<p><strong>Food/antacids</strong>: The absorption and pharmacokinetics of Paroxetine are not affected by food or antacids.<br />
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<strong>Tryptophan</strong>: As with other 5-HT re uptake inhibitors, animal studies indicate that an interaction between Paroxetine and Tryptophan may occur, resulting in a &lsquo;serotonin syndrome&rsquo; suggested by a combination of agitation, restlessness and gastrointestinal symptoms including diarrhoea.&nbsp;<br />
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<strong>Drug metabolizing enzyme inducers /inhibitors</strong>: The metabolism and pharmacokinetics of Paroxetine may be affected by drugs, which induce or inhibit hepatic drug metabolizing enzymes. When Paroxetine is to be coadministered with a known drug metabolizing inhibitor, consideration should be given to using doses at the lower end of the range. No initial dosage adjustment of Paroxetine is considered necessary when it is to be co-administered with known drug metabolizing enzyme inducers. Any subsequent dosage adjustment should be guided by clinical effect (tolerabilityand efficacy).<br />
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<strong>Alcohol</strong>: Although Paroxetine does not increase the impairment of mental and motor skill caused by alcohol, the concomitant use of Paroxetine and alcohol in depressed patients is not advised.<br />
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<strong>Haloperidol/amylobarbitone/oxazepam</strong>: Experience in a limited number of healthy subjects has shown that Paroxetine did not increase the sedation and drowsiness associated with haloperidol, amylobarbitone or oxazepam when given in combination.<br />
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<strong>MAOls</strong>: As with other 5-HT re uptake inhibitors, animal studies indicate that an interaction between Paroxetine and monoamine oxidase (MAO) inhibitors may occur.<br />
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<strong>Lithium</strong>: Since there is little clinical experience, and there have been reports of interaction of lithium with other 5-HT re-uptake inhibitors, the concurrent administration of Paroxetine and lithium should be undertaken with caution.<br />
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<strong>Lithium levels should be monitored.&nbsp;</strong><strong>Phenytoin / anticonvulsants</strong>: Co-administration of Paroxetine and phenytoin is associated with decreased plasma concentrations of Paroxetine and increased adverse experiences. Co-administration of Paroxetine with other anticonvulsants may also be associated with an increased incidence of adverse experiences.<br />
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<strong>Warfarin</strong>: Preliminary data suggest that there may be a pharmacodynamic interaction between Paroxetine and warfarin, which may result in increased bleeding in the presence of unaltered prothrombin times. Paroxetine should therefore be administered with great caution to patients receiving oral anticoagulants.</p>