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1 Medication Guide 1416 PAXIL (PAX-il) 1417 (paroxetine hydrochloride) 1418 Tablets and Oral Suspension Read the Medication Guide that comes with PAXIL before you start taking it and each time you 1421 get a refill. There may be new information. This Medication Guide does not take the place of 1422 talking to your healthcare provider about your medical condition or treatment. Talk with your 1423 healthcare provider if there is something you do not understand or want to learn more about What is the most important information I should know about PAXIL? 1426 PAXIL and other antidepressant medicines may cause serious side effects, including: Suicidal thoughts or actions: 1428 PAXIL and other antidepressant medicines may increase suicidal thoughts or 1429 actions in some children, teenagers, or young adults within the first few months of 1430 treatment or when the dose is changed Depression or other serious mental illnesses are the most important causes of suicidal 1432 thoughts or actions Watch for these changes and call your healthcare provider right away if you notice: 1434 New or sudden changes in mood, behavior, actions, thoughts, or feelings, especially 1435 if severe Pay particular attention to such changes when PAXIL is started or when the dose is 1437 changed Keep all follow-up visits with your healthcare provider and call between visits if you are worried 1439 about symptoms Call your healthcare provider right away if you have any of the following symptoms, 1441 or call 911 if an emergency, especially if they are new, worse, or worry you: 1442 attempts to commit suicide 1443 acting on dangerous impulses 1444 acting aggressive or violent 1445 thoughts about suicide or dying 1446 new or worse depression 1447 new or worse anxiety or panic attacks 1448 feeling agitated, restless, angry, or irritable 1449 trouble sleeping 1450 an increase in activity or talking more than what is normal for you 1451 other unusual changes in behavior or mood 1452 Call your healthcare provider right away if you have any of the following symptoms, or call 43
2 if an emergency. PAXIL may be associated with these serious side effects: Serotonin Syndrome or Neuroleptic Malignant Syndrome-like reactions. This 1455 condition can be life-threatening and may include: 1456 agitation, hallucinations, coma, or other changes in mental status 1457 coordination problems or muscle twitching (overactive reflexes) 1458 racing heartbeat, high or low blood pressure 1459 sweating or fever 1460 nausea, vomiting, or diarrhea 1461 muscle rigidity Severe allergic reactions: 1463 trouble breathing 1464 swelling of the face, tongue, eyes, or mouth 1465 rash, itchy welts (hives), or blisters, alone or with fever or joint pain Abnormal bleeding: PAXIL and other antidepressant medicines may increase your risk of 1467 bleeding or bruising, especially if you take the blood thinner warfarin (Coumadin, 1468 Jantoven ), a non-steroidal anti-inflammatory drug (NSAIDs, like ibuprofen or naproxen), 1469 or aspirin Seizures or convulsions Manic episodes: 1472 greatly increased energy 1473 severe trouble sleeping 1474 racing thoughts 1475 reckless behavior 1476 unusually grand ideas 1477 excessive happiness or irritability 1478 talking more or faster than usual Changes in appetite or weight. Children and adolescents should have height and weight 1480 monitored during treatment Low salt (sodium) levels in the blood. Elderly people may be at greater risk for this Symptoms may include: 1483 headache 1484 weakness or feeling unsteady 1485 confusion, problems concentrating or thinking, or memory problems 1486 Do not stop PAXIL without first talking to your healthcare provider. Stopping PAXIL too 1487 quickly may cause serious symptoms including: 1488 anxiety, irritability, high or low mood, feeling restless, or changes in sleep habits 1489 headache, sweating, nausea, dizziness 1490 electric shock-like sensations, shaking, confusion What is PAXIL? 44
3 1493 PAXIL is a prescription medicine used to treat depression. It is important to talk with your 1494 healthcare provider about the risks of treating depression and also the risks of not treating it. You 1495 should discuss all treatment choices with your healthcare provider. PAXIL is also used to treat: 1496 Major Depressive Disorder (MDD) 1497 Obsessive Compulsive Disorder (OCD) 1498 Panic Disorder 1499 Social Anxiety Disorder 1500 Generalized Anxiety Disorder (GAD) 1501 Posttraumatic Stress Disorder (PTSD) 1502 Talk to your healthcare provider if you do not think that your condition is getting better with 1503 treatment using PAXIL Who should not take PAXIL? 1506 Do not take PAXIL if you: 1507 are allergic to paroxetine or any of the ingredients in PAXIL. See the end of this Medication 1508 Guide for a complete list of ingredients in PAXIL take a monoamine oxidase inhibitor (MAOI). Ask your healthcare provider or pharmacist if 1510 you are not sure if you take an MAOI, including the antibiotic linezolid Do not take an MAOI within 2 weeks of stopping PAXIL unless directed to do so by 1512 your physician Do not start PAXIL if you stopped taking an MAOI in the last 2 weeks unless directed to 1514 do so by your physician People who take PAXIL close in time to an MAOI may have serious or even life threatening side effects. Get medical help right away if you have any of these 1517 symptoms: 1518 high fever 1519 uncontrolled muscle spasms 1520 stiff muscles 1521 rapid changes in heart rate or blood pressure 1522 confusion 1523 loss of consciousness (pass out) 1524 take MELLARIL (thioridazine). Do not take MELLARIL together with PAXIL 1525 because this can cause serious heart rhythm problems or sudden death take the antipsychotic medicine pimozide (ORAP ) because this can cause serious heart 1527 problems What should I tell my healthcare provider before taking PAXIL? Ask if you are not sure Before starting PAXIL, tell your healthcare provider if you: 45
4 1531 are pregnant, may be pregnant, or plan to become pregnant. There is a possibility that 1532 PAXIL may harm your unborn baby, including an increased risk of birth defects, particularly 1533 heart defects. Other risks may include a serious condition in which there is not enough 1534 oxygen in the baby s blood. Your baby may also have certain other symptoms shortly after 1535 birth. Premature births have also been reported in some women who used PAXIL during 1536 pregnancy are breastfeeding. PAXIL passes into your milk. Talk to your healthcare provider about the 1538 best way to feed your baby while taking PAXIL are taking certain drugs such as: 1540 triptans used to treat migraine headache 1541 other antidepressants (SSRIs, SNRIs, tricyclics, or lithium) or antipsychotics 1542 drugs that affect serotonin, such as lithium, tramadol, tryptophan, St. John s wort 1543 certain drugs used to treat irregular heart beats 1544 certain drugs used to treat schizophrenia 1545 certain drugs used to treat HIV infection 1546 certain drugs that affect the blood, such as warfarin, aspirin, and ibuprofen 1547 certain drugs used to treat epilepsy 1548 atomoxetine 1549 cimetidine 1550 fentanyl 1551 metoprolol 1552 pimozide 1553 procyclidine 1554 tamoxifen 1555 have liver problems 1556 have kidney problems 1557 have heart problems 1558 have or had seizures or convulsions 1559 have bipolar disorder or mania 1560 have low sodium levels in your blood 1561 have a history of a stroke 1562 have high blood pressure 1563 have or had bleeding problems 1564 have glaucoma (high pressure in the eye) Tell your healthcare provider about all the medicines you take, including prescription and 1567 non-prescription medicines, vitamins, and herbal supplements. PAXIL and some medicines may 1568 interact with each other, may not work as well, or may cause serious side effects. 46
5 1569 Your healthcare provider or pharmacist can tell you if it is safe to take PAXIL with your other 1570 medicines. Do not start or stop any medicine while taking PAXIL without talking to your 1571 healthcare provider first If you take PAXIL, you should not take any other medicines that contain paroxetine, including 1573 PAXIL CR and PEXEVA (paroxetine mesylate) How should I take PAXIL? 1576 Take PAXIL exactly as prescribed. Your healthcare provider may need to change the dose of 1577 PAXIL until it is the right dose for you PAXIL may be taken with or without food If you are taking PAXIL Oral Suspension, shake the suspension well before use If you miss a dose of PAXIL, take the missed dose as soon as you remember. If it is almost 1581 time for the next dose, skip the missed dose and take your next dose at the regular time. Do 1582 not take two doses of PAXIL at the same time If you take too much PAXIL, call your healthcare provider or poison control center right 1584 away, or get emergency treatment Do not stop taking PAXIL suddenly without talking to your doctor (unless you have 1586 symptoms of a severe allergic reaction). If you need to stop taking PAXIL, your healthcare 1587 provider can tell you how to safely stop taking it What should I avoid while taking PAXIL? 1590 PAXIL can cause sleepiness or may affect your ability to make decisions, think clearly, or react 1591 quickly. You should not drive, operate heavy machinery, or do other dangerous activities until 1592 you know how PAXIL affects you. Do not drink alcohol while using PAXIL What are possible side effects of PAXIL? 1595 PAXIL may cause serious side effects, including all of those described in the section entitled 1596 What is the most important information I should know about PAXIL? 1597 Common possible side effects in people who take PAXIL include: 1598 nausea 1599 sleepiness 1600 weakness 1601 dizziness 1602 feeling anxious or trouble sleeping 1603 sexual problems 1604 sweating 1605 shaking 1606 not feeling hungry 47
6 1607 dry mouth 1608 constipation 1609 infection 1610 yawning 1611 Tell your healthcare provider if you have any side effect that bothers you or that does not go 1612 away. These are not all the possible side effects of PAXIL. For more information, ask your 1613 healthcare provider or pharmacist CALL YOUR DOCTOR FOR MEDICAL ADVICE ABOUT SIDE EFFECTS. YOU MAY 1615 REPORT SIDE EFFECTS TO THE FDA AT FDA-1088 or How should I store PAXIL? 1618 Store PAXIL Tablets at room temperature between 59º and 86ºF (15º and 30ºC) Store PAXIL Oral Suspension at or below 77ºF (25ºC) Keep PAXIL away from light Keep bottle of PAXIL closed tightly Keep PAXIL and all medicines out of the reach of children General information about PAXIL 1625 Medicines are sometimes prescribed for purposes other than those listed in a Medication Guide Do not use PAXIL for a condition for which it was not prescribed. Do not give PAXIL to other 1627 people, even if they have the same condition. It may harm them This Medication Guide summarizes the most important information about PAXIL. If you would 1630 like more information, talk with your healthcare provider. You may ask your healthcare provider 1631 or pharmacist for information about PAXIL that is written for healthcare professionals For more information about PAXIL call or go to What are the ingredients in PAXIL? 1636 Active ingredient: paroxetine hydrochloride 1637 Inactive ingredients in tablets: dibasic calcium phosphate dihydrate, hypromellose, magnesium 1638 stearate, polyethylene glycols, polysorbate 80, sodium starch glycolate, titanium dioxide, and or more of the following: D&C Red No. 30 aluminum lake, D&C Yellow No. 10 aluminum lake, 1640 FD&C Blue No. 2 aluminum lake, FD&C Yellow No. 6 aluminum lake Inactive ingredients in suspension for oral administration: polacrilin potassium, 1642 microcrystalline cellulose, propylene glycol, glycerin, sorbitol, methylparaben, propylparaben, 1643 sodium citrate dihydrate, citric acid anhydrous, sodium saccharin, flavorings, FD&C Yellow 1644 No. 6 aluminum lake, and simethicone emulsion, USP. 48
7 PAXIL and PAXIL CR are registered trademarks of GlaxoSmithKline. The other brands listed 1647 are trademarks of their respective owners and are not trademarks of GlaxoSmithKline. The 1648 makers of these brands are not affiliated with and do not endorse GlaxoSmithKline or its 1649 products This Medication Guide has been approved by the U.S. Food and Drug Administration GlaxoSmithKline Research Triangle Park, NC , GlaxoSmithKline. All rights reserved. December 2012 PXL:XX 49
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