Closely.itraconazoleMonitor Closely (1)itraconazole and paroxetine both increase QTc interval. Modify Therapy/Monitor Closely.ivacaftorMonitor Closely (1)paroxetine increases levels of ivacaftor by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Monitor when coadministered with weak CYP3A4 inhibitors .ketoconazoleMonitor Closely (1)ketoconazole and paroxetine both increase QTc interval. Modify Therapy/Monitor Closely.ketoprofenMonitor Closely (1)paroxetine, ketoprofen. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.ketorolacMonitor Closely (1)paroxetine, ketorolac. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.ketorolac intranasalMonitor Closely (1)paroxetine, ketorolac intranasal. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.L-tryptophanMonitor Closely (1)paroxetine and L-tryptophan both increase serotonin levels. Modify Therapy/Monitor Closely.lamotrigineMonitor Closely (1)lamotrigine increases toxicity of paroxetine by unspecified interaction mechanism. Modify Therapy/Monitor Closely. CNS depressants may increase the toxic effects of selective serotonin reuptake inhibitors; psychomotor impairment may be enhanced.lapatinibMonitor Closely (1)lapatinib and paroxetine both increase QTc interval. Use Caution/Monitor.lasmiditanMonitor Closely (2)lasmiditan, paroxetine. Either increases effects of the other by sedation. Use Caution/Monitor. Coadministration of lasmiditan and other CNS depressant drugs, including alcohol have not been evaluated in clinical studies. Lasmiditan may cause sedation, as well as other cognitive and/or neuropsychiatric adverse reactions. paroxetine increases effects of lasmiditan by serotonin levels. Use Caution/Monitor. Coadministration may increase risk of serotonin syndrome.lemborexantMonitor Closely (2)paroxetine will increase the level or effect of lemborexant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Lower nightly dose of lemborexant recommended if coadministered with weak CYP3A4 inhibitors. See drug monograph for specific dosage modification. lemborexant, paroxetine. Either increases effects of the other by sedation. Modify Therapy/Monitor Closely. Dosage adjustment may be necessary if lemborexant is coadministered with other CNS depressants because of potentially additive effects.levofloxacinMonitor Closely (1)levofloxacin and paroxetine both increase QTc interval. Use Caution/Monitor.levoketoconazoleMonitor Closely (1)levoketoconazole and paroxetine both increase QTc interval. Modify Therapy/Monitor Closely.levomilnacipranSerious - Use Alternative (1)levomilnacipran and paroxetine both increase serotonin levels. Avoid or Use Alternate Drug.linezolidSerious - Use Alternative (1)linezolid and paroxetine both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.lisdexamfetamineMonitor Closely (1)paroxetine, lisdexamfetamine. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Initiate with lower doses and monitor for signs and symptoms of serotonin syndrome, particularly during initiation or dosage increase. If serotonin syndrome occurs, discontinue along with concomitant serotonergic drug(s).lithiumMonitor Closely (2)paroxetine and lithium both increase serotonin levels. Modify Therapy/Monitor Closely. lithium and paroxetine both increase QTc interval. Use Caution/Monitor.Minor (1)paroxetine, lithium. Mechanism: unknown. Minor/Significance Unknown. Risk of neurotoxicity.lofepramineMonitor Closely (1)lofepramine and paroxetine both increase QTc interval. Modify Therapy/Monitor Closely.Serious - Use Alternative (2)paroxetine and lofepramine both increase serotonin levels. Avoid or Use Alternate Drug. paroxetine will increase the level or effect of lofepramine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.lofexidineMonitor Closely (1)paroxetine will increase the level or effect of lofexidine by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Concomitant use of lofexidine with strong CYP2D6 inhibitors may increase lofexidine plasma levels. Monitor for symptoms of orthostasis and bradycardia if coadministered with a CYP2D6 inhibitor. Consider lofexidine dose reduction.lomitapideMonitor Closely (1)paroxetine increases levels of lomitapide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Lomitapide dose should not exceed 30 mg/day.lonafarnibSerious - Use Alternative (1)paroxetine will increase the level or effect of lonafarnib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration of lonafarnib (a sensitive CYP3A substrate) with weak CYP3A inhibitors is unavoidable, reduce to, or continue lonafarnib at starting dose. Closely monitor for arrhythmias and events (eg, syncope, heart palpitations) since lonafarnib effect on QT interval is unknown.loratadineMonitor Closely (1)paroxetine will increase the level or effect of loratadine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.lorcaserinMonitor Closely (1)lorcaserin will increase the level or effect of paroxetine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)paroxetine and lorcaserin both increase serotonin levels. Avoid or Use Alternate Drug.lornoxicamMonitor Closely (1)paroxetine, lornoxicam. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.loxapineMonitor Closely (1)paroxetine, loxapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).loxapine inhaledMonitor Closely (1)paroxetine, loxapine inhaled. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).lsdMonitor Closely (1)paroxetine and lsd both increase serotonin levels. Modify Therapy/Monitor Closely.lumefantrineMonitor Closely (2)lumefantrine and paroxetine both increase QTc interval. Modify Therapy/Monitor Closely. lumefantrine will increase the level or effect of paroxetine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.lurasidoneMonitor Closely (2)lurasidone, paroxetine. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Potential for increased CNS depressant effects when used concurrently; monitor for increased adverse effects and toxicity. paroxetine, lurasidone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).maprotilineMonitor Closely (1)maprotiline and paroxetine both increase QTc interval. Modify Therapy/Monitor Closely.Serious - Use Alternative (1)paroxetine and maprotiline both increase serotonin levels. Avoid or Use Alternate Drug.maravirocMinor (1)maraviroc will increase the level or effect of paroxetine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.marijuanaMinor (1)marijuana will increase the level or effect of paroxetine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.mavacamtenMonitor Closely (1)paroxetine will increase the level or effect of mavacamten by affecting hepatic enzyme CYP2C19 metabolism. Modify Therapy/Monitor Closely. Inititiation of weak CYP2C19 inhibitors may require decreased mavacamten dose. meclofenamateMonitor Closely (1)paroxetine, meclofenamate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.mefenamic acidMonitor Closely (1)paroxetine, mefenamic acid. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.mefloquineSerious - Use Alternative (1)mefloquine increases toxicity of paroxetine by QTc interval. Avoid or Use Alternate Drug. Mefloquine may enhance the QTc prolonging effect of high risk QTc prolonging agents.meloxicamMonitor Closely (1)paroxetine, meloxicam. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.meperidineSerious - Use Alternative (2)paroxetine and meperidine both increase serotonin levels. Avoid or Use Alternate Drug. meperidine, paroxetine. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.metforminMonitor Closely (1)paroxetine increases effects of metformin by pharmacodynamic synergism. Use Caution/Monitor.methadoneMonitor Closely (1)methadone and paroxetine both increase QTc interval. Use Caution/Monitor.methamphetamineSerious - Use Alternative (1)paroxetine will increase the level or effect of methamphetamine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.methylene blueSerious - Use Alternative (1)methylene blue and paroxetine both increase serotonin levels. Avoid or Use Alternate Drug. Methylene blue may increase serotonin as a result of MAO-A inhibition. If methylene blue must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last methylene blue dose or after 2 weeks of monitoring, whichever comes first.methylphenidate transdermalMonitor Closely (1)methylphenidate transdermal will increase the level or effect of paroxetine by decreasing metabolism. Modify Therapy/Monitor Closely. Consider decreasing the dose of these drugs when given coadministered with methylphenidate. Monitor for drug toxiticities when initiating or discontinuing methylphenidate. metoclopramideSerious - Use Alternative (1)metoclopramide and paroxetine both increase serotonin levels. Avoid or Use Alternate Drug. Additive effects; increased risk for serotonin syndrome, neuroleptic malignant syndrome, dystonia, or other extrapyramidal reactionsmetoclopramide intranasalSerious - Use Alternative (2)paroxetine will increase the level or effect of metoclopramide intranasal by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug. Concurrent use of metoclopramide intranasal and strong CYP2D6 inhibitors is not recommended since the metoclopramide intranasal dose cannot be adjusted. paroxetine, metoclopramide intranasal. Either increases effects of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Avoid use of metoclopramide intranasal or interacting drug, depending on importance of drug to patient.metoprololSerious - Use Alternative (1)paroxetine will increase the level or effect of metoprolol by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.mexiletineSerious - Use Alternative (1)paroxetine will increase the level or effect of mexiletine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.midazolam intranasalMonitor Closely (2)paroxetine will increase the level or effect of midazolam intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration of mild CYP3A4 inhibitors with midazolam intranasal may cause higher midazolam systemic exposure, which may prolong sedation. midazolam intranasal, paroxetine. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Concomitant use of barbiturates, alcohol, or other CNS depressants may increase the risk of hypoventilation, airway obstruction, desaturation, or apnea and may contribute to profound and/or prolonged drug effect.milnacipranSerious - Use Alternative (1)milnacipran and paroxetine both increase serotonin levels. Avoid or Use Alternate Drug.mipomersenMonitor Closely (1)mipomersen, paroxetine. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Both drugs have potential to increase hepatic enzymes; monitor LFTs.mirabegronMonitor Closely (1)mirabegron will increase the level or effect of paroxetine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.mirtazapineMonitor Closely (2)mirtazapine and paroxetine both increase QTc interval. Use Caution/Monitor. paroxetine and mirtazapine both increase serotonin levels. Modify Therapy/Monitor Closely.molindoneMonitor Closely (1)paroxetine, molindone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).morphineMonitor Closely (1)paroxetine and morphine both increase serotonin levels. Modify Therapy/Monitor Closely.Serious - Use Alternative (2)paroxetine will increase the level or effect of morphine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug. morphine, paroxetine. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.moxifloxacinMonitor Closely (2)moxifloxacin and paroxetine both increase QTc interval. Modify Therapy/Monitor Closely. paroxetine and moxifloxacin both increase QTc interval. Modify Therapy/Monitor Closely.nabumetoneMonitor Closely (1)paroxetine, nabumetone. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.naproxenMonitor Closely (1)paroxetine, naproxen. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.naratriptanMonitor Closely (1)naratriptan and paroxetine both increase serotonin levels. Modify Therapy/Monitor Closely.Minor (1)paroxetine, naratriptan. Mechanism: unknown. Minor/Significance Unknown. Risk of weakness, dyspnea, chest pain.nebivololSerious - Use Alternative (1)paroxetine will increase the level or effect of nebivolol by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.nefazodoneSerious - Use Alternative (1)nefazodone and paroxetine both increase serotonin levels. Avoid or Use Alternate Drug.netupitant/palonosetronSerious - Use Alternative (1)netupitant/palonosetron, paroxetine. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.nilotinibMonitor Closely (1)nilotinib and paroxetine both increase QTc interval. Modify Therapy/Monitor Closely.Minor (1)nilotinib will increase the level or effect of paroxetine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.nortriptylineMonitor Closely (1)nortriptyline and paroxetine both increase QTc interval. Modify Therapy/Monitor Closely.Serious - Use Alternative (2)paroxetine and nortriptyline both increase serotonin levels. Avoid or Use Alternate Drug. paroxetine will increase the level or effect of nortriptyline by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.octreotideMonitor Closely (1)octreotide and paroxetine both increase QTc interval. Modify Therapy/Monitor Closely.octreotide (Antidote)Monitor Closely (1)octreotide (Antidote) and paroxetine both increase QTc interval. Modify Therapy/Monitor Closely.ofloxacinMonitor Closely (1)ofloxacin and paroxetine both increase QTc interval. Use