Paroxetine and Venlafaxine interaction
Paroxetine and Venlafaxine: both prescribing labels 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.
If it occurs, discontinue BRISDELLE and serotonergic agents and initiate supportive measures ( 5.2 , 7.3 ).
Discontinue BRISDELLE and any concomitant serotonergic agents immediately if the above events occur and initiate supportive symptomatic treatment.
From the Venlafaxine (Venlafaxine Hydrochloride) label · effective 2025-01-31
Anyone considering the use of Venlafaxine Extended Release Tablets or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need.
If concomitant use of Venlafaxine Extended Release Tablets with other serotonergic drugs is clinically warranted, patients should be made aware of a potential increased risk for serotonin syndrome, particularly during treatment initiation and dose increases.
If concomitant use of Venlafaxine Extended Release Tablets with other serotonergic drugs is clinically warranted, inform patients of the increased risk for serotonin syndrome and monitor for symptoms.
Bleeding events related to SSRIs and SNRIs use have ranged from ecchymoses, hematomas, epistaxis, and petechiae to life-threatening hemorrhages.
If serotonin syndrome occurs, consider discontinuation of Venlafaxine Extended Release Tablets and/or concomitant serotonergic drugs [see Warning and Precautions ( 5.2 )].
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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.