Doxepin and Paroxetine interaction
Doxepin and Paroxetine: the Paroxetine prescribing label flag this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.
Do not combine without a prescriber's guidance. The label language below is the strongest FDA uses.
What the FDA labels say
From the Paroxetine (BRISDELLE) label · effective 2025-04-28
Serotonin Syndrome: BRISDELLE can cause serotonin syndrome with increased risk when co-administered with other serotonergic agents, but also when taken alone.
If concomitant use of BRISDELLE with other serotonergic drugs (besides MAOIs) is clinically warranted, consider the increased risk of serotonin syndrome and carefully observe the patient, particularly during BRISDELLE initiation [see Contraindications ( 4.1 )
The risk is increased with concomitant use of other serotonergic agents (including triptans, tricyclic antidepressants, fentanyl, tramadol, meperidine, methadone, lithium, tryptophan, buspirone, amphetamines, and St.
Tricyclic Antidepressants (TCA) (e.g., Desipramine) Increased plasma concentrations and elimination half-life Plasma TCA concentrations may need to be monitored and the TCA dosage may need to be reduced if a TCA is used concomitantly with BRISDELLE.
If it occurs, discontinue BRISDELLE and serotonergic agents and initiate supportive measures ( 5.2 , 7.3 ).
Taking more than these two? Interactions stack. Check your whole list at once; it stays in your browser.
Open in the checkerNot medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.