Drug interactions
Paliperidone + Paroxetine
Severity: Moderate
Paliperidone 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 is a strong CYP2D6 inhibitor and may modestly raise paliperidone exposure, though paliperidone is mostly excreted unchanged by the kidney. Both drugs can prolong the QT interval, and serotonergic effects combined with dopamine blockade carry a rare risk of serotonin syndrome or neuroleptic malignant syndrome.
What this interaction means in plain words
Paliperidone 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.
Paliperidone belongs to Central Nervous System; Paroxetine belongs to Central Nervous System.
Why it happens
Additive QT prolongation and serotonergic/dopaminergic pharmacodynamic effects, with minor CYP2D6 inhibition by paroxetine.
What to do
Monitor for extrapyramidal symptoms, sedation and signs of serotonin toxicity or NMS, and obtain an ECG if other QT risk factors exist. Adjust paliperidone dose according to tolerability.
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 Paliperidone
- Ibutilide + Paliperidone Contraindicated
- Paliperidone + Pimozide Contraindicated
- Paliperidone + Vandetanib Contraindicated
- Adagrasib + Paliperidone Major
- Amiodarone + Paliperidone Major
- Amisulpride + Paliperidone Major
Frequently asked questions
Can I take Paliperidone with Paroxetine?
MediHelp rates the interaction as moderate. Paliperidone 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 is a strong CYP2D6 inhibitor and may modestly raise paliperidone exposure, though paliperidone is mostly excreted unchanged by the kidney. Both drugs can prolong the QT interval, and serotonergic effects combined with dopamine blockade carry a rare risk of serotonin syndrome or neuroleptic malignant syndrome.
How serious is the interaction between Paliperidone 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: Monitor for extrapyramidal symptoms, sedation and signs of serotonin toxicity or NMS, and obtain an ECG if other QT risk factors exist. Adjust paliperidone dose according to tolerability.
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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