Drug interactions
Paroxetine + Remifentanil
Severity: Moderate
Paroxetine and Remifentanil: 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
Opioid and SSRI co-therapy can raise the risk of serotonin syndrome. Evidence for remifentanil specifically is limited, but the reaction can be severe.
What this interaction means in plain words
Paroxetine and Remifentanil 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 belongs to Central Nervous System; Remifentanil belongs to Musculoskeletal.
Why it happens
Additive serotonergic effects from SSRI reuptake inhibition and opioid activity.
What to do
Monitor for neuromuscular excitability, agitation and autonomic instability. Withdraw serotonergic agents and give supportive care if serotonin syndrome is suspected.
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 Remifentanil
- Alvimopan + Remifentanil Contraindicated
- Isocarboxazid + Remifentanil Contraindicated
- Olanzapine / samidorphan + Remifentanil Contraindicated
- Phenelzine + Remifentanil Contraindicated
- Benzhydrocodone / acetaminophen + Remifentanil Major
- Brexanolone + Remifentanil Major
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 Remifentanil?
MediHelp rates the interaction as moderate. Paroxetine and Remifentanil 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. Opioid and SSRI co-therapy can raise the risk of serotonin syndrome. Evidence for remifentanil specifically is limited, but the reaction can be severe.
How serious is the interaction between Paroxetine and Remifentanil?
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 neuromuscular excitability, agitation and autonomic instability. Withdraw serotonergic agents and give supportive care if serotonin syndrome is suspected.
What other medicines interact with Remifentanil?
MediHelp also lists interactions of Remifentanil with, for example, Alvimopan, Isocarboxazid, Olanzapine / samidorphan. The full list is on the Remifentanil page.
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