Parotin 20 | 1 Strip

✔️ Uses of Parotin 20mg Tablet

• Treatment of Depression
• Treatment of Panic disorder
• Treatment of Anxiety disorder

✔️ How does Parotin 20mg Tablet work?

Parotin 20 works by inhibiting the reuptake of serotonin (a chemical that acts as a messenger between nerve cells of the brain and throughout the body) and increases the levels of serotonin in the brain thus improving mood and physical symptoms of depression and also relieving symptoms of panic disorder, anxiety, and obsessive-compulsive disorder.

✔️ Side Effects of Parotin 20mg Tablet

• Insomnia (difficulty sleeping)
• Headache
• Diarrhea
• Nausea
• Fatigue
• Dry mouth
• Loss of appetite
• Sexual disturbances

✔️ Indication of Parotin 20

Paroxetine is used in the treatment of depression, Panic disorder, and anxiety disorder.

✔️ Words of Advice

• Take Paroxetine as instructed by the doctor.
• Do not use in smaller or larger than the recommended dose.
• The dose is likely to change over time based on your response and hence adherence to the changes is a must.
• Do not stop the use of this medicine abruptly.

✔️ Mechanism of Action of Paroxetine:

• Serotonergic Activity Potentiation: The efficacy of Paroxetine is believed to be associated with the enhancement of serotonergic activity in the central nervous system (CNS). This is achieved by inhibiting the reuptake of serotonin (5-hydroxytryptamine, 5-HT) by neuronal cells.
• Inhibition of Serotonin Reuptake: Studies conducted at clinically relevant doses in humans have demonstrated that Paroxetine effectively blocks the uptake of serotonin into human platelets. This action increases the concentration of serotonin in the synaptic cleft, thereby prolonging its activity and enhancing neurotransmission.
• Selective Serotonin Reuptake Inhibition (SSRI): Paroxetine is recognized as a potent and highly selective inhibitor of neuronal serotonin reuptake. It has minimal effects on the reuptake of other neurotransmitters such as norepinephrine and dopamine.
• Receptor Affinity: In vitro radioligand binding studies have indicated that Paroxetine exhibits little affinity for various receptors including muscarinic, alpha1, alpha2, beta-adrenergic, dopamine (D2), 5-HT1, 5-HT2, and histamine (H1) receptors. This suggests that its therapeutic effects are primarily mediated through its actions on serotonin reuptake inhibition.
• Metabolism: The major metabolites of Paroxetine are significantly less potent compared to the parent compound, with relative potencies at most being 1/50 of the parent compound. As a result, these metabolites are considered essentially inactive in terms of pharmacological activity.

✔️ Dosage Guidelines for Paroxetine in Various Disorders:

1. Major Depressive Disorder:

• Usual Initial Dosage: 20 mg/day, administered as a single daily dose with or without food in the morning.
• Dose Adjustment: Patients not responding to 20 mg may benefit from dose increases in 10 mg/day increments, up to a maximum of 50 mg/day. Dose changes should occur at intervals of at least 1 week.
• Maintenance Therapy: Efficacy is maintained for up to 1 year with doses averaging about 30 mg/day.

2. Obsessive Compulsive Disorder (OCD):

• The usual Initial Dosage: is 20 mg/day, with a recommended dose of 40 mg/day.
• Dose Adjustment: Patients should be started on 20 mg/day and the dose can be increased in 10 mg/day increments. Dose changes should occur at intervals of at least 1 week.
• Maintenance Therapy: Dosage adjustments should be made to maintain the patient on the lowest effective dosage.

3. Panic Disorder:

• The usual Initial Dosage: is 10 mg/day, with a target dose of 40 mg/day.
• Dose Adjustment: Dose changes should occur in 10 mg/day increments at intervals of at least 1 week. The maximum dosage should not exceed 60 mg/day.
• Maintenance Therapy: Dosage adjustments should be made to maintain the patient on the lowest effective dosage.

4. Social Anxiety Disorder (SAD):

• The usual Initial Dosage: is 20 mg/day.
• Maintenance Therapy: Dosage adjustments should be made to maintain the patient on the lowest effective dosage.

5. Generalized Anxiety Disorder (GAD):

• The usual Initial Dosage: is 20 mg/day.
• Maintenance Therapy: Dosage adjustments should be made to maintain the patient on the lowest effective dosage.

6. Posttraumatic Stress Disorder (PTSD):

• The usual Initial Dosage: is 20 mg/day.
• Dose Adjustment: Dose changes, if indicated, should occur in 10 mg/day increments at intervals of at least 1 week.
• Maintenance Therapy: Dosage adjustments should be made to maintain the patient on the lowest effective dosage.

✔️ Interaction

Drug Interactions:

• Blood Thinners: Interaction with warfarin and clopidogrel.
• Antipsychotics: Potential interactions with perphenazine, thioridazine, and clozapine.
• Antidepressants: Interaction with clomipramine, moclobemide, methylthioninium chloride/methylene blue, nortriptyline, and desipramine.
• NSAIDs: Interaction with acetylsalicylic acid, ibuprofen, celecoxib, and others.
• Anticancer Drugs: Interaction with tamoxifen.
• Anti-migraine Medications: Interaction with sumatriptan.
• Dietary Supplement: Interaction with tryptophan.
• Anti-HIV Drugs: Interaction with ritonavir and fosamprenavir.
• Anticonvulsants: Interaction with phenobarbital, phenytoin, and carbamazepine.
• Antibiotics: Interaction with linezolid.
• Statins: Interaction with pravastatin.
• Neuromuscular Blockers: Interaction with mivacurium and suxamethonium.
• Herbal Supplements: Interaction with St. John’s wort.
• Anticholinergic Medications: Interaction with procyclidine.

Drug-Food Interactions: No established interactions were found.

Drug-Disease Interactions: Inform your doctor if you have glaucoma, diabetes, epilepsy, mania, bleeding problems, hyponatremia, heart, liver, or kidney dysfunction.

✔️ Contraindications

Do not take Parotin 20 if you are allergic to any of its components.

✔️ Pregnancy & Lactation

The effect of Paroxetine on labor and delivery in humans is currently unknown. Further research is needed to determine its impact in this regard.

Paroxetine, like many other drugs, is secreted in human milk. Caution should be exercised when Paroxetine hydrochloride is administered to a nursing woman. It's important to discuss the potential risks and benefits with your healthcare provider before using Paroxetine while breastfeeding.

✔️ Precautions & Warnings

• Avoid Parotin 20 if you have taken MAOIs in the last 14 days or if you are taking antipsychotic medicines like thioridazine or pimozide.
• Consult your doctor immediately if you experience suicidal thoughts or behaviors.
• Inform your doctor if you have/had epilepsy, mania, diabetes, low sodium levels in the blood, glaucoma, or are undergoing electro-convulsive therapy for severe depression.
• Do not take Parotin 20 if you are pregnant, and consult your doctor before taking it while breastfeeding.
• Parotin 20 may cause dizziness, confusion, sleepiness, and blurred vision, so avoid driving or operating machinery.
• PAROXETINE is not recommended for children under 18 years old due to a lack of established safety and effectiveness.
• Avoid alcohol consumption while taking Parotin 20 as it may exacerbate symptoms or side effects.

✔️ Storage Conditions:

Store below 30°C