Drug interactions
Paroxetine + Protriptyline
Severity: Major
Paroxetine and Protriptyline: 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 inhibits CYP2D6 and can substantially raise protriptyline levels, increasing anticholinergic and cardiac effects. Both drugs also raise serotonergic activity, raising the risk of serotonin syndrome.
What this interaction means in plain words
Paroxetine and Protriptyline 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
CYP2D6 inhibition by paroxetine plus additive serotonin reuptake inhibition.
What to do
Avoid if possible; otherwise lower the protriptyline dose, and monitor ECG and tricyclic levels and signs of serotonin toxicity.
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
Frequently asked questions
Can I take Paroxetine with Protriptyline?
MediHelp rates the interaction as major. Paroxetine and Protriptyline 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 inhibits CYP2D6 and can substantially raise protriptyline levels, increasing anticholinergic and cardiac effects. Both drugs also raise serotonergic activity, raising the risk of serotonin syndrome.
How serious is the interaction between Paroxetine and Protriptyline?
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; otherwise lower the protriptyline dose, and monitor ECG and tricyclic levels and signs of serotonin toxicity.
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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