Paxil with antibiotics: interactions and safety
Antibiotic courses are common, short-term and often combined with chronic medications such as Paxil (Paroxetine). Most antibiotics do not interfere meaningfully with Paroxetine at 10mg, 20mg, 30mg, 40mg, but a few classes do, and a small number of combinations are best avoided.
Common antibiotic interactions
Macrolides (clarithromycin, erythromycin) and certain antifungals can inhibit hepatic metabolism (CYP3A4) and raise plasma levels of many medications including some Anti-Depressants agents. Rifampicin has the opposite effect, accelerating metabolism. Most penicillins, cephalosporins, fluoroquinolones and tetracyclines have no clinically meaningful interaction with Paroxetine at 10mg, 20mg, 30mg, 40mg.
Practical guidance
According to the prescribing information for Paroxetine, an antibiotic course should be reviewed by the prescriber or pharmacist for known interactions before Paxil is co-administered. Adjusted 10mg, 20mg, 30mg, 40mg dosing or temporary substitution is sometimes preferred for the duration of the antibiotic course.
Frequently asked questions
Can I take Paxil during an antibiotic course? ▾
For most common antibiotics, yes. A few classes — notably macrolides and azole antifungals — alter how Paroxetine is metabolised and may need a temporary 10mg, 20mg, 30mg, 40mg adjustment. The prescribing pharmacist should review any new antibiotic against the existing Paxil regimen.
Will antibiotics make Paxil stop working? ▾
Most antibiotics do not affect Paxil efficacy. Rifampicin and a few others can lower Paroxetine levels and reduce effect; in those cases the prescriber may adjust the dose during and shortly after the antibiotic course.
More on Paxil
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