Patient/caregiver was educated on contraindications for using Paroxetine as follows:
- Paroxetine intake carries the risk of causing seizures, especially in individuals with history of seizures. Individuals can present with sudden episodes of loss of consciousness, intense convulsions with muscle contractions, bowel and bladder incontinence. Paroxetine is contraindicated or cautiously administered in individuals with history of seizures.
- Paroxetine intake can thin the blood and increase risk for bleeding in the skin and mucus membranes. This risk is further more in individuals concurrently taking blood thinners and anticoagulants, such as, aspirin, warfarin, Xarelto, and Eliquis. Some other antidepressants and antipsychotic medications also contribute to thinning of blood and episodes of bleeding. Administration of paroxetine along with these medications can also precipitate dangerous bleeding episodes. Check with your physician on the safety with paroxetine use and the possibility for interaction with other medications on your list.
- Paroxetine is extensively metabolized in the liver and inactive metabolites are excreted in the urine and feces. If liver function is deficient, the metabolism of Paroxetine can be compromised. In this case, paroxetine can stay in the body for prolonged duration of time in comparison to normal leading to increased blood levels of the medication for longer periods of time. This can lead to increased risk for side-effects and consequent toxicity. So, Paroxetine could be cautiously administered or avoided for an alternative medication, in individuals with hepatic dysfunction. Periodical labs for liver function could be ordered and individuals monitored for development of any toxic symptoms. Discuss with your physician regarding history of compromised liver function, if any.
