Drug interactions
Paroxetine + Tetrabenazine
Severity: Major
Paroxetine and Tetrabenazine: 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 converts the active metabolites of tetrabenazine, causing much higher exposure to them. This increases the risk of QT prolongation, parkinsonism, sedation, akathisia and depression. Tetrabenazine itself prolongs the QT interval modestly.
What this interaction means in plain words
Paroxetine and Tetrabenazine 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; Tetrabenazine belongs to Central Nervous System.
Why it happens
CYP2D6 inhibition by paroxetine raises exposure to active tetrabenazine metabolites, with additive QT effects.
What to do
Limit tetrabenazine dose to the label maximum for strong CYP2D6 inhibitors, titrate slowly, and monitor ECG, mood and movement adverse effects. Consider an alternative antidepressant if possible.
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 Tetrabenazine
- Dronedarone + Tetrabenazine Contraindicated
- Isocarboxazid + Tetrabenazine Contraindicated
- Linezolid + Tetrabenazine Contraindicated
- Phenelzine + Tetrabenazine Contraindicated
- Pimozide + Tetrabenazine Contraindicated
- Procarbazine + Tetrabenazine Contraindicated
Frequently asked questions
Can I take Paroxetine with Tetrabenazine?
MediHelp rates the interaction as major. Paroxetine and Tetrabenazine 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 converts the active metabolites of tetrabenazine, causing much higher exposure to them. This increases the risk of QT prolongation, parkinsonism, sedation, akathisia and depression. Tetrabenazine itself prolongs the QT interval modestly.
How serious is the interaction between Paroxetine and Tetrabenazine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Limit tetrabenazine dose to the label maximum for strong CYP2D6 inhibitors, titrate slowly, and monitor ECG, mood and movement adverse effects. Consider an alternative antidepressant if possible.
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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