Drug interactions
Iloperidone + Paroxetine
Severity: Major
Iloperidone and Paroxetine: major 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, which metabolizes iloperidone, and can raise iloperidone exposure. Iloperidone prolongs the QT interval, so higher levels increase arrhythmia risk.
What this interaction means in plain words
Iloperidone 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.
Iloperidone belongs to Central Nervous System; Paroxetine belongs to Central Nervous System.
Why it happens
Paroxetine inhibits CYP2D6-mediated iloperidone metabolism, increasing exposure.
What to do
Reduce the iloperidone dose by about half when adding paroxetine, and return to the usual dose if paroxetine is stopped. Monitor ECG and for orthostasis.
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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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 Iloperidone
- Iloperidone + Thioridazine Contraindicated
- Alfuzosin + Iloperidone Major
- Amiodarone + Iloperidone Major
- Amisulpride + Iloperidone Major
- Amitriptyline + Iloperidone Major
- Anagrelide + Iloperidone Major
Frequently asked questions
Can I take Iloperidone with Paroxetine?
MediHelp rates the interaction as major. Iloperidone 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. Paroxetine strongly inhibits CYP2D6, which metabolizes iloperidone, and can raise iloperidone exposure. Iloperidone prolongs the QT interval, so higher levels increase arrhythmia risk.
How serious is the interaction between Iloperidone 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: Reduce the iloperidone dose by about half when adding paroxetine, and return to the usual dose if paroxetine is stopped. Monitor ECG and for orthostasis.
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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