Paxil and Promethegan

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.

Using promethazine together with PARoxetine may increase some of the side effects of promethazine. This includes tremor (uncontrolled shaking), trouble walking, drooling, and restless muscle movements in your eyes, tongue, jaw, or neck. Talk with your doctor before using these medications together. You may need a dose adjustment or special tests to safely 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 phenothiazines. The mechanism is paroxetine inhibition of CYP450 2D6, the isoenzyme responsible for the metabolic clearance of most, if not all, phenothiazines. The interaction has been studied specifically with perphenazine. In eight extensive metabolizers of CYP450 2D6, paroxetine treatment (20 mg/day orally for 10 days) resulted in a 2- to 21-fold decrease in 2D6 activity and a 2- to 13-fold increase in peak plasma concentrations of perphenazine (0.11 mg/kg single oral dose). These changes were associated with a significant increase in central nervous system side effects of perphenazine, including oversedation, extrapyramidal symptoms, and impairment of psychomotor performance and memory. Severe extrapyramidal adverse effects were also reported in a 29-year-old man treated with trifluoperazine following addition of paroxetine. The symptoms resolved after withdrawal of medication and did not recur following reinstitution of trifluoperazine.

MANAGEMENT: Caution is advised if phenothiazines must be used concomitantly with paroxetine. Pharmacologic response to the phenothiazine should be monitored more closely whenever paroxetine is added to or withdrawn from therapy, and the phenothiazine dosage adjusted as necessary.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.

Paxil

Generic Name: paroxetine

Brand name: Paxil, Brisdelle, Paxil CR, Pexeva

Synonyms: n.a.

What is Paxil?

Promethegan

Generic Name: promethazine

Brand name: Phenadoz, Promethegan, Phenergan

Synonyms: Promethegan (rectal)

What is Promethegan?