Drug interactions
Amoxapine + Paroxetine
Severity: Major
Amoxapine and Paroxetine: major interaction.
Last updated Sources: US FDA label
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Combining an SSRI with a tricyclic-type antidepressant increases the risk of serotonin toxicity. Paroxetine is a strong CYP2D6 inhibitor and can raise amoxapine concentrations, increasing anticholinergic, sedative and cardiac effects.
What this interaction means in plain words
Amoxapine and Paroxetine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Additive serotonergic effects and paroxetine inhibition of CYP2D6-mediated amoxapine metabolism.
What to do
Avoid if possible. If coadministered, use low amoxapine doses with slow titration and monitor for serotonin syndrome, anticholinergic effects and ECG changes.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
Other interactions of Paroxetine
- Isocarboxazid + Paroxetine Contraindicated
- Methylene blue + Paroxetine Contraindicated
- Paroxetine + Phenelzine Contraindicated
- Paroxetine + Pimozide Contraindicated
- Paroxetine + Procarbazine Contraindicated
- Paroxetine + Selegiline Contraindicated
Frequently asked questions
Can I take Amoxapine with Paroxetine?
MediHelp rates the interaction as major. Amoxapine and Paroxetine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Combining an SSRI with a tricyclic-type antidepressant increases the risk of serotonin toxicity. Paroxetine is a strong CYP2D6 inhibitor and can raise amoxapine concentrations, increasing anticholinergic, sedative and cardiac effects.
How serious is the interaction between Amoxapine and Paroxetine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid if possible. If coadministered, use low amoxapine doses with slow titration and monitor for serotonin syndrome, anticholinergic effects and ECG changes.
What other medicines interact with Paroxetine?
MediHelp also lists interactions of Paroxetine with, for example, Isocarboxazid, Methylene blue, Phenelzine. The full list is on the Paroxetine page.
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