Buy Paroxetine No Prescription

Generic Name: Paroxetine HCl

Brand Names: Paxil, Paxil CR, Pexeva, Seroxat

Dosages: Tablets 10 mg, 20 mg, 30 mg, 40 mg; Suspension, oral 10 mg per 5 mL; Tablets, controlled-release (CR) 12.5 mg, 25 mg, 37.5 mg

Buying Paroxetine Without Prescription

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Indications:

Paroxetine hydrochloride (Paxil) is an antidepressant belonging to a class of Selective Serotonin Reuptake Inhibitors. Paroxetine is indicated for the treatment of depression, obsessive-compulsive disorder, panic disorder, generalized anxiety disorder, post-traumatic stress disorder, and social anxiety.

Contraindications:

• Concomitant or recent (within 14 days) use of MAO inhibitors.
• Concomitant use with thioridazine or pimozide.
• Hypersensitivity to paroxetine.

Paroxetine dosage:

Paroxetine is taken without regard to meals. Paxil CR tablets should be swallowed whole. Do not crush, chew, divide, or break tablets.

ADULTS:

Depression:
IR formulation: Initially 20 mg once a day, usually in the morning. Dose may be increased by 10 mg per day at intervals of at least one week; to a maximum of 50 mg per day.

CR formulation: 25 mg once a day, usually in the morning. Dose may be increased in increments of 12.5 mg per day at intervals of at least one week; to a maximum of 62.5 mg per day.

Paroxetine maintains an antidepressant response for up to 52 weeks.

Anxiety, Post-traumatic stress disorder:
IR formulation: 20 mg once a day, usually in the morning. Dose may be increased in 10 mg increments weekly. Usual range is 20 to 50 mg per day.

CR formulation: 12.5 mg once a day, usually in the morning. The dose may be increased in 12.5 mg increments weekly, to a maximum of 37.5 mg per day.

Social Anxiety Disorder:
Adults IR formulation: 20 mg/day as a single daily dose, usually in the morning. Usual range is 20 to 60mg/day.
Adults CR formulation: 12.5 mg initially, usually in the morning. Usual range is 12.5 to 37.5 mg/day. Dose may be increased in increments of 12.5 mg/day at intervals of at least 7 days (max, 37.5 mg/day).

Obsessive-compulsive disorder:
IR formulation: Initially 20 mg once a day, usually in the morning. The dose may be increased by 10 mg per day at intervals of one week; up to 40-60 mg per day.

Panic Disorder:
IR formulation: Initially 10 mg once a day, usually in morning. The dose may be increased by 10 mg weekly; up to 40-60 mg per day.

CR formulation: 12.5 mg once a day, usually in the morning. Dose may be increased in 12.5 mg increments weekly, to a maximum of 75 mg per day.

CHILDREN and ADOLESCENTS under 18 years of age:

Paroxetine should not be used in children and adolescents under the age of 18 years. Suicide related behaviours (suicide attempts and suicidal thoughts) and hostility were more frequently observed among children and adolescents treated with antidepressants compared to those treated with placebo.

Dosage adjustment in elderly, severe renal or hepatic function impairment

• IR formulation: 10 mg/day initially; do not exceed 40 mg/day.
• CR formulation: 12.5 mg/day initially; do not exceed 50 mg/day.

How long does Paxil take to work?

Insomnia and anxiety may improve early within the first 1-2 weeks. Other depressive symptoms such as sad or depressed mood may take 4-6 weeks before improvement is evident.

In generalized anxiety the onset of response and remission may occur after 8 weeks.

Paroxetine (Paxil) side effects:

Central nervous system: somnolence (15% to 24%); malaise, weakness (12% to 22%); tremor (4% to 11%); insomnia (11% to 24%); headache (17% to 18%); dizziness (6% to 14%); nervousness (9%); anxiety (6%).

Gastrointestinal: nausea (19% to 26%), dry mouth (9% to 18%), constipation (5% to 16%), diarrhea (9% to 12%), decreased appetite (9%); weight gain.

Genitourinary: abnormal ejaculation (28%); libido decreased (3% to 15%); anorgasmia, impotence (9%).

Miscellaneous: sweating (5% to 14%), blurred vision (8%).

Paroxetine precautions:

• Akathisia/psychomotor restlessness. The use of paroxetine has been associated with the development of akathisia, which is characterized by an inner sense of restlessness and psychomotor agitation such as an inability to sit or stand still usually associated with subjective distress. This is most likely to occur within the first few weeks of treatment.
• Glaucoma. Paroxetine infrequently causes mydriasis which can exacerbate narrow angle glaucoma.
• Bleeding. Caution is advised in persons taking SSRIs concomitantly with anticoagulants or other drugs that may increase risk of bleeding as well as in persons with a history of bleeding disorders or conditions which may predispose to bleeding.

Drug Interactions:

Paroxetine is a potent inhibitor of cytochrome P450 2D6 (CYP2D6), but a very weak inhibitor of CYP3A4.

Use with caution and consider reducing dosage of concomitantly administered CYP2D6 substrate, particularly those with a narrow therapeutic index, such as tricyclic antidepressants, class IC antiarrhythmics, and phenothiazines.

Interactions with drugs metabolized by the CYP3A4 isoenzyme are unlikely.

• Aspirin, NSAIDs, anticoagulants: increased risk of bleeding.
• Cimetidine: may increase paroxetine concentrations.
• Metoprolol: severe hypotension.
• Monoamine oxidase (MAO) inhibitors: potentially serious or fatal serotonin syndrome; concurrent use is contraindicated, and at least 14 days should elapse between discontinuation of one drug and initiation of the other.
• Serotonergics or other serotonin-enhancing drugs: increased risk of developing the serotonin syndrome, a rare but potentially fatal hyperserotonergic state.
• Thioridazine and pimozide: potential for QTc prolongation, which is associated with serious ventricular arrhythmias and sudden death. Concurrent use is contraindicated.
• Tryptophan: detrimental effects resembling serotonin syndrome.

Pregnancy and lactation

Pregnancy Category D.
The data suggests that Paroxetine leads to increased rates of congenital malformations.

Some epidemiological studies suggest a small increased risk of cardiovascular malformation (e.g. ventricular and atrial septum defects) associated with the use of paroxetine during the first trimester. The risk of having an infant with a cardiovascular defect following maternal paroxetine exposure is less than 2/100 compared with an expected rate for such defects of approximately 1/100 in the general population.

Paroxetine is generally considered compatible (low risk to infant) while breast-feeding.

References:

• 1. U.S. Paxil (Paroxetine) Prescribing Information