B6, SLC6A4, HTR2A and Serotonin Reuptake Inhibitor Antidepressants) [PMID 25974703, 37032427]
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Clinical relevance: does this interaction matter in practice?trivialcritical
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CPIC rec 8094686 [Moderate]: Select alternative drug not predominantly metabolized by CYP2D6. CPIC pair-level A (CYP2D6, CYP2C19, CYP2B6, SLC6A4, HTR2A and Serotonin Reuptake Inhibitor Antidepressants) [PMID 25974703, 37032427] FDA labeling (Drug Interactions, Clinical Pharmacology)
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CPIC rec 8094706 [Moderate]: Consider a 50% reduction in recommended starting dose, slower titration schedule, and a 50% lower maintenance dose as compared to normal metabolizers. CPIC pair-level A (CYP2D6, CYP2C19, CYP2B6, SLC6A4, HTR2A and Serotonin Reuptake Inhibitor Antidepressants) [PMID 25974703, 37032427] FDA labeling (Drug Interactions, Clinical Pharmacology)
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CPIC rec 8094702 [Optional]: Consider a lower starting dose and slower titration schedule as compared to normal metabolizers. CPIC pair-level A (CYP2D6, CYP2C19, CYP2B6, SLC6A4, HTR2A and Serotonin Reuptake Inhibitor Antidepressants) [PMID 25974703, 37032427] FDA labeling (Drug Interactions, Clinical Pharmacology)
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Pharmacokinetic mechanismSubstrate / metabolism relationships from primary literature
FDA Drug Interactions Table: strong index inhibitor of CYP2D6.
⏱ mechanism-based, interaction persists ~4-6 weeks after stopping the inhibitorRate this interaction. Reports are anonymous and help curate the page.
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Inferred from pharmacokinetic dataMaterialised by the inference engine; provenance shown per row
Paroxetine inhibits CYP2D6 (inhibitor_strong, intensity 90); Codeine is a prodrug_activated_by of CYP2D6 (intensity 100). Derived: Codeine exposure lowered.
⏱ mechanism-based, interaction persists ~4-6 weeks after stopping the inhibitorInferred via Enzyme:CYP2D6 (exposure lowered)
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Clinical relevance: does this interaction matter in practice?trivialcritical
Confidence in this inference: is the inferred magnitude sound?overstatedsound
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Paroxetine inhibits CYP2D6 (inhibitor_strong, intensity 90); Desipramine is a substrate_major of CYP2D6 (intensity 80). Derived: Desipramine exposure raised.
⏱ mechanism-based, interaction persists ~4-6 weeks after stopping the inhibitorInferred via Enzyme:CYP2D6 (exposure raised)
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Clinical relevance: does this interaction matter in practice?trivialcritical
Confidence in this inference: is the inferred magnitude sound?overstatedsound
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Paroxetine inhibits CYP2D6 (inhibitor_strong, intensity 90); Dextromethorphan is a substrate_major of CYP2D6 (intensity 80). Derived: Dextromethorphan exposure raised.
⏱ mechanism-based, interaction persists ~4-6 weeks after stopping the inhibitorInferred via Enzyme:CYP2D6 (exposure raised)
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Clinical relevance: does this interaction matter in practice?trivialcritical
Confidence in this inference: is the inferred magnitude sound?overstatedsound
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Paroxetine inhibits CYP2D6 (inhibitor_strong, intensity 90); Nebivolol is a substrate_major of CYP2D6 (intensity 80). Derived: Nebivolol exposure raised.
⏱ mechanism-based, interaction persists ~4-6 weeks after stopping the inhibitorInferred via Enzyme:CYP2D6 (exposure raised)
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Clinical relevance: does this interaction matter in practice?trivialcritical
Confidence in this inference: is the inferred magnitude sound?overstatedsound
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Patient experience
Fluoxetine via Category:Antidepressants exp n/a/5 outcome n/a (n=1) exp 1.0/5 outcome +33.0 (n=1)
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- checking this mechanism here
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Summary
Classes
SSRI, Antidepressant
Common uses
Pharmacy
Pharmacology
Purported mechanism
Selective serotonin reuptake inhibitor