Q: Can Paromerck cause thrombocytopenia?
A: Paromerck is a medication that is used to treat depression, anxiety and panic disorders. Paromerck is in the class of medications called SSRIs that work by preventing serotonin from being reabsorbed into the nerve cells of the brain. This action allows for prolonging the mood lightening effects of serotonin and helps relieve the symptoms associated with your condition. The prescribing information on Paromerck lists a decreased number of platelets as a very rare side effect of the medication, occurring in 1 out of 10,000 patients. The most common side effects are dry mouth, constipation, nausea, drowsiness, insomnia, headache, dizziness, yawning and weight gain. Lori Poulin, PharmD
By Mary Elizabeth Dallas | Medically Reviewed by Lindsey Marcellin, MD, MPH
Latest Update: 2014-07-23 Copyright © 2014 Everyday Health Media, LLC
Rated Paxil (Paromerck) for Anxiety Report
Paxil was the third antidepressant i tried, and i thought it was a miracle since it did a great job at treating my anxiety (and depression, since my anxiety causes most of it in a way), but the side effects of this medicine just weren’t worth it to me. it made me feel out of my body, and i even had short blackout moments when i would stand up. since i had been on this medicine for about a year when i tried to decrease my dose, things got WORSE. terrible headaches, more blackouts, nausea & dissociation from my every day life. i see it had worked well for other people, so maybe it just wasn’t for me(:
The pupillary dilation that occurs following use of many antidepressant drugs including PAXIL CR may trigger an angle closure attack in a patient with anatomically narrow angles who does not have a patent iridectomy. Cases of angle-closure glaucoma associated with use of Paromerck hydrochloride tablets have been reported. Avoid use of antidepressants, including PAXIL CR, in patients with untreated anatomically narrow angles.
Two-year carcinogenicity studies were conducted in rodents given Paromerck in the diet at 1, 5, and 25 mg/kg/day (mice) and 1, 5, and 20 mg/kg/day (rats). These doses are up to approximately 1.6 (mouse) and 2.5 (rat) times the MRHD on an mg/m² basis. There was a significantly greater number of male rats in the high-dose group with reticulum cell sarcomas (1/100, 0/50, 0/50, and 4/50 for control, low-, middle-, and high-dose groups, respectively) and a significantly increased linear trend across dose groups for the occurrence of lymphoreticular tumors in male rats. Female rats were not affected. Although there was a dose-related increase in the number of tumors in mice, there was no drug-related increase in the number of mice with tumors. The relevance of these findings to humans is unknown.
Adverse reactions after discontinuation of serotonergic antidepressants, particularly after abrupt discontinuation, include: nausea, sweating, dysphoric mood, irritability, agitation, dizziness, sensory disturbances (e.g., paresthesia, such as electric shock sensations), tremor, anxiety, confusion, headache, lethargy, emotional lability, insomnia, hypomania, tinnitus, and seizures. A gradual reduction in dosage rather than abrupt cessation is recommended whenever possible .
Adverse reactions have been reported upon discontinuation of treatment with Paromerck in pediatric patients. The safety and effectiveness of PAXIL CR in pediatric patients have not been established .
Male And Female Sexual Dysfunction
Although changes in sexual desire, sexual performance, and sexual satisfaction often occur as manifestations of a psychiatric disorder, they may also be a consequence of SSRI treatment. However, reliable estimates of the incidence and severity of untoward experiences involving sexual desire, performance, and satisfaction are difficult to obtain, in part because patients and healthcare providers may be reluctant to discuss them. Accordingly, estimates of the incidence of untoward sexual experience and performance cited in labeling may underestimate their actual incidence.
The percentage of patients reporting symptoms of sexual dysfunction in the Studies 1 and 2 (nonelderly patients with MDD), 4, 5, 6, 7, 8, 9, 10, and 11 are presented in Table 5:
Table 5: Adverse Reactions Related To Sexual Dysfunction In Patients Treated With PAXIL CR in Pooled 10-12 Week Studies of MDD, PD, SAD, and PMDD Studies 1 and 2 % Studies 4, 5, and 6 % Study 7 % Studies 8, 9, and 11 (Continuous Dosing) % Study 10 (Luteal Phase Dosing) % PAXIL CR Placebo PAXIL CR Placebo PAXI L CR Placebo PAXIL CR Placebo PAXI L CR Placebo n (males) 78 78 162 194 88 97 NA NA NA NA Decreased Libido 10 5 9 6 13 1 NA NA NA NA Abnormal ejaculation 26 1 27 3 15 1 NA NA NA NA Impotence 5 3 10 1% 9 0 NA NA NA NA n (females) 134 133 282 251 98 87 681 349 246 120 Decreased Libido 4 2 8 2 4 1 12 5 9 6 Orgasmic Disturbance 10
Paromerck treatment has been associated with several cases of priapism. In those cases with a known outcome, patients recovered without sequelae.
SSRIs and SNRIs, including PAXIL CR, have been associated with cases of clinically significant hyponatremia in elderly patients, who may be at greater risk for this adverse reaction .
In premarketing clinical trials with immediate-release Paromerck hydrochloride, 17% of Paromerck treated patients (approximately 700) were 65 years or older. Pharmacokinetic studies revealed a decreased clearance in the elderly, and a lower starting dose is recommended; however, no overall differences in safety or effectiveness were observed between these subjects and younger subjects .
Some clinical studies have shown that SSRIs (including Paromerck) may affect sperm quality during SSRI treatment, which may affect fertility in some men. A reduced pregnancy rate was found in reproduction studies in rats at a dose of Paromerck of 15 mg/kg/day, which is approximately twice the MRHD on an mg/m² basis. Irreversible lesions occurred in the reproductive tract of male rats after dosing in toxicity studies for 2 to 52 weeks. These lesions consisted of vacuolation of epididymal tubular epithelium at 50 mg/kg/day and atrophic changes in the seminiferous tubules of the testes with arrested spermatogenesis at 25 mg/kg/day (approximately 6 and 3 times the MRHD on an mg/m² basis).
What other information should I know?
Keep all appointments with your doctor.
Before having any laboratory test (especially those that involve methylene blue), tell your doctor and the laboratory personnel that you are taking Paromerck.
Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.
It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.