Medication Safety Issues
PARoxetine may be confused with DULoxetine, FLUoxetine, PACLitaxel, piroxicam, pyridoxine, vortioxetine
Paxil may be confused with Doxil, PACLitaxel, Plavix, PROzac, Taxol, Trexall
Pexeva [DSC] may be confused with Lexiva
The Institute for Safe Medication Practices (ISMP) includes this medication among its list of drugs (contraindicated in pregnancy [Brisdelle]) which have a heightened risk of causing significant patient harm when used in error (High-Alert Medications in Community/Ambulatory Care Settings).
Beers Criteria: Paroxetine is identified in the Beers Criteria as a potentially inappropriate medication to be avoided in patients 65 years and older (independent of diagnosis or condition) due to its strong anticholinergic properties and potential for sedation and orthostatic hypotension. In addition, use the SSRIs with caution due to their potential to cause or exacerbate syndrome of inappropriate antidiuretic hormone secretion (SIADH) or hyponatremia; monitor sodium closely with initiation or dosage adjustments in older adults (Beers Criteria [AGS 2023]).
Paroxetine is identified in the Screening Tool of Older Person's Prescriptions (STOPP) criteria as a potentially inappropriate medication in older adults (≥65 years of age) with a history of recurrent falls due to an increased risk of falls. In addition, some disease states of concern include hyponatremia and recent or current significant bleeding (O’Mahony 2023).
