Paroxetine Controlled-Release Tablets and Risperdal

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Before taking PARoxetine, tell your doctor if you also use risperiDONE. This combination may increase the effects of risperiDONE. This can cause development of extrapyramidal symptoms resulting in tremor, shuffling of your feet, drooling, a mask-like face, tongue stiffness, muscle spasms or rigidity, and involuntary movements. If you take both medications together, tell your doctor if you have any of these symptoms. You may need a dose adjustment if you take both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

MONITOR: The coadministration with paroxetine may increase the plasma concentrations of certain neuroleptic agents such as phenothiazines and others that are thought to be metabolized by CYP450 2D6. The mechanism is decreased neuroleptic clearance due to inhibition of the isoenzyme by paroxetine. The interaction has been studied with risperidone. In 10 patients stabilized on risperidone (4 to 8 mg/day) for schizophrenia or schizoaffective disorder, paroxetine (20 mg/day for 4 weeks) increased the mean plasma concentration of risperidone by 388% after two weeks and 453% after four weeks compared to baseline. After four weeks, the sum of the concentrations of risperidone and its active metabolite, 9-hydroxyrisperidone, increased significantly (45% over baseline), as was the mean plasma risperidone to 9-hydroxyrisperidone ratio. One patient developed Parkinsonian symptoms in the second week. In this patient, total plasma levels of risperidone and its active metabolite increased by 62% during paroxetine coadministration. The interaction has also been cited in a clinical study with perphenazine and a case report of a 29-year-old man treated with trifluoperazine who developed severe extrapyramidal adverse effects following addition of paroxetine. The symptoms resolved after withdrawal of medication and did not recur following reinstitution of trifluoperazine.

MANAGEMENT: Caution is advised if neuroleptic agents such as phenothiazines, haloperidol, risperidone, or zuclopenthixol must be used concomitantly with paroxetine. Pharmacologic response and plasma neuroleptic levels should be monitored more closely whenever paroxetine is added to or withdrawn from therapy, and the neuroleptic dosage adjusted as necessary. Patients should be monitored for the development of extrapyramidal symptoms (e.g., tremor, shuffling gait, drooling, mask-like face, tongue stiffness, muscle spasms or rigidity, involuntary movements) and changes in mental status.

Paroxetine Controlled-Release Tablets

Generic Name: paroxetine

Brand name: Brisdelle, Paxil, Paxil CR, Pexeva

Synonyms: Paroxetine, PARoxetine

What is Paroxetine Controlled-Release Tablets?

Risperdal

Generic Name: risperidone

Brand name: Risperdal, Perseris, Risperdal Consta, Risperdal Consta, Risperdal M-Tab

Synonyms: n.a.

What is Risperdal?