Paroxetine with Galantamine Interaction Details
Brand Names Associated with Paroxetine
- Brisdelle®
- Paroxetine
- Paxil®
- Paxil® CR
- Pexeva®
Brand Names Associated with Galantamine
- Galantamine
- Razadyne® (formerly available as Reminyl®)
- Razadyne® ER
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Nov 13, 2023
Interaction Effect
Increased galantamine exposure and an increased risk of QT interval prolongation
Interaction Summary
Based upon in vitro studies, the major enzymes involved in galantamine metabolism are CYP3A4 and CYP2D6. PARoxetine is a potent inhibitor of CYP2D6. When PARoxetine 20 mg daily for 16 days was administered concurrently with galantamine, the galantamine oral bioavailability increased approximately 40%. Such an increase may warrant caution when coadministering these two medications. Monitor for galantamine toxicity including anorexia, nausea, vomiting, dizziness, arrhythmias or gastrointestinal bleeding. Also, PARoxetine is associated with ventricular tachycardia and torsade de pointes. Hence, coadministration of PARoxetine with other QT prolonging drugs such as galantamine may increase the risk of QT interval prolongation .
Severity
Major
Onset
Unspecified
Evidence
Probable
How To Manage Interaction
Increased galantamine plasma concentrations may result from PARoxetine inhibition of galantamine CYP2D6-mediated metabolism. Monitor for galantamine toxicity including anorexia, nausea, vomiting, dizziness, arrhythmias, or gastrointestinal bleeding. Also, PARoxetine is associated with ventricular tachycardia and torsade de pointes. Hence, coadministration of PARoxetine with other QT prolonging drugs such as galantamine may increase the risk of QT interval prolongation .
Mechanism Of Interaction
Inhibition of CYP2D6-mediated galantamine metabolism; additive QT interval prolongation
Literature Reports
A) When PARoxetine 20 mg daily for 16 days was administered concurrently with galantamine, the galantamine oral bioavailability increased approximately 40% .
Paroxetine Overview
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Paroxetine tablets, suspension (liquid), and extended-release (long-acting) tablets are used to treat depression, panic disorder (sudden, unexpected attacks of extreme fear and worry about these attacks), and social anxiety disorder (extreme fear of interacting with others or performing in front of others that interferes with normal life). Paroxetine tablets and suspension are also used to treat obsessive-compulsive disorder (bothersome thoughts that won't go away and the need to perform certain actions over and over), generalized anxiety disorder (GAD; excessive worrying that is difficult to control), and posttraumatic stress disorder (disturbing psychological symptoms that develop after a frightening experience). Paroxetine extended-release tablets are also used to treat premenstrual dysphoric disorder (PMDD, physical and psychological symptoms that occur before the onset of the menstrual period each month). Paroxetine capsules (Brisdelle) are used to treat hot flashes (sudden feelings of warmth, especially in the face, neck, and chest) in women who are experiencing menopause (stage of life when menstrual periods become less frequent and stop and women may experience other symptoms and body changes). Paroxetine is in a class of medications called selective serotonin-reuptake inhibitors (SSRIs). It treats depression and other mental illnesses by increasing the amount of serotonin, a natural substance in the brain that helps maintain mental balance. There is not enough information available at this time to know how paroxetine works to treat hot flashes.
Galantamine Overview
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Galantamine is used to treat the symptoms of Alzheimer's disease (AD; a brain disease that slowly destroys the memory and the ability to think, learn, communicate and handle daily activities). Galantamine is in a class of medications called acetylcholinesterase inhibitors. It works by increasing the amount of a certain natural substance in the brain that is needed for memory and thought. Galantamine may improve the ability to think and remember or slow the loss of these abilities in people who have AD. However, galantamine will not cure AD or prevent the loss of mental abilities at some time in the future.
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Definitions
Severity Categories
Contraindicated
These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.
Major
This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.
Moderate
This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.
Minor
While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.
Onset
Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.
Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.
Evidence
Level of documentation of the interaction.
Established: The interaction is documented and substantiated in peer-reviewed medical literature.
Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.
How To Manage The Interaction
Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.
It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.
Mechanism Of Interaction
The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.
Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.
Where Does Our Information Come From?
Information for our drug interactions is compiled from several drug compendia, including:
The prescribing information for each drug, as published on DailyMED, is also used.
Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.
The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.