Drug & supplement interaction

Hirudotherapy + Paroxetine

Paroxetine brand names: Paxil CR, Paxil, Brisdelle.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 20, 2026
The bottom line No known interaction

We found no known interaction between Hirudotherapy and Paroxetine in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

Hirudotherapy and Paroxetine

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Paroxetine and Hirudotherapy in our sources. This does not guarantee that the combination is completely free of risk — research on Hirudotherapy alongside specific medications may be limited.

Worth understanding: our licensed dataset holds no drug-interaction record for Hirudotherapy at all — not against Paroxetine, and not against any other medication we track. This verdict therefore rests on the absence of any recorded data, not on research that looked at this combination and found nothing. We cannot rule an interaction out.

Hirudotherapy is a treatment rather than something you take. Tell whoever provides it which medicines you use, and ask your prescriber whether it is appropriate for your health and treatment. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Hirudotherapy safety at a glance

Hirudotherapy overall Use caution Should only be performed by trained practitioners using medical-grade leeches due to infection and bleeding risks.
Pregnancy Avoid Not enough safety data; the bleeding and infection risks make it best avoided in pregnancy.
Breastfeeding Avoid Safety during breastfeeding is unknown, so it is best avoided unless a doctor advises otherwise.

Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Paroxetine and Hirudotherapy? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
What to actually watch for

No Interaction Found — But Data Suggests Hirudotherapy and Paroxetine May Share Several of the Same Side Effects

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so having Hirudotherapy while taking the medicine can make those effects more likely to turn up, and harder to pin on one or the other if they do. 2 of them are worth acting on rather than waiting out — marked below.

  • Bleeding or bruising Worth acting on Additional detail

    Hirudotherapy

    “Topically, hirudotherapy can cause prolonged bleeding and anemia. In a case report, a young adult male presented with neck bleeding after self-applying leeches for acne. Bleeding was controlled by suturing. A case series in critically ill pediatric patients describes bleeding that led to hirudotherapy discontinuation in 5 of 7 cases, and 4 of the patients expired secondary to multiorgan failure.”

    Hirudotherapy · Natural Medicines adverse-effect record, reported in acne.

    4 sources cited
    1. 99399. Zengin S, Yarbil P, Kilic H, Al B. Prolonged bleeding due to a medicinal leech bite: another treatment method, primary suture. BMJ Case Rep. 2012;2012. pii: bcr0220125759. PubMed
    2. 106752. Sepaskhah M, Yazdanpanah N, Sari Aslani F, Akbarzadeh Jahromi M. Cutaneous pseudolymphoma as a rare adverse effect of medicinal leech therapy: a case report and review of the literature. Cureus. 2020 Apr 2;12(4):e7517. PubMed
    3. 106753. Temiz SA, Özer I, Ataseven A, Dursun R, Findik S. Cutaneous pseudolymphoma due to hirudotherapy. Turkiye Parazitol Derg. 2019;43(1):50-2. PubMed
    4. 112900. Resch JC, Hedstrom R, Steiner ME, Said SM, Somani A. Hirudotherapy for limb ischemia in the pediatric intensive care unit: A retrospective observational cohort. Front Pediatr 2023;10:1011171. PubMed

    Paroxetine

    Listed in the ADVERSE REACTIONS section of the FDA label for Paroxetine. Read the label on DailyMed ›

  • A higher chance of infection Worth acting on Additional detail

    Hirudotherapy

    “Topically, hirudotherapy can cause itching, pain, vesicle formation, and skin redness at the application site. Less often, it can cause necrotic ulcers, keloid formation, allergic or irritant contact dermatitis, and skin infections. Use of leeches can sometimes cause infections with Aeromonas hydrophila, which is found in the leech gut, and also with parasites.”

    Hirudotherapy · Natural Medicines adverse-effect record, reported in cluster headache.

    6 sources cited
    1. 99392. Bibbo C, Fritsche T, Stemper M, Hall M. Flap infection associated with medicinal leeches in reconstructive surgery: two new drug-resistant organisms. J Reconstr Microsurg. 2013;29(7):457-60. PubMed
    2. 99394. Michalsen A, Lüdtke R, Cesur O, et al. Effectiveness of leech therapy in women with symptomatic arthrosis of the first carpometacarpal joint: a randomized controlled trial. Pain. 2008;137(2):452-9. PubMed
    3. 99395. Pietrzak A, Kanitakis J, Tomasiewicz K, et al. Cutaneous complications of improper leech application. Ann Agric Environ Med. 2012;19(4):790-2.
    4. 99397. van Alphen NA, Gonzalez A, McKenna MC, McKenna TK, Carlsen BT, Moran SL. Ciprofloxacin-resistant Aeromonas infection following leech therapy for digit replantation: report of 2 cases. J Hand Surg Am. 2014;39(3):499-502. PubMed
    5. 99398. Wang H, Zhang J, Chen L. The efficacy and safety of medical leech therapy for osteoarthritis of the knee: A meta-analysis of randomized controlled trials. Int J Surg. 2018;54(Pt A):53-61. PubMed
    6. 106752. Sepaskhah M, Yazdanpanah N, Sari Aslani F, Akbarzadeh Jahromi M. Cutaneous pseudolymphoma as a rare adverse effect of medicinal leech therapy: a case report and review of the literature. Cureus. 2020 Apr 2;12(4):e7517. PubMed

    Paroxetine

    Listed in the ADVERSE REACTIONS section of the FDA label for Paroxetine. Read the label on DailyMed ›

  • A skin rash Additional detail

    Hirudotherapy

    Recorded for Hirudotherapy in the same Natural Medicines adverse-effect record shown under Bleeding or bruising above.

    Paroxetine

    Listed in the ADVERSE REACTIONS section of the FDA label for Paroxetine. Read the label on DailyMed ›

  • Headache Additional detail

    Hirudotherapy

    Recorded for Hirudotherapy in the same Natural Medicines adverse-effect record shown under A higher chance of infection above.

    Paroxetine

    Listed in the ADVERSE REACTIONS section of the FDA label for Paroxetine. Read the label on DailyMed ›

Reported for Hirudotherapy but not commonly for Paroxetine: bleeding in the gut, low blood pressure, swelling and pain in an arm or leg.

Effects for Paroxetine come from the ADVERSE REACTIONS section of its FDA label; effects for Hirudotherapy come from the Natural Medicines adverse-effect record, quoted above. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

From our Q&A

Questions About Hirudotherapy or Paroxetine

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Hirudotherapy or Paroxetine, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Paroxetine

This page covers Hirudotherapy only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Paroxetine page lists 134 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Iboga (major), Lithium (major), 1,3-dmaa (moderate) and 5-htp (moderate).

By severity: 3 major · 105 moderate · 26 minor.

From our pharmacist’s overview on the Paroxetine page

“I treat paroxetine (Paxil, Paxil CR, Brisdelle) as a medication where supplement choices genuinely matter, not one to wave through. This antidepressant raises serotonin, so about twenty of the ingredients listed here, lithium among them, can push serotonin too high and risk serotonin syndrome, a dangerous reaction.”

Reviewed by 2 · Jul 18, 2026

Open the Paroxetine interaction page

How much people look this up

Where Hirudotherapy and Paroxetine Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Hirudotherapy
Steady interest

#1,137 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Paroxetine
Top 25%

#692 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Hirudotherapy reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 20, 2026. The Hirudotherapy and Paroxetine records this page draws on were last updated July 10, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
Treatment approach

About Hirudotherapy

What is Hirudotherapy?

  • Reconstructive and plastic surgery (relieving blood congestion in reattached tissue)
  • Osteoarthritis and joint pain
  • Circulation problems
  • Varicose veins
  • Traditional treatment for various inflammatory conditions

Hirudotherapy is the medical use of living leeches placed on the skin to draw blood and release saliva compounds that thin blood and ease congestion. It has a real, accepted role in some surgical settings (such as saving reattached fingers or skin flaps), but evidence for most other uses is limited. It should only be done by trained professionals because of risks of infection and bleeding.

Hirudo medicinalis · Hirudinidae · Whole living medicinal leech (and its saliva) · Live medicinal leeches applied to the skin by a trained practitioner

An interaction check asks whether these two react with each other — it does not ask whether Hirudotherapy is a good idea for someone in your situation. Here is what our Hirudotherapy record says about it on its own.

Hirudotherapy: dosing

There is no standardized "dose" for hirudotherapy. The number of leeches, where they are placed, and how long treatment continues are decided by the treating clinician based on the medical situation, such as how much blood is congested in a tissue flap.This is a medical procedure, not a supplement you take at home.

From our Hirudotherapy monograph — the full record covers uses, side effects and every documented interaction.

Read the full Hirudotherapy monograph & all interactions
Medication

About Paroxetine

What Is Paroxetine Used For?

Brand names: Paxil CR, Paxil, Brisdelle

Paroxetine tablets, film-coated tablets, and oral suspensions are approved in adults for major depressive disorder (MDD), obsessive compulsive disorder (OCD), panic disorder, social anxiety disorder, generalized anxiety disorder (GAD), and post-traumatic stress disorder (PTSD). The extended-release tablet forms (Paxil CR, paroxetine HCL CR, and paroxetine extended-release tablets) are approved in adults for MDD, panic disorder, social anxiety disorder, and premenstrual dysphoric disorder (PMDD).

Brisdelle (paroxetine 7.5 mg capsule) and generic paroxetine capsules are approved specifically for moderate to severe vasomotor symptoms (hot flashes) associated with menopause — not for any psychiatric condition. Paroxetine tablets are not approved for use in children.

Most-Reported Side Effects for Paroxetine

From FAERS, the FDA’s public side-effect reporting system (91,207 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Drug withdrawal syndrome 6,210 reports
Nausea 6,139 reports
Dizziness 5,469 reports
Fatigue 5,430 reports
Anxiety 5,396 reports
See full Paroxetine drug information
Keep checking

Other Drugs & Hirudotherapy

Browse every other medication we’ve checked against Hirudotherapy — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
0Moderate
0Minor
2,829No known interaction
2,829 No interaction
No interaction 2,829 drugs checked — show the list

We also checked Hirudotherapy against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,829 medications checked with no known interaction — see the full Hirudotherapy list.

See the full Hirudotherapy interactions page
See every supplement checked against Paroxetine, ranked by severity
Evidence & sources

Hirudotherapy References

The 15 references that drive our Hirudotherapy monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Altamura D, Calonje E, Liau Jl, Rogers M, Verdolini R. Diffuse cutaneous pseudolymphoma due to therapy with medicinal leeches. JAMA Dermatol. 2014;150(7):783-4. PubMed
  2. Bibbo C, Fritsche T, Stemper M, Hall M. Flap infection associated with medicinal leeches in reconstructive surgery: two new drug-resistant organisms. J Reconstr Microsurg. 2013;29(7):457-60. PubMed
  3. Khelifa E, Kaya G, Laffitte E. Cutaneous pseudolymphomas after leech therapy. J Dermatol. 2013;40(8):674-5. doi: PubMed
  4. Michalsen A, Lüdtke R, Cesur O, et al. Effectiveness of leech therapy in women with symptomatic arthrosis of the first carpometacarpal joint: a randomized controlled trial. Pain. 2008;137(2):452-9. PubMed
  5. Pietrzak A, Kanitakis J, Tomasiewicz K, et al. Cutaneous complications of improper leech application. Ann Agric Environ Med. 2012;19(4):790-2.
  6. van Alphen NA, Gonzalez A, McKenna MC, McKenna TK, Carlsen BT, Moran SL. Ciprofloxacin-resistant Aeromonas infection following leech therapy for digit replantation: report of 2 cases. J Hand Surg Am. 2014;39(3):499-502. PubMed
  7. Wang H, Zhang J, Chen L. The efficacy and safety of medical leech therapy for osteoarthritis of the knee: A meta-analysis of randomized controlled trials. Int J Surg. 2018;54(Pt A):53-61. PubMed
  8. Zengin S, Yarbil P, Kilic H, Al B. Prolonged bleeding due to a medicinal leech bite: another treatment method, primary suture. BMJ Case Rep. 2012;2012. pii: bcr0220125759. PubMed
  9. Sepaskhah M, Yazdanpanah N, Sari Aslani F, Akbarzadeh Jahromi M. Cutaneous pseudolymphoma as a rare adverse effect of medicinal leech therapy: a case report and review of the literature. Cureus. 2020 Apr 2;12(4):e7517. PubMed
  10. Temiz SA, Özer I, Ataseven A, Dursun R, Findik S. Cutaneous pseudolymphoma due to hirudotherapy. Turkiye Parazitol Derg. 2019;43(1):50-2. PubMed
  11. Daye M, Isik B, Kilinç F. Lichen planus due to hirudotherapy. Turkiye Parazitol Derg. 2021;45(2):149-52. PubMed
  12. Mentes BB, Leventoglu S, Osmanov I, Kösehan D, Erol T. Anal abscess due to leech therapy of hemorrhoids: mumbo jumbo is still in vogue. J Surg Case Rep. 2019 Jul 31;2019(7):rjz218. PubMed
  13. Kiliç M, Ak R. Orbital cellulitis due to leech therapy. Bull Emerg Trauma. 2019 Jul;7(3):335-6. PubMed
  14. Dolek UC, Ozdemir S, Babayeva K, Gol M. Leech Application-related Upper Gastrointestinal Bleeding: A Case Report. Bull Emerg Trauma 2023;11(1):47-50.
  15. Resch JC, Hedstrom R, Steiner ME, Said SM, Somani A. Hirudotherapy for limb ischemia in the pediatric intensive care unit: A retrospective observational cohort. Front Pediatr 2023;10:1011171. PubMed

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Having Hirudotherapy While Taking Paroxetine: Common Questions

Is it safe to have Hirudotherapy while taking Paroxetine?
We do not list a known interaction between Hirudotherapy and Paroxetine. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do Hirudotherapy and Paroxetine have any of the same side effects?
Yes — our sources link each of them separately to 4 of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
Does Paroxetine interact with any supplements?
Yes. Paroxetine has documented interactions with 134 supplements in our database — Hirudotherapy is not one of them. The Paroxetine interaction page linked on this page lists every one, ranked by severity.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Where next

Keep Exploring

Hirudotherapy monograph Uses, safety profile, and every drug interaction in one place Paroxetine drug information The full plain-English guide to this medication Paroxetine supplement interactions Every supplement checked against Paroxetine, ranked by severity Supplement interaction checker Check any supplement or product against your medications Browse medications A–Z Every drug we’ve checked against herbs & supplements References The 15 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Paroxetine and Hirudotherapy?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.