Drug interactions
Paroxetine + Rasagiline
Severity: Major
Paroxetine and Rasagiline: 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
Combining an SSRI with the MAO-B inhibitor rasagiline has been associated with serotonin syndrome and severe CNS toxicity with hyperthermia. Labeling advises a washout period between the agents.
What this interaction means in plain words
Paroxetine and Rasagiline 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 belongs to Central Nervous System; Rasagiline belongs to Central Nervous System.
Why it happens
Increased synaptic serotonin from reuptake inhibition combined with monoamine oxidase inhibition.
What to do
Avoid concurrent use where possible; allow at least 14 days after stopping rasagiline before starting paroxetine and about 5 weeks after stopping paroxetine before starting rasagiline. If combined under specialist care, monitor closely for 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
Other interactions of Rasagiline
- Atomoxetine + Rasagiline Contraindicated
- Brimonidine + Rasagiline Contraindicated
- Bupropion-naltrexone + Rasagiline Contraindicated
- Bupropion + Rasagiline Contraindicated
- Clomipramine + Rasagiline Contraindicated
- Desvenlafaxine + Rasagiline Contraindicated
Frequently asked questions
Can I take Paroxetine with Rasagiline?
MediHelp rates the interaction as major. Paroxetine and Rasagiline 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 the MAO-B inhibitor rasagiline has been associated with serotonin syndrome and severe CNS toxicity with hyperthermia. Labeling advises a washout period between the agents.
How serious is the interaction between Paroxetine and Rasagiline?
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 concurrent use where possible; allow at least 14 days after stopping rasagiline before starting paroxetine and about 5 weeks after stopping paroxetine before starting rasagiline. If combined under specialist care, monitor closely for 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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