Drug/Small Molecule:
paroxetine

last updated 08/10/2011

Dutch Pharmacogenetics Working Group Guideline for paroxetine and CYP2D6

Summary

Select an alternative drug rather than paroxetine for CYP2D6 ultra metabolizer patients.

Annotation

The Royal Dutch Pharmacists Association - Pharmacogenetics Working Group has evaluated therapeutic dose recommendations for paroxetine based on CYP2D6 genotype (PMID:21412232). They suggest using an alternative drug for ultra metabolizers.

Phenotype (Genotype) Therapeutic Dose Recommendation Level of Evidence Clinical Relevance
PM (2 inactive alleles) None. Published controlled studies of good quality* relating to phenotyped and/or genotyped patients or healthy volunteers, and having relevant pharmacokinetic or clinical endpoints. Minor clinical effect (S): QTc prolongation (<450 ms men, <470 ms women); INR increase < 4.5. Kinetic effect (S).
IM (2 decreased activity alleles, or 1 active and 1 inactive allele, or 1 decreased activity and 1 inactive allele) None. Published controlled studies of good quality* relating to phenotyped and/or genotyped patients or healthy volunteers, and having relevant pharmacokinetic or clinical endpoints. Minor clinical effect (S): QTc prolongation (<450 ms men, <470 ms women); INR increase < 4.5. Kinetic effect (S).
UM (gene duplication in absence of inactive or decreased activity alleles) Insufficient data to allow calculation of dose adjustment. Select alternative drug (e.g., citalopram, sertraline). Published controlled studies of good quality* relating to phenotyped and/or genotyped patients or healthy volunteers, and having relevant pharmacokinetic or clinical endpoints. Clinical effect (S): long-standing discomfort (48-168 hr) without permanent injury e.g. failure of therapy with tricyclic antidepressants, atypical antipsychotic drugs; extrapyramidal side effects; parkinsonism; ADE resulting from increased bioavailability of tricyclic antidepressants, metoprolol, propafenone (central effects e.g. dizziness); INR 4.5-6.0; neutropenia 1.0-1.5x10^9/l; leucopenia 2.0-3.0x10^9/l; thrombocytopenia 50-75x10^9/l.
Allele Type Alleles
active *1, *2, *33, *35
decreased activity *9, *10, *17, *29, *36, *41
inactive *3-*8, *11-*16, *19-*21, *38, *40, *42

PharmGKB gathers information regarding PGx on FDA drug labels from the FDA's "Table of Pharmacogenomic Biomarkers in Drug Labels", and from FDA-approved FDA and EMA-approved (European Medicines Agency) EMA labels brought to our attention. Excerpts from the label and downloadable highlighted label PDFs are manually curated by PharmGKB.

Please note that some drugs may have been removed from or added to the FDA's "Table of Pharmacogenomic Biomarkers in Drug Labels" without our knowledge. We periodically check the table for additions to this table and update PharmGKB accordingly.

There is currently no such list for European drug labels - we are working with the EMA to establish a list of European Public Assessment Reports (EPAR)s that contain PGx information. We are constructing this list by initially searching for drugs for which we have PGx-containing FDA drug labels - of these 44 EMA EPARs were identified and are being curated for pgx information.

We welcome any information regarding drug labels containing PGx information approved by the FDA, EMA or other Medicine Agencies around the world - please contact feedback.


last updated 10/25/2013

FDA Label for paroxetine and CYP2D6

This label is on the FDA Biomarker List
Informative PGx

Summary

The metabolism of paroxetine is accomplished in part by cytochrome CYP2D6. Coadministration of paroxetine with other drugs that are metabolized by this isozyme should be approached with caution. Due to the risk of serious ventricular arrhythmias and sudden death potentially associated with elevated plasma levels of thioridazine, paroxetine, and thioridazine should not be coadministered.

Annotation

PGx information can be found in the Pharmacokinetics and Drug Interactions label sections.

Excerpts from the paroxetine label:

The metabolism of paroxetine is accomplished in part by cytochrome CYP2D6. Saturation of this enzyme at clinical doses appears to account for the nonlinearity of paroxetine kinetics with increasing dose and increasing duration of treatment. The role of this enzyme in paroxetine metabolism also suggests potential drug-drug interactions.

In vitro drug interaction studies reveal that paroxetine inhibits CYP2D6. Clinical drug interaction studies have been performed with substrates of CYP2D6 and show that paroxetine can inhibit the metabolism of drugs metabolized by CYP2D6 including desipramine, risperidone, and atomoxetine.

Therefore, coadministration of paroxetine hydrochloride with other drugs that are metabolized by this isozyme, including certain drugs effective in the treatment of major depressive disorder (e.g., nortriptyline, amitriptyline, imipramine, desipramine, and fluoxetine), phenothiazines, risperidone, tamoxifen and Type 1C antiarrhythmics (e.g., propafenone, flecainide, and encainide), or that inhibit this enzyme (e.g., quinidine), should be approached with caution.

However, due to the risk of serious ventricular arrhythmias and sudden death potentially associated with elevated plasma levels of thioridazine, paroxetine, and thioridazine should not be coadministered.
Tamoxifen is a pro-drug requiring metabolic activation by CYP2D6. Inhibition of CYP2D6 by paroxetine may lead to reduced plasma concentrations of an active metabolite (endoxifen) and hence reduced efficacy of tamoxifen.

For the complete drug label text with sections containing pharmacogenetic information highlighted, see the paroxetine drug label.

*Disclaimer: The contents of this page have not been endorsed by the FDA and are the sole responsibility of PharmGKB.

Full label available at DailyMed

Genes and/or phenotypes found in this label

  • Anxiety Disorders
    • Indications & usage section, Adverse reactions section, Precautions section
    • source: PHONT
  • Breast Neoplasms
    • Adverse reactions section, Precautions section
    • source: PHONT
  • Death
    • Indications & usage section, Warnings section, Precautions section
    • source: PHONT
  • Depression
    • Indications & usage section, Contraindications section, Warnings section, Adverse reactions section, Precautions section
    • source: PHONT
  • Depression, Postpartum
    • Indications & usage section, Contraindications section, Warnings section, Adverse reactions section, Precautions section
    • source: PHONT
  • Depressive Disorder
    • Indications & usage section, Contraindications section, Warnings section, Adverse reactions section, Precautions section
    • source: PHONT
  • Depressive Disorder, Major
    • Warnings section, Adverse reactions section, Precautions section
    • source: PHONT
  • Nausea
    • Indications & usage section, Warnings section, Adverse reactions section, Precautions section
    • source: PHONT
  • Obsessive-Compulsive Disorder
    • Indications & usage section, Warnings section, Adverse reactions section, Precautions section
    • source: PHONT
  • CYP2D6
    • Drug interactions section, Pharmacokinetics section
    • source: FDA Label

PharmGKB contains no Clinical Variants that meet the highest level of criteria.

To see more Clinical Variants with lower levels of criteria, click the button at the bottom of the page.

Disclaimer: The PharmGKB's clinical annotations reflect expert consensus based on clinical evidence and peer-reviewed literature available at the time they are written and are intended only to assist clinicians in decision-making and to identify questions for further research. New evidence may have emerged since the time an annotation was submitted to the PharmGKB. The annotations are limited in scope and are not applicable to interventions or diseases that are not specifically identified.

The annotations do not account for individual variations among patients, and cannot be considered inclusive of all proper methods of care or exclusive of other treatments. It remains the responsibility of the health-care provider to determine the best course of treatment for a patient. Adherence to any guideline is voluntary, with the ultimate determination regarding its application to be made solely by the clinician and the patient. PharmGKB assumes no responsibility for any injury or damage to persons or property arising out of or related to any use of the PharmGKB clinical annotations, or for any errors or omissions.

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This is a non-comprehensive list of genetic tests with pharmacogenetics relevance, typically submitted by the manufacturer and manually curated by PharmGKB. The information listed is provided for educational purposes only and does not constitute an endorsement of any listed test or manufacturer.

A more complete listing of genetic tests is found at the Genetic Testing Registry (GTR).

PGx Test Variants Assayed Gene?
Roche AmpliChip CYP450 Test CYP2D6*1, CYP2D6*10A, CYP2D6*10B, CYP2D6*11, CYP2D6*15, CYP2D6*17, CYP2D6*19, CYP2D6*20, CYP2D6*29, CYP2D6*2A, CYP2D6*2B, CYP2D6*2D, CYP2D6*3, CYP2D6*40, CYP2D6*41, CYP2D6*4A, CYP2D6*4B, CYP2D6*4D, CYP2D6*4J, CYP2D6*4K, CYP2D6*5, CYP2D6*6A, CYP2D6*6B, CYP2D6*6C, CYP2D6*7, CYP2D6*8, CYP2D6*9 , CYP2D6*1XN , CYP2D6*2XN , CYP2D6*4XN , CYP2D6*10XN , CYP2D6*17XN , CYP2D6*35XN , CYP2D6*41XN , *35 , *36
DMET Plus (Affymetrix, Inc) Variant in CYP2D6
VeraCode ADME Core Panel (Illumina, Inc) Variant in CYP2D6
TaqMan Drug Metabolism Genotyping Assay Sets (Applied Biosystems, Inc) Variant in CYP2D6
Laboratory Corporation of America Variant in CYP2D6
Quest Diagnostics, Inc Variant in CYP2D6
iPLEX ADME PGx (Sequenom, Inc) CYP2D6*11, CYP2D6*12, CYP2D6*14A, CYP2D6*14B, CYP2D6*15, CYP2D6*17, CYP2D6*18, CYP2D6*19, CYP2D6*1A, CYP2D6*20, CYP2D6*21A, CYP2D6*21B, CYP2D6*3, CYP2D6*30, CYP2D6*38, CYP2D6*4, CYP2D6*40, CYP2D6*41, CYP2D6*42, CYP2D6*44, CYP2D6*4M, CYP2D6*56A, CYP2D6*56B, CYP2D6*58, CYP2D6*6, CYP2D6*64, CYP2D6*69, CYP2D6*7, CYP2D6*8, CYP2D6*9 , Indistinguishable haplotypes with the current ADME core SNP: (CYP2D6*2A,CYP2D6*31,CYP2D6*51), (CYP2D6*2L,CYP2D6*35,CYP2D6*71), (CYP2D6*10,CYP2D6*36,CYP2D6*37,CYP2D6*47,CYP2D6*49,CYP2D6*52,CYP2D6*54,CYP2D6*57,CYP2D6*65,CYP2D6*72), CNV Assay: CYP2D6*5, CYP2D6*NxN (Haplotypes are identified manually)
Luminex xTAG CYP2D6 Assay CYP2D6*1, CYP2D6*10, CYP2D6*11, CYP2D6*15, CYP2D6*17, CYP2D6*2, CYP2D6*29, CYP2D6*3, CYP2D6*4, CYP2D6*41, CYP2D6*5, CYP2D6*6, CYP2D6*7, CYP2D6*8, CYP2D6*9 , CYP2D6*XN , *35
Cytochrome P450 2D6 (CYP2D6) CYP2D6*2, CYP2D6*5, CYP2D6*8 , rs28371725 , rs5030867 , rs5030656 , rs35742686 , rs3892097 , rs5030865 , rs5030655 , rs61736512 , rs28371706 , rs5030862 , rs1065852
GenoChip CYP2D6 (PharmGenomics, GmbH) CYP2D6*5 , rs59421388 , rs28371725 , rs5030867 , rs5030656 , rs35742686 , rs3892097 , rs5030865 , rs5030655 , rs28371706 , rs5030863 , rs1065852 , *xN (gene duplication)
INFINITI CYP450 2D6I (AutoGenomics, Inc) CYP2D6*10, CYP2D6*12, CYP2D6*17, CYP2D6*2, CYP2D6*29, CYP2D6*3, CYP2D6*4, CYP2D6*41, CYP2D6*5, CYP2D6*6, CYP2D6*7, CYP2D6*8, CYP2D6*9 , rs28371725 , rs5030867 , rs5030656 , rs35742686 , rs3892097 , rs5030865 , rs5030655 , rs61736512 , rs28371706 , rs5030862 , rs1065852 , CYP2D6*XN , *14

The table below contains information about pharmacogenomic variants on PharmGKB. Please follow the link in the "Variant" column for more information about a particular variant. Each link in the "Variant" column leads to the corresponding PharmGKB Variant Page. The Variant Page contains summary data, including PharmGKB manually curated information about variant-drug pairs based on individual PubMed publications. The PMIDs for these PubMed publications can be found on the Variant Page.

The tags in the first column of the table indicate what type of information can be found on the corresponding Variant Page.

Links in the "Gene" column lead to PharmGKB Gene Pages.

Gene ? Variant?
(138)
Alternate Names / Tag SNPs ? Drugs ? Alleles ?
(+ chr strand)
Function ? Amino Acid?
Translation
No VIP available No VIP available VA CYP2C19 *1 N/A N/A N/A
No VIP available No VIP available VA CYP2C19 *2 N/A N/A N/A
No VIP available No VIP available VA CYP2C19 *3 N/A N/A N/A
No VIP available No VIP available VA CYP2C19 *17 N/A N/A N/A
VIP CA VA CYP2D6 *1 N/A N/A N/A
No VIP available CA VA CYP2D6 *1XN N/A N/A N/A
VIP CA VA CYP2D6 *2 N/A N/A N/A
No VIP available CA VA CYP2D6 *2XN N/A N/A N/A
VIP CA VA CYP2D6 *3 N/A N/A N/A
VIP CA VA CYP2D6 *4 N/A N/A N/A
No VIP available CA VA CYP2D6 *5 N/A N/A N/A
VIP CA VA CYP2D6 *6 N/A N/A N/A
VIP No VIP available VA CYP2D6 *9 N/A N/A N/A
VIP CA VA CYP2D6 *10 N/A N/A N/A
VIP No VIP available VA CYP2D6 *17 N/A N/A N/A
VIP No VIP available No VIP available CYP2D6 *29 N/A N/A N/A
No VIP available No VIP available VA CYP2D6 *39 N/A N/A N/A
VIP No VIP available VA CYP2D6 *41 N/A N/A N/A
No VIP available CA VA SLC6A4 HTTLPR long form (L allele) N/A N/A N/A
No VIP available CA VA SLC6A4 HTTLPR short form (S allele) N/A N/A N/A
No VIP available No VIP available VA SLC6A4 L allele-rs25531C N/A N/A N/A
No VIP available No VIP available VA SLC6A4 L allele-rs25531T N/A N/A N/A
No VIP available No Clinical Annotations available VA
CYP2D6 poor metabolizers N/A N/A N/A
No VIP available No Clinical Annotations available VA
CYP2D6 poor metabolizer N/A N/A N/A
No VIP available CA VA
rs10042486 13855688C>T, 1791G>A, 63261329C>T
C > T
Not Available
No VIP available CA VA
rs10248420 182579T>C, 2481+788T>C, 25197829A>G, 87164986A>G
A > G
Intronic
No VIP available CA VA
rs10280101 193980T>G, 25186428A>C, 2686-3393T>G, 87153585A>C
A > C
Intronic
No VIP available No Clinical Annotations available VA
rs1045642 208920T>A, 208920T>C, 25171488A>G, 25171488A>T, 3435T>A, 3435T>C, 87138645A>G, 87138645A>T, ABCB1*6, ABCB1: 3435C>T, ABCB1: C3435T, ABCB1: c.3435C>T, ABCB1:3435C>T, Ile1145=, Ile1145Ile, MDR1 3435C>T, MDR1 C3435T, PGP C3435T, c.3435C>T, mRNA 3853C>T
A > T
A > G
Synonymous
Ile1145Ile
No VIP available No Clinical Annotations available VA
rs1062613 -24T>C, 113846006T>C, 17408422T>C, 210T>C, 5210T>C, HTR3A:C178T, Pro16Ser
T > C
Not Available
rs1065852 100C>T, 21917263G>A, 42526694G>A, 5190C>T, CYP2D6:100C>T, Pro34Ser, part of CYP2D6*4 and CYP2D6*10
G > A
Missense
Pro34Ser
No VIP available No Clinical Annotations available VA
rs10789970 -1710C>T, 113773946C>T, 17336362C>T, 3358C>T
C > T
5' Flanking
No VIP available CA VA
rs11042725 -1473C>A, -1923, 10265325C>A, 10325325C>A, ADM:, C>A
C > A
5' Flanking
No VIP available No Clinical Annotations available VA
rs1109866 117G>A, 220083279C>T, 5434G>A, 70292697C>T, Leu39=
C > T
Synonymous
Leu39Leu
No VIP available No Clinical Annotations available VA
rs1109867 -58C>A, 220083453G>T, 5260C>A, 70292871G>T
G > T
5' UTR
No VIP available No Clinical Annotations available VA
rs11214763 -761G>A, 113774895G>A, 17337311G>A, 4307G>A
G > A
5' Flanking
No VIP available No Clinical Annotations available VA
rs1160351 280+127738T>G, 29015982A>C, 48015982A>C
A > C
Intronic
No VIP available No Clinical Annotations available VA
rs1176713 113860425A>G, 1332A>G, 1395A>G, 1467A>G, 1491A>G, 17422841A>G, 19629A>G, Leu444=, Leu465=, Leu497=
A > G
Not Available
Leu444Leu
No VIP available No Clinical Annotations available VA
rs1176722 113848474G>A, 17410890G>A, 23-19G>A, 319-19G>A, 7678G>A, 86-19G>A
G > A
Intronic
No VIP available No Clinical Annotations available VA
rs1176744 113803028A>C, 17365444A>C, 32440A>C, 386A>C, Tyr129Ser
A > C
Missense
Tyr129Ser
No VIP available No Clinical Annotations available VA
rs1176746 113802601A>G, 17365017A>G, 32013A>G, 368+12A>G
A > G
Intronic
No VIP available CA VA
rs11983225 186045A>G, 2482-707A>G, 25194363T>C, 87161520T>C
T > C
Intronic
No VIP available CA VA
rs12720067 178209G>A, 2320-695G>A, 25202199C>T, 87169356C>T
C > T
Intronic
No VIP available CA VA
rs130058 -161A>T, 16293115T>A, 78173281T>A
T > A
5' Flanking
No VIP available CA VA
rs1360780 106-2636A>G, 35547571T>C, 35607571T>C, 93790A>G
T > C
Intronic
No VIP available CA VA
rs1364043 13845210T>G, 63250851T>G
T > G
Not Available
No VIP available No Clinical Annotations available VA
rs1374385 -1099G>C, 239149645C>G, 5095904C>G
C > G
5' Flanking
No VIP available No Clinical Annotations available VA
rs1386494 24918T>C, 34495849T>C, 608+9108T>C, 72352543T>C
T > C
Intronic
No VIP available CA VA
rs153549 112236297A>G, 20550169A>G, 351+1780T>C
A > G
Intronic
No VIP available CA VA
rs153560 112254377G>A, 20568249G>A, 212+2483C>T
G > A
Intronic
VIP No Clinical Annotations available No Variant Annotations available
rs16947 21914512A>G, 42523943A>G, 733C>C, 7941C>C, 886C>C, Arg245=, Arg296=, CYP2D6:2850C>T
A > G
Not Available
No VIP available No Clinical Annotations available VA
rs1800042 13851088C>T, 63256729C>T, 6391G>A, 818G>A, Gly273Asp
C > T
Missense
Gly273Asp
No VIP available CA VA
rs1800532 17987816G>T, 18047816G>T, 19520C>A, 803+221C>A
G > T
Intronic
No VIP available No Clinical Annotations available VA
rs1805054 19992513C>T, 267C>T, 6672601C>T, Tyr89=
C > T
Not Available
No VIP available No Clinical Annotations available VA
rs182694 43698815A>G, 522+1760A>G, 579+1760A>G, 588+1760A>G, 594+1760A>G, 621+1760A>G, 693256A>G
A > G
Intronic
No VIP available CA VA
rs2032582 186947T>A, 186947T>G, 25193461A>C, 25193461A>T, 2677A, 2677G, 2677T, 2677T>A, 2677T>G, 3095G>T/A, 87160618A>C, 87160618A>T, 893 Ala, 893 Ser, 893 Thr, ABCB1*7, ABCB1: 2677G>T/A, ABCB1: 2677T/A>G, ABCB1: A893S, ABCB1: G2677T/A, ABCB1: c.2677G>T/A, ABCB1:2677G>A/T, ABCB1:2677G>T/A, ABCB1:A893T, Ala893Ser/Thr, MDR1, MDR1 G2677T/A, Ser893Ala, Ser893Thr, mRNA 3095G>T/A, p.Ala893Ser/Thr
A > C
A > T
Missense
Ser893Ala
Ser893Thr
No VIP available CA VA
rs2032583 187004T>C, 25193404A>G, 2685+49T>C, 87160561A>G
A > G
Intronic
No VIP available CA VA
rs2235015 148001G>T, 25232407C>A, 287-25G>T, 87199564C>A
C > A
Intronic
No VIP available CA VA
rs2235040 181815G>A, 2481+24G>A, 25198593C>T, 87165750C>T
C > T
Intronic
No VIP available CA VA
rs2235067 197643G>A, 25182765C>T, 2786+170G>A, 87149922C>T
C > T
Intronic
No VIP available No Clinical Annotations available VA
rs2276305 113803104G>A, 113803104G>C, 17365520G>A, 17365520G>C, 32516G>A, 32516G>C, 462G>A, 462G>C, Ala154=
G > C
G > A
Synonymous
Ala154Ala
No VIP available No Clinical Annotations available VA
rs2276307 113803887A>G, 17366303A>G, 33299A>G, 696+72A>G
A > G
Intronic
No VIP available CA VA
rs2470890 +, 1548C>T, 295T>C, 37544C>T, 45837983C>T, 75047426C>T, Asn516=, CYP1A2*1B, CYP1A2:1545T>C, CYP1A2:1548T>C, CYP1A2:5347T>C, CYP1A2:Asn516Asn, CYP1A2:Ex7
C > T
Synonymous
Asn516Asn
No VIP available CA VA
rs2472304 1042+43G>A, 34356G>A, 45834795G>A, 75044238G>A
G > A
Intronic
rs28371706 21916341G>A, 320C>T, 42525772G>A, 6112C>T, CYP2D6:1023 C>T, Thr107Ile
G > A
Missense
Thr107Ile
rs28371725 21914374C>T, 42523805C>T, 8079G>A, 832+39G>A, 985+39G>A, CYP2D6*41, CYP2D6:2988G>A, part of CYP2D6*41
C > T
Intronic
No VIP available CA VA
rs28401781 199237G>A, 25181171C>T, 2927+314G>A, 87148328C>T
C > T
Intronic
rs35742686 -1793delT, -1830delT, -1940delT, 23418678delT, 40+2664delT, 42128242delT, 50569delT, 50583delT, 598delA, 622delA, 6750delA, 775delA, Arg200Glyfs, Arg208Glyfs, Arg259Glyfs
T > -
Not Available
Arg208Gly
No VIP available No Clinical Annotations available VA
rs3731885 *700C>T, -1074C>T, 220084469G>A, 4244C>T, 70293887G>A
G > A
5' Flanking
No VIP available No Clinical Annotations available VA
rs3747802 -440T>C, 25375429A>G, 458+2615A>G, 4979T>C, 509+2615A>G, 87342586A>G
A > G
5' UTR
No VIP available No Clinical Annotations available VA
rs3755047 *305C>T, -1469C>T, 220084864G>A, 3849C>T, 70294282G>A
G > A
5' Flanking
No VIP available No Clinical Annotations available VA
rs3758987 -381T>C, 113775275T>C, 17337691T>C, 4687T>C
T > C
5' Flanking
No VIP available No Clinical Annotations available VA
rs3800373 *1136G>T, 158885G>T, 35482476C>A, 35542476C>A
C > A
3' UTR
No VIP available No Clinical Annotations available VA
rs3813929 -759, -759C>T, -850C>T, 113818520C>T, 250852C>T, 4970C>T, HTR2C:, HTR2C: -759C/T
C > T
5' Flanking
rs3892097 21915516C>T, 353-1G>A, 42524947C>T, 506-1G>A, 6937G>A, CYP2D6*4, CYP2D6:1846G>A, part of CYP2D6*4
C > T
Acceptor
No VIP available CA VA
rs4148739 186516A>G, 2482-236A>G, 25193892T>C, 87161049T>C
T > C
Intronic
No VIP available CA VA
rs4148740 195462T>C, 25184946A>G, 2686-1911T>C, 87152103A>G
A > G
Intronic
No VIP available CA VA
rs4646425 33399C>T, 45833838C>T, 75043281C>T, 832-249C>T
C > T
Intronic
No VIP available CA VA
rs4646427 1253+81T>C, 35810T>C, 45836249T>C, 75045692T>C
T > C
Intronic
rs4680 1-5G>A, 19951271G>A, 27009G>A, 3103421G>A, 322G>A, 472G>A, COMP: Val158Met, COMT:Val108Met, Val108Met, Val158Met
G > A
5' Flanking
Val158Met
No VIP available CA VA
rs4713916 -20+18122T>C, 31378T>C, 35609983A>G, 35669983A>G
A > G
Intronic
No VIP available CA VA
rs495794 112201094A>G, 20514966A>G, 225+665A>G, 229+665A>G, 301+665A>G
A > G
Intronic
rs5030655 -1098delA, -1563delA, -951delA, -988delA, 23419520delA, 277delT, 353-140delT, 40+3506delA, 42129084delA, 454delT, 51411delA, 51425delA, 5908delT, CYP2D6*6, CYP2D6:1707 del T, Trp152Glyfs, Trp93Glyfs, part of CYP2D6*6
A > -
Not Available
Trp152Gly
rs5030656 21914745_21914747delCTT, 42524176_42524178delCTT, 688_690delAAG, 7706_7708delAAG, 841_843delAAG, Lys230del, Lys281del
CTT > -
CTT > TTC
Non-synonymous
No VIP available No Clinical Annotations available VA
rs518147 -697G>C, -788G>C, 113818582G>C, 250914G>C, 5032G>C, HTR2C: -697G/C
C > G
5' UTR
No VIP available No Clinical Annotations available VA
rs56294817 -424G>T, 239148970C>A, 5095229C>A
C > A
5' Flanking
No VIP available CA VA
rs57098334 GGGTGGGCT, SLC6A4:
C > (CCCACCCGA)9
C > (CCCACCCGA)10
C > (CCCACCCGA)12
Not Available
rs59421388 1012G>A, 21914179C>T, 3271G>A, 42523610C>T, 8274G>A, 859G>A, CYP2D6: 3183G>A, Val287Met, Val338Met
G > T
G > C
Missense
Val287Met
rs61736512 1747G>A, 21915703C>T, 353-188G>A, 406G>A, 42525134C>T, 6750G>A, CYP2D6: 1659G>A, Val136Met
G > T
G > C
Intronic
Val136Met
No VIP available CA VA
rs6265 196G>A, 220G>A, 241G>A, 27619916C>T, 27679916C>T, 283G>A, 434C>T, 442G>A, 503C>T, 68690G>A, BDNF:Val66Met, Val148Met, Val66Met, Val74Met, Val81Met, Val95Met
C > T
Missense
Val66Met
No VIP available CA VA
rs6280 113890815C>T, 12085G>A, 20385961C>T, 25G>A, DRD3 Ser9Gly, DRD3 rs6280, DRD3: 9 Ser>Gly, DRD3: Gly9Ser, DRD3: Ser9Gly, DRD3:Ser9Gly, Gly9Ser, c.25T>C, p.S9G
C > T
Missense
Gly9Ser
No VIP available CA VA
rs6295 1-1019C>G, 1-1019G>C, 13852924C>C, 13852924C>G, 4555G>C, 4555G>G, 63258565C>C, 63258565C>G, HTR1A: -1019C/G
C > G
5' Flanking
No VIP available No Clinical Annotations available VA
rs6311 -1438, -510G>A, -998G>A, 28451478C>T, 4692G>A, 47471478C>T, G>A, HTR2A c.-1438G>A, HTR2A:, HTR2A: -1438G/A, HTR2A:-1438G>A
C > T
5' Flanking
No VIP available CA VA
rs6313 102C>T, 160+869C>T, 28449940G>A, 47469940G>A, 6230C>T, HTR2A:102C>T, HTR2A:T102C, Ser34=
G > A
Intronic
Ser34Ser
No VIP available CA VA
rs6314 1102C>T, 1354C>T, 28389034G>A, 47409034G>A, 67136C>T, HTR2A: C1354T, HTR2A: His452Tyr, His368Tyr, His452Tyr
G > A
Missense
His368Tyr
No VIP available No Clinical Annotations available VA
rs6946119 25161708T>C, 87128865T>C
T > C
Not Available
rs762551 -9-154C>A, 32035C>A, 45832474C>A, 75041917C>A, CYP1A2*1F, CYP1A2:734C>A
C > A
Intronic
No VIP available CA VA
rs7787082 190514C>T, 25189894G>A, 2685+3559C>T, 87157051G>A
G > A
Intronic
No VIP available No Clinical Annotations available VA
rs7997012 28391985A>G, 362-2211T>C, 47411985A>G, 5-HTR2A intron 2 variant, 614-2211T>C, 64185T>C
A > G
Intronic
No VIP available No Clinical Annotations available VA
rs9282564 118125A>G, 25262283T>C, 61A>G, 87229440T>C, ABCB1: c.61A>G, Asn21Asp, mRNA 479A>G, p.Asn21Asp
T > C
Missense
Asn21Asp
Alleles, Functions, and Amino Acid Translations are all sourced from dbSNP 138
2D structure from PubChem
provided by PubChem

Overview

Generic Names
  • Paroxetina [INN-Spanish]
  • Paroxetine Hcl
  • Paroxetinum [INN-Latin]
  • paroxetine
Trade Names
  • Aropax
  • Paxil
  • Paxil CR
  • Pexeva
  • Seroxat
  • Seroxat CR
Brand Mixture Names

PharmGKB Accession Id:
PA450801

Description

Paroxetine hydrochloride and paroxetine mesylate belong to a class of antidepressant agents known as selective serotonin-reuptake inhibitors (SSRIs). Despite distinct structural differences between compounds in this class, SSRIs possess similar pharmacological activity. As with other antidepressant agents, several weeks of therapy may be required before a clinical effect is seen. SSRIs are potent inhibitors of neuronal serotonin reuptake. They have little to no effect on norepinephrine or dopamine reuptake and do not antagonize alpha- or beta-adrenergic, dopamine D 2 or histamine H 1 receptors. During acute use, SSRIs block serotonin reuptake and increase serotonin stimulation of somatodendritic 5-HT 1A and terminal autoreceptors. Chronic use leads to desensitization of somatodendritic 5-HT 1A and terminal autoreceptors. The overall clinical effect of increased mood and decreased anxiety is thought to be due to adaptive changes in neuronal function that leads to enhanced serotonergic neurotransmission. Side effects include dry mouth, nausea, dizziness, drowsiness, sexual dysfunction and headache (see Toxicity section below for a complete listing of side effects). Side effects generally occur during the first two weeks of therapy and are usually less severe and frequent than those observed with tricyclic antidepressants. Paroxetine hydrochloride and mesylate are considered therapeutic alternatives rather than generic equivalents by the US Food and Drug Administration (FDA); both agents contain the same active moiety (i.e. paroxetine), but are formulated as different salt forms. Clinical studies establishing the efficacy of paroxetine in various conditions were performed using paroxetine hydrochloride. Since both agents contain the same active moiety, the clinical efficacy of both agents is thought to be similar. Paroxetine may be used to treat major depressive disorder (MDD), panic disorder with or without agoraphobia, obsessive-compulsive disorder (OCD), social anxiety disorder (social phobia), generalized anxiety disorder (GAD), post-traumatic stress disorder (PTSD) and premenstrual dysphoric disorder (PMDD). Paroxetine has the most evidence supporting its use for anxiety-related disorders of the SSRIs. It has the greatest anticholinergic activity of the agents in this class and compared to other SSRIs, paroxetine may cause greater weight gain, sexual dysfunction, sedation and constipation.

Source: Drug Bank

Indication

Labeled indications include: major depressive disorder (MDD), panic disorder with or without agoraphobia, obsessive-compulsive disorder (OCD), social anxiety disorder (social phobia), generalized anxiety disorder (GAD), post-traumatic stress disorder (PTSD), and premenstrual dysphoric disorder (PMDD). Unlabeled indications include: eating disorders, impulse control disorders, vasomotor symptoms of menopause, obsessive-compulsive disorder (OCD) in children, and mild dementia-associated agitation in nonpsychotic individuals.

Source: Drug Bank

Other Vocabularies

Information pulled from DrugBank has not been reviewed by PharmGKB.

Pharmacology, Interactions, and Contraindications

Mechanism of Action

Paroxetine is a potent and highly selective inhibitor of neuronal serotonin reuptake. Paroxetine likely inhibits the reuptake of serotonin at the neuronal membrane, enhances serotonergic neurotransmission by reducing turnover of the neurotransmitter, therefore it prolongs its activity at synaptic receptor sites and potentiates 5-HT in the CNS; paroxetine is more potent than both sertraline and fluoxetine in its ability to inhibit 5-HT reuptake. Compared to the tricyclic antidepressants, SSRIs have dramatically decreased binding to histamine, acetylcholine, and norepinephrine receptors.

Source: Drug Bank

Pharmacology

Paroxetine, an antidepressant drug of the selective serotonin reuptake inhibitor (SSRI) type, has no active metabolites and has the highest specificity for serotonin receptors of all the SSRIs. It is used to treat depression resistant to other antidepressants, depression complicated by anxiety, panic disorder, social and general anxiety disorder, obsessive-compulsive disorder (OCD), premenstrual dysphoric disorder, premature ejaculation, and hot flashes of menopause in women with breast cancer.

Source: Drug Bank

Food Interaction

Take without regard to meals. Avoid alcohol.

Source: Drug Bank

Absorption, Distribution, Metabolism, Elimination & Toxicity

Biotransformation

Paroxetine is extensively metabolized, likely in the liver. The main metabolites are polar and conjugated products of oxidation and methylation, which are readily eliminated by the body. The predominant metabolites are glucuronic acid and sulfate conjugates. Paroxetine metabolites do not possess significant pharmacologic activity (less than 2% that of parent compound). Paroxetine is metabolized by cytochrome P450 (CYP) 2D6. Enzyme saturation appears to account for the nonlinear pharmacokinetics observed with increasing dose and duration of therapy.

Source: Drug Bank

Protein Binding

~ 95% bound to plasma proteins.

Source: Drug Bank

Absorption

Paroxetine hydrochloride is slowly, but completely absorbed following oral administration. The oral bioavailability appears to be low due to extensive first-pass metabolism. Paroxetine hydrochloride oral tablets and suspension are reportedly bioequivalent. Paroxetine mesylate is completely following oral administration. Absorption of either salt form is not substantially affected by food.

Source: Drug Bank

Half-Life

21-24 hours

Source: Drug Bank

Toxicity

LD 50=500mg/kg (orally in mice). Symptoms of overdose include: coma, dizziness, drowsiness, facial flushing, nausea, sweating, tremor, vomiting. Side effects include: nervous system effects such as asthenia, somnolence, dizziness, insomnia, tremor, and nervousness; GI effects such as nausea, decreased appetite, constipation, diarrhea, and dry mouth; impotence, ejaculatory dysfunction (principally ejaculatory delay), and other male genital disorders; female genital disorders (principally anorgasmia or difficulty reaching climax/orgasm); and sweating. Discontinuation syndrome may occur with abrupt withdrawal. Symptoms of discontinuation syndrome include flu-like symptoms, insomnia, nausea, imbalance, sensory changes, and hyperactivity.

Source: Drug Bank

Route of Elimination

Paroxetine is extensively metabolized and the metabolites are primarily excreted in the urine and to some extent in the feces.

Source: Drug Bank

Volume of Distribution

3.1-28 L/kg observed in animal studies

Source: Drug Bank

Chemical Properties

Chemical Formula

C19H20FNO3

Source: Drug Bank

Isomeric SMILES

c1cc(ccc1[C@@H]2CCNC[C@H]2COc3ccc4c(c3)OCO4)F

Source: OpenEye

Canonical SMILES

FC1=CC=C(C=C1)[C@@H]1CCNC[C@H]

Source: Drug Bank

Average Molecular Weight

329.3654

Source: Drug Bank

Monoisotopic Molecular Weight

329.142721716

Source: Drug Bank

PharmGKB Curated Pathways

Pathways created internally by PharmGKB based primarily on literature evidence.

  1. Paroxetine Pathway, Pharmacokinetics
    Genes involved in the metabolism of paroxetine and in the mechanism of action.
  1. Selective Serotonin Reuptake Inhibitor Pathway, Pharmacodynamics
    Genes involved in serotonin synthesis, release, reuptake, and in mediation of the antidepressant effect of selective serotonin reuptake inhibitors (SSRI) in human brain.

External Pathways

Links to non-PharmGKB pathways.

PharmGKB contains no links to external pathways for this drug. To report a pathway, click here.

Genes that are associated with this drug in PharmGKB's database based on (1) variant annotations, (2) literature review, (3) pathways or (4) information automatically retrieved from DrugBank, depending on the "evidence" and "source" listed below.

Curated Information ?

Drug Targets

Gene Description
CHRM1 (source: Drug Bank)
CHRM2 (source: Drug Bank)
CHRM3 (source: Drug Bank)
CHRM4 (source: Drug Bank)
CHRM5 (source: Drug Bank)
HTR2A (source: Drug Bank)
SLC6A2 (source: Drug Bank)
SLC6A4 (source: Drug Bank)

Drug Interactions

Drug Description
paroxetine Increased risk of CNS adverse effects (source: Drug Bank)
paroxetine Increased risk of CNS adverse effects (source: Drug Bank)
paroxetine The CYP2D6 inhibitor could increase the effect and toxicity of atomoxetine (source: Drug Bank)
paroxetine The CYP2D6 inhibitor could increase the effect and toxicity of atomoxetine (source: Drug Bank)
paroxetine The SSRI increases the effect of the beta-blocker (source: Drug Bank)
paroxetine The SSRI, paroxetine, may increase the bradycardic effect of the beta-blocker, carvedilol. (source: Drug Bank)
paroxetine Risk of serotoninergic syndrome (source: Drug Bank)
paroxetine Combination associated with possible serotoninergic syndrome (source: Drug Bank)
paroxetine Combination associated with possible serotoninergic syndrome (source: Drug Bank)
paroxetine Risk of serotoninergic syndrome (source: Drug Bank)
paroxetine Increased risk of CNS adverse effects (source: Drug Bank)
paroxetine Increased risk of CNS adverse effects (source: Drug Bank)
paroxetine Risk of serotoninergic syndrome (source: Drug Bank)
paroxetine Risk of serotoninergic syndrome (source: Drug Bank)
paroxetine Increased risk of CNS adverse effects (source: Drug Bank)
paroxetine Paroxetine increases the effect and toxicity of galantamine (source: Drug Bank)
paroxetine Paroxetine increases the effect and toxicity of galantamine (source: Drug Bank)
paroxetine Additive anticoagulant/antiplatelet effects may increase bleed risk. Concomitant therapy should be avoided. (source: Drug Bank)
paroxetine Possible severe adverse reaction with this combination (source: Drug Bank)
paroxetine Possible severe adverse reaction with this combination (source: Drug Bank)
paroxetine Concomitant therapy may result in additive antiplatelet effects and increase the risk of bleeding. Monitor for increased risk of bleeding during concomitant therapy. (source: Drug Bank)
paroxetine Combination associated with possible serotoninergic syndrome (source: Drug Bank)
paroxetine Combination associated with possible serotoninergic syndrome (source: Drug Bank)
paroxetine Risk of serotoninergic syndrome (source: Drug Bank)
paroxetine Risk of serotoninergic syndrome (source: Drug Bank)
paroxetine Increased risk of cardiotoxicity and arrhythmias (source: Drug Bank)
paroxetine Increased risk of cardiotoxicity and arrhythmias (source: Drug Bank)
paroxetine The SSRI increases the effect of the beta-blocker (source: Drug Bank)
paroxetine The SSRI increases the effect of the beta-blocker (source: Drug Bank)
paroxetine Possible severe adverse reaction with this combination (source: Drug Bank)
paroxetine Possible severe adverse reaction with this combination (source: Drug Bank)
paroxetine Increased risk of CNS adverse effects (source: Drug Bank)
paroxetine Increased risk of CNS adverse effects (source: Drug Bank)
paroxetine Increased risk of serotonin syndrome (source: Drug Bank)
paroxetine Increased risk of serotonin syndrome (source: Drug Bank)
acenocoumarol The SSRI increases the effect of the anticoagulant (source: Drug Bank)
acenocoumarol The SSRI, paroxetine, increases the effect of the anticoagulant, acenocoumarol. (source: Drug Bank)
almotriptan Increased risk of CNS adverse effects (source: Drug Bank)
almotriptan Increased risk of CNS adverse effects (source: Drug Bank)
amphetamine Risk of serotoninergic syndrome (source: Drug Bank)
amphetamine Risk of serotoninergic syndrome (source: Drug Bank)
anisindione The SSRI, paroxetine, increases the effect of the anticoagulant, anisindione. (source: Drug Bank)
atomoxetine The CYP2D6 inhibitor could increases the effect and toxicity of atomoxetine (source: Drug Bank)
atomoxetine The CYP2D6 inhibitor could increases the effect and toxicity of atomoxetine (source: Drug Bank)
benzphetamine Risk of serotoninergic syndrome (source: Drug Bank)
benzphetamine Risk of serotoninergic syndrome (source: Drug Bank)
carvedilol The SSRI increases the effect of the beta-blocker (source: Drug Bank)
carvedilol The SSRI increases the effect of the beta-blocker (source: Drug Bank)
dexfenfluramine Risk of serotoninergic syndrome (source: Drug Bank)
dextroamphetamine Risk of serotoninergic syndrome (source: Drug Bank)
dextroamphetamine Risk of serotoninergic syndrome (source: Drug Bank)
dextromethorphan Combination associated with possible serotoninergic syndrome (source: Drug Bank)
dextromethorphan Combination associated with possible serotoninergic syndrome (source: Drug Bank)
dicumarol The SSRI, paroxetine, increases the effect of anticoagulant, dicumarol. (source: Drug Bank)
diethylpropion Risk of serotoninergic syndrome (source: Drug Bank)
eletriptan Increased risk of CNS adverse effects (source: Drug Bank)
eletriptan Increased risk of CNS adverse effects (source: Drug Bank)
fenfluramine Risk of serotoninergic syndrome (source: Drug Bank)
fenfluramine Risk of serotoninergic syndrome (source: Drug Bank)
frovatriptan Increased risk of CNS adverse effects (source: Drug Bank)
galantamine Paroxetine increases the effect and toxicity of galantamine (source: Drug Bank)
galantamine Paroxetine increases the effect and toxicity of galantamine (source: Drug Bank)
isocarboxazid Possible severe adverse reaction with this combination (source: Drug Bank)
isocarboxazid Possible severe adverse reaction with this combination (source: Drug Bank)
linezolid Combination associated with possible serotoninergic syndrome (source: Drug Bank)
linezolid Combination associated with possible serotoninergic syndrome (source: Drug Bank)
mazindol Risk of serotoninergic syndrome (source: Drug Bank)
mazindol Risk of serotoninergic syndrome (source: Drug Bank)
mesoridazine Increased risk of cardiotoxicity and arrhythmias (source: Drug Bank)
mesoridazine Increased risk of cardiotoxicity and arrhythmias (source: Drug Bank)
methamphetamine Risk of serotoninergic syndrome (source: Drug Bank)
methamphetamine Risk of serotoninergic syndrome (source: Drug Bank)
metoprolol The SSRI increases the effect of the beta-blocker (source: Drug Bank)
metoprolol The SSRI increases the effect of the beta-blocker (source: Drug Bank)
moclobemide Possible severe adverse reaction with this combination (source: Drug Bank)
moclobemide Possible severe adverse reaction with this combination (source: Drug Bank)
naratriptan Increased risk of CNS adverse effects (source: Drug Bank)
naratriptan Increased risk of CNS adverse effects (source: Drug Bank)
oxycodone Increased risk of serotonin syndrome (source: Drug Bank)
oxycodone Increased risk of serotonin syndrome (source: Drug Bank)
phendimetrazine Risk of serotoninergic syndrome (source: Drug Bank)
phendimetrazine Risk of serotoninergic syndrome (source: Drug Bank)
phenelzine Possible severe adverse reaction with this combination (source: Drug Bank)
phenelzine Possible severe adverse reaction with this combination (source: Drug Bank)
phentermine Risk of serotoninergic syndrome (source: Drug Bank)
phenylpropanolamine Risk of serotoninergic syndrome (source: Drug Bank)
pimozide Increased risk of cardiotoxicity and arrhythmias (source: Drug Bank)
pimozide Increased risk of cardiotoxicity and arrhythmias (source: Drug Bank)
propafenone Fluoxetine increases the effect and toxicity of propafenone (source: Drug Bank)
propafenone Paroxetine increases the effect and toxicity of propafenone (source: Drug Bank)
propranolol The SSRI increases the effect of the beta-blocker (source: Drug Bank)
propranolol The SSRI increases the effect of the beta-blocker (source: Drug Bank)
rasagiline Possible severe adverse reaction with this combination (source: Drug Bank)
risperidone The SSRI increases the effect and toxicity of risperidone (source: Drug Bank)
risperidone The SSRI, paroxetine, increases the effect and toxicity of risperidone. (source: Drug Bank)
rizatriptan Increased risk of CNS adverse effects (source: Drug Bank)
rizatriptan Increased risk of CNS adverse effects (source: Drug Bank)
selegiline Possible severe adverse reaction with this combination (source: Drug Bank)
selegiline Possible severe adverse reaction with this combination (source: Drug Bank)
sibutramine Risk of serotoninergic syndrome (source: Drug Bank)
sibutramine Risk of serotoninergic syndrome (source: Drug Bank)
sumatriptan Increased risk of CNS adverse effects (source: Drug Bank)
sumatriptan Increased risk of CNS adverse effects (source: Drug Bank)
thioridazine Increased risk of cardiotoxicity and arrhythmias (source: Drug Bank)
thioridazine Increased risk of cardiotoxicity and arrhythmias (source: Drug Bank)
tramadol Risk of serotoninergic syndrome (source: Drug Bank)
tramadol Risk of serotoninergic syndrome (source: Drug Bank)
tranylcypromine Possible severe adverse reaction with this combination (source: Drug Bank)
tranylcypromine Possible severe adverse reaction with this combination (source: Drug Bank)
warfarin The SSRI increases the effect of the anticoagulant (source: Drug Bank)
warfarin The SSRI, paroxetine, increases the effect of the anticoagulant, warfarin. (source: Drug Bank)
zolmitriptan Increased risk of CNS adverse effects (source: Drug Bank)
zolmitriptan Increased risk of CNS adverse effects (source: Drug Bank)
paroxetine Possible severe adverse reaction with this combination (source: Drug Bank)
paroxetine Possible severe adverse reaction with this combination (source: Drug Bank)
paroxetine Risk of serotoninergic syndrome (source: Drug Bank)
paroxetine Risk of serotoninergic syndrome (source: Drug Bank)
paroxetine Increased risk of cardiotoxicity/arrhythmias (source: Drug Bank)
paroxetine Increased risk of cardiotoxicity/arrhythmias (source: Drug Bank)
paroxetine Fluoxetine increases the effect and toxicity of propafenone (source: Drug Bank)
paroxetine Fluoxetine increases the effect and toxicity of propafenone (source: Drug Bank)
paroxetine The SSRI increases the effect of the beta-blocker (source: Drug Bank)
paroxetine The SSRI, paroxetine, may increase the bradycardic effect of the beta-blocker, propranolol. (source: Drug Bank)
paroxetine Possible severe adverse reaction with this combination (source: Drug Bank)
paroxetine Paroxetine may decrease the therapeutic effect of Tamoxifen by decreasing the production of active metabolites. Concomitant therapy should be avoided. (source: Drug Bank)
paroxetine Paroxetine may decrease the therapeutic effect of Tamoxifen by decreasing the production of active metabolites. Concomitant therapy should be avoided. (source: Drug Bank)
paroxetine Paroxetine, a CYP2D6 inhibitor, may decrease the metabolism and clearance of Tamsulosin, a CYP2D6 substrate. Monitor for changes in therapeutic/adverse effects of Tamsulosin if Paroxetine is initiated, discontinued, or dose changed. (source: Drug Bank)
paroxetine Paroxetine, a CYP2D6 inhibitor, may decrease the metabolism and clearance of Tamsulosin, a CYP2D6 substrate. Monitor for changes in therapeutic/adverse effects of Tamsulosin if Paroxetine is initiated, discontinued, or dose changed. (source: Drug Bank)
paroxetine Terbinafine may reduce the metabolism and clearance of Paroxetine. Consider alternate therapy or monitor for therapeutic/adverse effects of Paroxetine if Terbinafine is initiated, discontinued or dose changed. (source: Drug Bank)
paroxetine Increased risk of cardiotoxicity and arrhythmias (source: Drug Bank)
paroxetine Increased risk of cardiotoxicity and arrhythmias (source: Drug Bank)
paroxetine Additive antiplatelet effects increase the risk of bleeding. Consider alternate therapy or monitor for increased bleeding. (source: Drug Bank)
paroxetine Tipranavir increases the concentration of Paroxetine. The Paroxetine dose may require an adjustment. (source: Drug Bank)
paroxetine Increased antiplatelet effects may enhance the risk of bleeding. Alternate therapy may be considered or monitor for inreased bleeding during concomitant therapy. (source: Drug Bank)
paroxetine Paroxetine may decrease the metabolism and clearance of Tolterodine. Monitor for adverse/toxic effects of Tolterodine. (source: Drug Bank)
paroxetine Paroxetine may decrease the metabolism and clearance of Tolterodine. Monitor for adverse/toxic effects of Tolterodine. (source: Drug Bank)
paroxetine Tramadol increases the risk of serotonin syndrome and seizures. Paroxetine may decrease the effect of Tramadol by decreasing active metabolite production. (source: Drug Bank)
paroxetine Increased risk of serotonin syndrome. Concomitant therapy should be avoided. A significant washout period, dependent on the half-lives of the agents, should be employed between therapies. (source: Drug Bank)
paroxetine Increased risk of serotonin syndrome. The 2D6 inhibitor, Trazodone, may also increase the efficacy of Paroxetine by decreasing Paroxetine metabolism and clearance. Monitor for symptoms of serotonin syndrome and changes in Paroxetine efficacy if Trazodone is initiated, discontinued or dose changed. (source: Drug Bank)
paroxetine Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome. (source: Drug Bank)
paroxetine The prostacyclin analogue, Treprostinil, increases the risk of bleeding when combined with the antiplatelet agent, Paroxetine. Monitor for increased bleeding during concomitant thearpy. (source: Drug Bank)
paroxetine The SSRI, Paroxetine, may decrease the metabolism and clearance of Trimipramine. Increased risk of serotonin syndrome. Monitor for changes in Trimipramine efficacy and toxicity if Paroxetine is initiated, discontinued or dose changed. (source: Drug Bank)
paroxetine The CNS depressants, Triprolidine and Paroxetine, may increase adverse/toxic effects due to additivity. Monitor for increased CNS depressant effects during concomitant therapy. (source: Drug Bank)
paroxetine The CNS depressants, Triprolidine and Paroxetine, may increase adverse/toxic effects due to additivity. Monitor for increased CNS depressant effects during concomitant therapy. (source: Drug Bank)
paroxetine Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome. (source: Drug Bank)
paroxetine Use of two serotonin modulators, such as zolmitriptan and paroxetine, increases the risk of serotonin syndrome. Consider alternate therapy or monitor for serotonin syndrome during concomitant therapy. (source: Drug Bank)
paroxetine Paroxetine, a strong CYP2D6 inhibitor, may increase the serum concentration of zuclopenthixol by decreasing its metabolism. Consider alternate therapy or monitor for changes in the therapeutic and adverse effects of zuclopenthixol if paroxetine is initiated, discontinued or dose changed. (source: Drug Bank)

Curated Information ?

Relationships from National Drug File - Reference Terminology (NDF-RT)

May Treat
Contraindicated With

Publications related to paroxetine: 160

No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Pharmacogenetics of antidepressant treatment in obsessive-compulsive disorder: an update and implications for clinicians. Pharmacogenomics. 2014. Zai Gwyneth, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available VA No VIP available No VIP available
Possible impact of the CYP2D6*10 polymorphism on the nonlinear pharmacokinetic parameter estimates of paroxetine in Japanese patients with major depressive disorders. Pharmacogenomics and personalized medicine. 2014. Saruwatari Junji, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
ABCB6, ABCB1 and ABCG1 genetic polymorphisms and antidepressant response of SSRIs in Chinese depressive patients. Pharmacogenomics. 2013. Huang Xiaoye, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available VA No VIP available No VIP available
Dynamics and persistence of CYP2D6 inhibition by paroxetine. Journal of clinical pharmacy and therapeutics. 2013. Juřica J, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
BDNF and CREB1 genetic variants interact to affect antidepressant treatment outcomes in geriatric depression. Pharmacogenetics and genomics. 2013. Murphy Greer M, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Challenges in pharmacogenetics. European journal of clinical pharmacology. 2013. Cascorbi Ingolf, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Pharmacokinetic model incorporating mechanism-based inactivation of CYP2D6 can explain both non-linear kinetics and drug interactions of paroxetine. International journal of clinical pharmacology and therapeutics. 2013. Mikami Akiko, et al. PubMed
No Dosing Guideline available No Drug Label available CA No Variant Annotation available No VIP available No VIP available
Pharmacogenetics in major depression: a comprehensive meta-analysis. Progress in neuro-psychopharmacology & biological psychiatry. 2013. Niitsu Tomihisa, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
Influence of CYP2D6 and CYP2C19 gene variants on antidepressant response in obsessive-compulsive disorder. The pharmacogenomics journal. 2013. Brandl E J, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
5-HTTLPR rs25531A > G differentially influence paroxetine and fluvoxamine antidepressant efficacy: a randomized, controlled trial. Journal of clinical psychopharmacology. 2013. Kato Masaki, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Cytochrome P450-mediated drug metabolism in the brain. Journal of psychiatry & neuroscience : JPN. 2012. Miksys Sharon, et al. PubMed
No Dosing Guideline available No Drug Label available CA No Variant Annotation available No VIP available No VIP available
TPH1, MAOA, serotonin receptor 2A and 2C genes in citalopram response: possible effect in melancholic and psychotic depression. Neuropsychobiology. 2013. Arias Bárbara, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
DRD3, but not BDNF, genotype affects treatment response to paroxetine in major depressive disorder: a preliminary study. Journal of clinical psychopharmacology. 2012. Tsuchimine Shoko, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
Association of APC and REEP5 gene polymorphisms with major depression disorder and treatment response to antidepressants in a Han Chinese population. General hospital psychiatry. 2012. Yang Zhenxing, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
The AmpliChip® CYP450 test and response to treatment in schizophrenia and obsessive compulsive disorder: a pilot study and focus on cases with abnormal CYP2D6 drug metabolism. Genetic testing and molecular biomarkers. 2012. Müller Daniel J, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available VA No VIP available No VIP available
Genome-wide association study of SSRI/SNRI-induced sexual dysfunction in a Japanese cohort with major depression. Psychiatry research. 2012. Kurose Kouichi, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Genome-wide miRNA expression profiling of human lymphoblastoid cell lines identifies tentative SSRI antidepressant response biomarkers. Pharmacogenomics. 2012. Oved Keren, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
ABCB1 gene variants influence tolerance to selective serotonin reuptake inhibitors in a large sample of Dutch cases with major depressive disorder. The pharmacogenomics journal. 2012. de Klerk O L, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Pharmacogenetics of glutamate system genes and SSRI-associated sexual dysfunction. Psychiatry research. 2012. Bishop Jeffrey R, et al. PubMed
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The relationship between clinical pharmacokinetics of aripiprazole and CYP2D6 genetic polymorphism: effects of CYP enzyme inhibition by coadministration of paroxetine or fluvoxamine. European journal of clinical pharmacology. 2012. Azuma Junichi, et al. PubMed
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Determinants of pharmacodynamic trajectory of the therapeutic response to paroxetine in Japanese patients with panic disorder. European journal of clinical pharmacology. 2011. Ishiguro Shin, et al. PubMed
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Impact of Smoking, Smoking Cessation, and Genetic Polymorphisms on CYP1A2 Activity and Inducibility. Clinical pharmacology and therapeutics. 2011. Dobrinas M, et al. PubMed
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The brain-derived neurotrophic factor (BDNF) polymorphism Val66Met is associated with neither serum BDNF level nor response to selective serotonin reuptake inhibitors in depressed Japanese patients. Progress in neuro-psychopharmacology & biological psychiatry. 2011. Yoshimura Reiji, et al. PubMed
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Detecting Drug Interactions From Adverse-Event Reports: Interaction Between Paroxetine and Pravastatin Increases Blood Glucose Levels. Clinical pharmacology and therapeutics. 2011. Tatonetti N P, et al. PubMed
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Pharmacogenetics of drug-induced birth defects: what is known so far?. Pharmacogenomics. 2011. Wilffert Bob, et al. PubMed
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Pharmacogenetics: From Bench to Byte- An Update of Guidelines. Clinical pharmacology and therapeutics. 2011. Swen J J, et al. PubMed
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Is 5-HTTLPR linked to the response of selective serotonin reuptake inhibitors in MDD?. European archives of psychiatry and clinical neuroscience. 2011. Illi Ari, et al. PubMed
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Very important pharmacogene summary: ABCB1 (MDR1, P-glycoprotein). Pharmacogenetics and genomics. 2011. Hodges Laura M, et al. PubMed
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Clinical and genetic correlates of suicidal ideation during antidepressant treatment in a depressed outpatient sample. Pharmacogenomics. 2011. Perroud Nader, et al. PubMed
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Genome-wide expression profiling of human lymphoblastoid cell lines identifies CHL1 as a putative SSRI antidepressant response biomarker. Pharmacogenomics. 2011. Morag Ayelet, et al. PubMed
CYP1A2 genetic polymorphisms are associated with treatment response to the antidepressant paroxetine. Pharmacogenomics. 2010. Lin Keh-Ming, et al. PubMed
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Identifying genomic and developmental causes of adverse drug reactions in children. Pharmacogenomics. 2010. Becker Mara L, et al. PubMed
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Meta-analysis of FKBP5 gene polymorphisms association with treatment response in patients with mood disorders. Neuroscience letters. 2010. Zou Yan-Feng, et al. PubMed
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HTR2A is associated with SSRI response in Major Depressive Disorder in a Japanese cohort. Neuromolecular medicine. 2010. Kishi Taro, et al. PubMed
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Pharmacogenomic implications of variants of monoaminergic-related genes in geriatric psychiatry. Pharmacogenomics. 2010. Shiroma Paulo R, et al. PubMed
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Early response to selective serotonin reuptake inhibitors in panic disorder is associated with a functional 5-HT1A receptor gene polymorphism. Journal of affective disorders. 2010. Yevtushenko Olga O, et al. PubMed
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Coprescription of tamoxifen and medications that inhibit CYP2D6. Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 2010. Sideras Kostandinos, et al. PubMed
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Polymorphisms in GRIK4, HTR2A, and FKBP5 show interactive effects in predicting remission to antidepressant treatment. Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology. 2010. Horstmann Sonja, et al. PubMed
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Brain-derived neurotrophic factor ( BDNF) gene: no major impact on antidepressant treatment response. The international journal of neuropsychopharmacology / official scientific journal of the Collegium Internationale Neuropsychopharmacologicum (CINP). 2010. Domschke Katharina, et al. PubMed
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Nationwide drug-dispensing data reveal important differences in adherence to drug label recommendations on CYP2D6-dependent drug interactions. British journal of clinical pharmacology. 2010. Mannheimer Buster, et al. PubMed
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Composite functional genetic and comedication CYP2D6 activity score in predicting tamoxifen drug exposure among breast cancer patients. Journal of clinical pharmacology. 2010. Borges Silvana, et al. PubMed
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Pharmacogenomics of membrane transporters: past, present and future. Pharmacogenomics. 2010. Yee Sook Wah, et al. PubMed
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FKBP5 polymorphisms and antidepressant response in geriatric depression. American journal of medical genetics. Part B, Neuropsychiatric genetics : the official publication of the International Society of Psychiatric Genetics. 2010. Sarginson Jane E, et al. PubMed
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Human lymphoblastoid cell line panels: novel tools for assessing shared drug pathways. Pharmacogenomics. 2010. Morag Ayelet, et al. PubMed
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Pharmacogenetic considerations in the treatment of psychiatric disorders. Expert opinion on pharmacotherapy. 2010. Lohoff Falk W, et al. PubMed
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Effects of the serotonin 1A, 2A, 2C, 3A, and 3B and serotonin transporter gene polymorphisms on the occurrence of paroxetine discontinuation syndrome. Journal of clinical psychopharmacology. 2010. Murata Yusuke, et al. PubMed
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Selective serotonin reuptake inhibitors and breast cancer mortality in women receiving tamoxifen: a population based cohort study. BMJ (Clinical research ed.). 2010. Kelly Catherine M, et al. PubMed
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Association of brain-derived neurotrophic factor genetic Val66Met polymorphism with severity of depression, efficacy of fluoxetine and its side effects in Chinese major depressive patients. Neuropsychobiology. 2010. Zou Yan-Feng, et al. PubMed
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Predicting new molecular targets for known drugs. Nature. 2009. Keiser Michael J, et al. PubMed
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Warfarin interactions with substances listed in drug information compendia and in the FDA-approved label for warfarin sodium. Clinical pharmacology and therapeutics. 2009. Anthony M, et al. PubMed
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Rapid response to paroxetine is associated with plasma paroxetine levels at 4 but not 8 weeks of treatment, and is independent of serotonin transporter promoter polymorphism in Japanese depressed patients. Human psychopharmacology. 2009. Yoshimura Reiji, et al. PubMed
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Expression and association analyses of promoter variants of the neurogenic gene HES6, a candidate gene for mood disorder susceptibility and antidepressant response. Neuroscience letters. 2009. Glubb Dylan M, et al. PubMed
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Monoamine transporter gene polymorphisms affect susceptibility to depression and predict antidepressant response. Psychopharmacology. 2009. Min Wenjiao, et al. PubMed
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Genetic and pharmacokinetic factors affecting the initial pharmacotherapeutic effect of paroxetine in Japanese patients with panic disorder. European journal of clinical pharmacology. 2009. Saeki Yoshinori, et al. PubMed
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Cytochrome P450 2D6. Pharmacogenetics and genomics. 2009. Owen Ryan P, et al. PubMed
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Pharmacogenetics of selective serotonin reuptake inhibitors and associated adverse drug reactions. Pharmacotherapy. 2009. Thomas Kelan L H, et al. PubMed
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Histone deacetylase inhibitors induce a very broad, pleiotropic anticancer drug resistance phenotype in acute myeloid leukemia cells by modulation of multiple ABC transporter genes. Clinical cancer research : an official journal of the American Association for Cancer Research. 2009. Hauswald Stefanie, et al. PubMed
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Response to serotonin reuptake inhibitors in OCD is not influenced by common CYP2D6 polymorphisms. International journal of psychiatry in clinical practice. 2009. Van Nieuwerburgh Filip C W, et al. PubMed
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5-HTR1A, 5-HTR2A, 5-HTR6, TPH1 and TPH2 polymorphisms and major depression. Neuroreport. 2009. Illi Ari, et al. PubMed
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5-HT2A gene variants influence specific and different aspects of antidepressant response in Japanese and Italian mood disorder patients. Psychiatry research. 2009. Kato Masaki, et al. PubMed
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Genetic determinants of response to clopidogrel and cardiovascular events. The New England journal of medicine. 2009. Simon Tabassome, et al. PubMed
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Association of a functional polymorphism in the adrenomedullin gene (ADM) with response to paroxetine. The pharmacogenomics journal. 2009. Glubb D M, et al. PubMed
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The catechol-O-methyltransferase Val(108/158)Met polymorphism affects antidepressant response to paroxetine in a naturalistic setting. Psychopharmacology. 2009. Benedetti Francesco, et al. PubMed
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Polymorphisms in the SLC6A4 and HTR2A genes influence treatment outcome following antidepressant therapy. The pharmacogenomics journal. 2009. Wilkie M J V, et al. PubMed
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Effect of 5-HT1A gene polymorphisms on antidepressant response in major depressive disorder. American journal of medical genetics. Part B, Neuropsychiatric genetics : the official publication of the International Society of Psychiatric Genetics. 2009. Kato Masaki, et al. PubMed
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Redox regulation of multidrug resistance in cancer chemotherapy: molecular mechanisms and therapeutic opportunities. Antioxidants & redox signaling. 2009. Kuo Macus Tien. PubMed
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Serotonin transporter gene promoter polymorphisms modify the association between paroxetine serotonin transporter occupancy and clinical response in major depressive disorder. Pharmacogenetics and genomics. 2009. Ruhé Henricus G, et al. PubMed
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Effect of cytochrome P450 2D6 genotype on maternal paroxetine plasma concentrations during pregnancy. Clinical pharmacokinetics. 2009. Ververs F F Tessa, et al. PubMed
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Effect of the selective serotonin reuptake inhibitor paroxetine on platelet function is modified by a SLC6A4 serotonin transporter polymorphism. Journal of thrombosis and haemostasis : JTH. 2008. Abdelmalik N, et al. PubMed
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Several major antiepileptic drugs are substrates for human P-glycoprotein. Neuropharmacology. 2008. Luna-Tortós Carlos, et al. PubMed
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A case with occurring adverse effects when cross-over titration from fluvoxamine to paroxetine associated with increasing the plasma fluvoxamine level in major depressive disorder. The world journal of biological psychiatry : the official journal of the World Federation of Societies of Biological Psychiatry. 2009. Hori Hikaru, et al. PubMed
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Functional pharmacogenetics/genomics of human cytochromes P450 involved in drug biotransformation. Analytical and bioanalytical chemistry. 2008. Zanger Ulrich M, et al. PubMed
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Pharmacogenetics of selective serotonin reuptake inhibitors in pediatric depression and anxiety. Pharmacogenomics. 2008. Kronenberg Sefi, et al. PubMed
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5-HT1A gene variants and psychiatric disorders: a review of current literature and selection of SNPs for future studies. The international journal of neuropsychopharmacology / official scientific journal of the Collegium Internationale Neuropsychopharmacologicum (CINP). 2008. Drago Antonio, et al. PubMed
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CYP2D6 and ABCB1 genetic variability: influence on paroxetine plasma level and therapeutic response. Therapeutic drug monitoring. 2008. Gex-Fabry Marianne, et al. PubMed
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Drug target identification using side-effect similarity. Science (New York, N.Y.). 2008. Campillos Monica, et al. PubMed
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Structure, function and regulation of P-glycoprotein and its clinical relevance in drug disposition. Xenobiotica; the fate of foreign compounds in biological systems. 2008. Zhou S-F. PubMed
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The FKBP5-gene in depression and treatment response--an association study in the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) Cohort. Biological psychiatry. 2008. Lekman Magnus, et al. PubMed
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Serotonin transporter polymorphism and bleeding time during SSRI therapy. British journal of clinical pharmacology. 2008. Hougardy Dahlia M C, et al. PubMed
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Serotonin receptor 1A-1019C/G variant: impact on antidepressant pharmacoresponse in melancholic depression?. Neuroscience letters. 2008. Baune B T, et al. PubMed
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Genetic variants in FKBP5 affecting response to antidepressant drug treatment. Pharmacogenomics. 2008. Kirchheiner Julia, et al. PubMed
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Influence of the CYP2D6*4 polymorphism on dose, switching and discontinuation of antidepressants. British journal of clinical pharmacology. 2008. Bijl Monique J, et al. PubMed
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Serotonin transporter genotype interacts with paroxetine plasma levels to influence depression treatment response in geriatric patients. Journal of psychiatry & neuroscience : JPN. 2008. Lotrich Francis E, et al. PubMed
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Genetic polymorphisms in the 5-hydroxytryptamine type 3B receptor gene and paroxetine-induced nausea. The international journal of neuropsychopharmacology / official scientific journal of the Collegium Internationale Neuropsychopharmacologicum (CINP). 2008. Tanaka Misuzu, et al. PubMed
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ABCB1 (MDR1) gene polymorphisms are associated with the clinical response to paroxetine in patients with major depressive disorder. Progress in neuro-psychopharmacology & biological psychiatry. 2008. Kato Masaki, et al. PubMed
Polymorphisms in the drug transporter gene ABCB1 predict antidepressant treatment response in depression. Neuron. 2008. Uhr Manfred, et al. PubMed
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Citalopram enantiomers in plasma and cerebrospinal fluid of ABCB1 genotyped depressive patients and clinical response: a pilot study. Pharmacological research : the official journal of the Italian Pharmacological Society. 2008. Nikisch Georg, et al. PubMed
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Association study of paroxetine therapeutic response with SERT gene polymorphisms in patients with major depressive disorder. The world journal of biological psychiatry : the official journal of the World Federation of Societies of Biological Psychiatry. 2008. Bozina Nada, et al. PubMed
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A monoamine oxidase B gene variant and short-term antidepressant treatment response. Progress in neuro-psychopharmacology & biological psychiatry. 2007. Tadi¿ André, et al. PubMed
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Pharmacogenetics in modern psychiatry. Psychiatria Danubina. 2007. Mihaljević-Peles Alma, et al. PubMed
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Clinical response and risk for reported suicidal ideation and suicide attempts in pediatric antidepressant treatment: a meta-analysis of randomized controlled trials. JAMA : the journal of the American Medical Association. 2007. Bridge Jeffrey A, et al. PubMed
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Genetic variability at HPA axis in major depression and clinical response to antidepressant treatment. Journal of affective disorders. 2007. Papiol Sergi, et al. PubMed
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Terbinafine increases the plasma concentration of paroxetine after a single oral administration of paroxetine in healthy subjects. European journal of clinical pharmacology. 2007. Yasui-Furukori Norio, et al. PubMed
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Reboxetine and cytochrome P450--comparison with paroxetine treatment in humans. International journal of clinical pharmacology and therapeutics. 2007. Kuhn U D, et al. PubMed
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Cobalamin potentiates vinblastine cytotoxicity through downregulation of mdr-1 gene expression in HepG2 cells. Cellular physiology and biochemistry : international journal of experimental cellular physiology, biochemistry, and pharmacology. 2007. Marguerite Véronique, et al. PubMed
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Links among paroxetine-induced sexual dysfunctions, gender, and CYP2D6 activity. Journal of sex & marital therapy. 2007. Zourková Alexandra, et al. PubMed
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Mechanism of inhibition of P-glycoprotein mediated efflux by vitamin E TPGS: influence on ATPase activity and membrane fluidity. Molecular pharmaceutics. 2007. Collnot Eva-Maria, et al. PubMed
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Tryptophan hydroxylase and serotonin transporter gene polymorphism does not affect the diagnosis, clinical features and treatment outcome of panic disorder in the Korean population. Progress in neuro-psychopharmacology & biological psychiatry. 2006. Kim Won, et al. PubMed
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Multiple dose pharmacokinetics of paroxetine in children and adolescents with major depressive disorder or obsessive-compulsive disorder. Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology. 2006. Findling Robert L, et al. PubMed
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Paroxetine: population pharmacokinetic analysis in late-life depression using sparse concentration sampling. British journal of clinical pharmacology. 2006. Feng Yan, et al. PubMed
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Gefitinib modulates the function of multiple ATP-binding cassette transporters in vivo. Cancer research. 2006. Leggas Markos, et al. PubMed
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Impact of P-glycoprotein on clopidogrel absorption. Clinical pharmacology and therapeutics. 2006. Taubert Dirk, et al. PubMed
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Serotonin transporter polymorphisms and side effects in antidepressant therapy--a pilot study. Pharmacogenomics. 2006. Popp Johannes, et al. PubMed
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The impact of CYP2D6 genotypes on the plasma concentration of paroxetine in Japanese psychiatric patients. Progress in neuro-psychopharmacology & biological psychiatry. 2006. Ueda Mikito, et al. PubMed
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Low serum concentrations of paroxetine in CYP2D6 ultrarapid metabolizers. Journal of clinical psychopharmacology. 2006. Güzey Cüneyt, et al. PubMed
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Single nucleotide polymorphisms in human P-glycoprotein: its impact on drug delivery and disposition. Expert opinion on drug delivery. 2006. Dey Surajit. PubMed
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Potential interactions of methylphenidate and atomoxetine with dextromethorphan. Journal of the American Pharmacists Association : JAPhA. 2006. Ciccone Patrick E, et al. PubMed
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Effects of the serotonin type 2A, 3A and 3B receptor and the serotonin transporter genes on paroxetine and fluvoxamine efficacy and adverse drug reactions in depressed Japanese patients. Neuropsychobiology. 2006. Kato Masaki, et al. PubMed
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Antipanic efficacy of paroxetine and polymorphism within the promoter of the serotonin transporter gene. Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology. 2005. Perna Giampaolo, et al. PubMed
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The effect of 5-hydroxytryptamine 3A and 3B receptor genes on nausea induced by paroxetine. The pharmacogenomics journal. 2006. Sugai T, et al. PubMed
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Controlled clinical comparison of paroxetine and fluvoxamine considering the serotonin transporter promoter polymorphism. International clinical psychopharmacology. 2005. Kato Masaki, et al. PubMed
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Polymorphisms in FKBP5 are associated with increased recurrence of depressive episodes and rapid response to antidepressant treatment. Nature genetics. 2004. Binder Elisabeth B, et al. PubMed
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Severe adverse effects in a newborn with two defective CYP2D6 alleles after exposure to paroxetine during late pregnancy. Therapeutic drug monitoring. 2004. Laine Kari, et al. PubMed
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Effects of the serotonin transporter gene promoter polymorphism on mirtazapine and paroxetine efficacy and adverse events in geriatric major depression. Archives of general psychiatry. 2004. Murphy Greer M, et al. PubMed
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Life-threatening serotonin syndrome in a patient with chronic heart failure and CYP2D6*1/*5. Mayo Clinic proceedings. Mayo Clinic. 2004. Sato Akinori, et al. PubMed
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Effects of dosage and CYP2D6-mutated allele on plasma concentration of paroxetine. European journal of clinical pharmacology. 2004. Sawamura Kazushi, et al. PubMed
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Further evidence of a combined effect of SERTPR and TPH on SSRIs response in mood disorders. American journal of medical genetics. Part B, Neuropsychiatric genetics : the official publication of the International Society of Psychiatric Genetics. 2004. Serretti Alessandro, et al. PubMed
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Influence of lipid lowering fibrates on P-glycoprotein activity in vitro. Biochemical pharmacology. 2004. Ehrhardt Manuela, et al. PubMed
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Interactions of human P-glycoprotein with simvastatin, simvastatin acid, and atorvastatin. Pharmaceutical research. 2004. Hochman Jerome H, et al. PubMed
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Breastfeeding during maternal antidepressant treatment with serotonin reuptake inhibitors: infant exposure, clinical symptoms, and cytochrome p450 genotypes. The Journal of clinical psychiatry. 2004. Berle Jan Øystein, et al. PubMed
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Polymorphisms in human MDR1 (P-glycoprotein): recent advances and clinical relevance. Clinical pharmacology and therapeutics. 2004. Marzolini Catia, et al. PubMed
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Increased incidence of CYP2D6 gene duplication in patients with persistent mood disorders: ultrarapid metabolism of antidepressants as a cause of nonresponse. A pilot study. European journal of clinical pharmacology. 2004. Kawanishi Chiaki, et al. PubMed
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Some aspects of genetic polymorphism in the biotransformation of antidepressants. Thérapie. 2004. Brøsen Kim. PubMed
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Polymorphisms in the CYP 2D6 gene: association with plasma concentrations of fluoxetine and paroxetine. Therapeutic drug monitoring. 2003. Charlier Corinne, et al. PubMed
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Pharmacogenetics of antidepressant medication intolerance. The American journal of psychiatry. 2003. Murphy Greer M, et al. PubMed
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Paroxetine-induced conversion of cytochrome P450 2D6 phenotype and occurence of adverse effects. General physiology and biophysics. 2003. Zourková A, et al. PubMed
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Genetic polymorphisms of the human MDR1 drug transporter. Annual review of pharmacology and toxicology. 2003. Schwab Matthias, et al. PubMed
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Clinical pharmacokinetics of galantamine. Clinical pharmacokinetics. 2003. Farlow Martin R. PubMed
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Effect of nortriptyline and paroxetine on CYP2D6 activity in depressed elderly patients. Journal of clinical psychopharmacology. 2002. Solai LalithKumar K, et al. PubMed
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CYP2D6 inhibition by selective serotonin reuptake inhibitors: analysis of achievable steady-state plasma concentrations and the effect of ultrarapid metabolism at CYP2D6. Pharmacotherapy. 2002. Lam Y W Francis, et al. PubMed
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Very long half-life of paroxetine following intoxication in an extensive cytochrome P4502D6 metabolizer. Therapeutic drug monitoring. 2002. Hilleret Henriette, et al. PubMed
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Cytochrome P450 2D6 genotype does not predict SSRI (fluoxetine or paroxetine) induced hyponatraemia. Human psychopharmacology. 2002. Stedman Catherine A M, et al. PubMed
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Serotonin syndrome - 'potential' role of the CYP2D6 genetic polymorphism in Asians. The international journal of neuropsychopharmacology / official scientific journal of the Collegium Internationale Neuropsychopharmacologicum (CINP). 2002. Kaneda Yasuhiro, et al. PubMed
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Med-psych drug-drug interactions update. Psychosomatics. 2002. Armstrong Scott C, et al. PubMed
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Inhibition of cytochrome P4502D6 activity with paroxetine normalizes the ultrarapid metabolizer phenotype as measured by nortriptyline pharmacokinetics and the debrisoquin test. Clinical pharmacology and therapeutics. 2001. Laine K, et al. PubMed
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Tryptophan hydroxylase gene associated with paroxetine antidepressant activity. European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology. 2001. Serretti A, et al. PubMed
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A prospective study of 86 new patients with social anxiety disorder. Acta psychiatrica Scandinavica. 2001. Allgulander C, et al. PubMed
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Interaction of omeprazole, lansoprazole and pantoprazole with P-glycoprotein. Naunyn-Schmiedeberg's archives of pharmacology. 2001. Pauli-Magnus C, et al. PubMed
No Dosing Guideline available No Drug Label available CA No Variant Annotation available No VIP available No VIP available
Serotonin-2A-receptor and -transporter polymorphisms: lack of association in patients with major depression. Neuroscience letters. 2001. Minov C, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available VA No VIP available No VIP available
Neonatal paroxetine withdrawal syndrome. Archives of disease in childhood. Fetal and neonatal edition. 2001. Stiskal J A, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
Allelic variation in the serotonin transporter promoter affects onset of paroxetine treatment response in late-life depression. Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology. 2000. Pollock B G, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
Relationship of paroxetine disposition to metoprolol metabolic ratio and CYP2D6*10 genotype of Korean subjects. Clinical pharmacology and therapeutics. 2000. Yoon Y R, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
CYP2B6 mediates the in vitro hydroxylation of bupropion: potential drug interactions with other antidepressants. Drug metabolism and disposition: the biological fate of chemicals. 2000. Hesse L M, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Science, medicine, and the future: Pharmacogenetics. BMJ (Clinical research ed.). 2000. Wolf C R, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
Efficacy of paroxetine in depression is influenced by a functional polymorphism within the promoter of the serotonin transporter gene. Journal of clinical psychopharmacology. 2000. Zanardi R, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
Serotonin transporter gene polymorphism and antidepressant response. Neuroreport. 2000. Kim D K, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
Paroxetine steady-state plasma concentration in relation to CYP2D6 genotype in extensive metabolizers. Journal of clinical psychopharmacology. 1999. Ozdemir V, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
Paroxetine pharmacokinetics in depressed children and adolescents. Journal of the American Academy of Child and Adolescent Psychiatry. 1999. Findling R L, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available VIP No VIP available
The role of intestinal P-glycoprotein in the interaction of digoxin and rifampin. The Journal of clinical investigation. 1999. Greiner B, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available VIP No VIP available
Biochemical, cellular, and pharmacological aspects of the multidrug transporter. Annual review of pharmacology and toxicology. 1999. Ambudkar S V, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Differences in interactions of SSRIs. International clinical psychopharmacology. 1998. Brøsen K. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available VA No VIP available No VIP available
CYP2D6 genotype and phenotyping by determination of dextromethorphan and metabolites in serum of healthy controls and of patients under psychotropic medication. Pharmacogenetics. 1997. Köhler D, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available VIP No VIP available
Competitive, non-competitive and cooperative interactions between substrates of P-glycoprotein as measured by its ATPase activity. Biochimica et biophysica acta. 1997. Litman T, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Selective serotonin reuptake inhibitors and CNS drug interactions. A critical review of the evidence. Clinical pharmacokinetics. 1997. Sproule B A, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Pharmacokinetic-pharmacodynamic relationship of the selective serotonin reuptake inhibitors. Clinical pharmacokinetics. 1996. Baumann P. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Cytochrome P450 monooxygenases and interactions of psychotropic drugs: a five-year update. International journal of psychiatry in medicine. 1995. Shen W W. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available VIP No VIP available
P-glycoprotein structure and evolutionary homologies. Cytotechnology. 1993. Croop J M. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Inhibition by paroxetine of desipramine metabolism in extensive but not in poor metabolizers of sparteine. European journal of clinical pharmacology. 1993. Brøsen K, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
Pharmacokinetics of the selective serotonin reuptake inhibitor paroxetine: nonlinearity and relation to the sparteine oxidation polymorphism. Clinical pharmacology and therapeutics. 1992. Sindrup S H, et al. PubMed
The relationship between paroxetine and the sparteine oxidation polymorphism. Clinical pharmacology and therapeutics. 1992. Sindrup S H, et al. PubMed

LinkOuts

Web Resource:
Wikipedia
National Drug Code Directory:
0029-3210-13
DrugBank:
DB00715
ChEBI:
7936
KEGG Compound:
C07415
KEGG Drug:
D02362
PubChem Compound:
43815
PubChem Substance:
46504821
9619
Drugs Product Database (DPD):
2262746
BindingDB:
22416
ChemSpider:
39888
Therapeutic Targets Database:
DAP001428
FDA Drug Label at DailyMed:
65ee7ef8-cc68-41d1-cc8b-c01a056409a9

Clinical Trials

These are trials that mention paroxetine and are related to either pharmacogenetics or pharmacogenomics.

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Sources for PharmGKB drug information: DrugBank, Open Eye Scientific Software.