Drug interactions
Brexpiprazole + Paroxetine
Severity: Moderate
Brexpiprazole and Paroxetine: moderate interaction.
Last updated
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
Paroxetine strongly inhibits CYP2D6, the main pathway clearing brexpiprazole, and raises its exposure substantially. This may increase adverse effects such as akathisia, sedation and weight gain.
What this interaction means in plain words
Brexpiprazole and Paroxetine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Brexpiprazole belongs to Central Nervous System; Paroxetine belongs to Central Nervous System.
Why it happens
Strong CYP2D6 inhibition by paroxetine reduces brexpiprazole clearance.
What to do
Per labeling, give about half the usual brexpiprazole dose with strong CYP2D6 inhibitors in schizophrenia, and a quarter if a strong or moderate CYP3A4 inhibitor is also given. Return to the usual dose when paroxetine is stopped.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Paroxetine
- Isocarboxazid + Paroxetine Contraindicated
- Methylene blue + Paroxetine Contraindicated
- Paroxetine + Phenelzine Contraindicated
- Paroxetine + Pimozide Contraindicated
- Paroxetine + Procarbazine Contraindicated
- Paroxetine + Selegiline Contraindicated
Other interactions of Brexpiprazole
Frequently asked questions
Can I take Brexpiprazole with Paroxetine?
MediHelp rates the interaction as moderate. Brexpiprazole and Paroxetine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Paroxetine strongly inhibits CYP2D6, the main pathway clearing brexpiprazole, and raises its exposure substantially. This may increase adverse effects such as akathisia, sedation and weight gain.
How serious is the interaction between Brexpiprazole and Paroxetine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Per labeling, give about half the usual brexpiprazole dose with strong CYP2D6 inhibitors in schizophrenia, and a quarter if a strong or moderate CYP3A4 inhibitor is also given. Return to the usual dose when paroxetine is stopped.
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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