Paroxetine dos and don’ts

Do understand what Paroxetine is and what it is used for

Premature ejaculation is when a man ejaculates with little sexual stimulation and/or too quickly during sex. The time it takes to ejaculate varies between men, and it is up to the couple to decide how quickly is too quickly.

Paroxetine belongs to a group of medicines called ‘selective serotonin reuptake inhibitors’ (SSRIs). 

Paroxetine is often used to treat psychological disorders such anxiety and depression, but it can be used "off-label" to treat premature ejaculation as it increases the time taken to ejaculate and can improve control over ejaculation. This may help to reduce the frustration or worry about ejaculating too fast.

"Off-label" use means that the medicine is licensed but being used in a way that is different to that described in the license.

When using Paroxetine for premature ejaculation you only need to take it when required, instead of everyday 

Don’t take it if…

• if you are allergic to paroxetine or any of the other ingredients of this medicine  
• if you are taking medicines called monoamine oxidase inhibitors (MAOIs, including moclobemide and methylthioninium chloride (methylene blue)) or have taken them at any time within the last two weeks
• if you are taking an anti-psychotic called thioridazine or an anti-psychotic called pimozide. 
• if you are female
• if you are under the age of 18 or aged 65 or older
• if you plan to take paroxetine for any reason other than the treatment of premature ejaculation
• If you have ever had a mental health problem such as depression, mania (symptoms include feeling over−excited, irritable or not being able to think clearly), bipolar disorder (symptoms include serious mood swings between mania and depression) or schizophrenia (a psychiatric disease). Numan recommend against using Paroxetine for treatment of premature ejaculation if you have had any of these issues before. However your doctor may prescribe Paroxetine to you for other conditions if necessary

you are taking:

• Medicines for depression called ‘monoamine oxidase inhibitors’ (MAOIs)
• Thioridazine used for schizophrenia
• Other medicines for depression
• Lithium – a medicine for bipolar disorder
• Linezolid – an antibiotic used to treat infections
• Atomoxetine which is used to treat attention deficit hyperactivity disorder (ADHD)
• Tryptophan – a medicine to help you sleep
• Medicines used to treat migraines
• St John’s wort – a herbal medicine
• Tramadol – used to treat serious pain
• Medicines used to treat migraines
• Rifampicin, used to treat tuberculosis (TB) and leprosy. 
• Tamoxifen, which is used to treat breast cancer or fertility problems

Do not take Paroxetine at the same time as any of the medicines listed above. If you have taken or are currently taking any of these medicines, you will need to wait 14 days after you stop taking it before you can start taking Paroxetine, and this should only be attempted with the advice and support of your doctor. Once you have stopped taking Paroxetine, you will need to wait 7 days before taking any of the medicines listed above. If you are not sure about what to do, talk to your doctor or pharmacist before taking this medicine.

Do take it correctly

Always take this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure.

• The recommended dose is 20 mg.
• Only take the medicine 3 to 4 hours before sexual activity is anticipated.
• Do not take this medicine more than once every 24 hours or every day.
• Swallow the tablets whole to avoid a bitter taste, with at least one full glass of water. 
• This medicine can be taken with or without food, but taking with food will reduce the likelihood of you feeling nauseous (sick).
• This medicine should not be used by men under 18 or over 65 years of age.
• This medicine can be taken with other medicines that treat erectile dysfunction called phosphodiesterase inhibitors

Do be aware of the possible side effects

Very common side effects (may affect more than 1 in 10 men):

• nausea
• sexual dysfunction

Common side effects (may affect up to 1 in 10 men):

• increases in cholesterol levels, decreased appetite
• tiredness, insomnia, agitation, abnormal dreams (including nightmares)
• dizziness, tremor, headache, concentration impaired
• blurred vision
• yawning
• constipation, diarrhoea, vomiting, dry mouth
• sweating
• weakness; lack of energy and strength body weight gain
• on discontinuation: dizziness, sensory disturbances, sleep disturbances, anxiety, headache

Uncommon side effects (may affect up to 1 in 100 men):

• abnormal bleeding
• altered blood sugar control has been reported in diabetic patients
• confusion, hallucinations
• involuntary movements
• fast heart rate
• high or low blood pressure, dizziness when you stand up
• dilated pupils

Rare side effects (may affect up to 1 in 1,000 men):

• manic reactions, anxiety, depersonalisation, panic attacks, inability to remain still
• convulsions, restless legs syndrome (RLS)
• slow heart rate

Very rare side effects (may affect up to 1 in 10,000):

• thrombocytopenia (low platelets in your blood)
• severe allergic reactions (anaphylaxis) or swelling of the face, lips, tongue and/or throat (angiodema)
• syndrome of inappropriate anti–diuretic hormone secretion (SIADH)
• serotonin syndrome (symptoms may include agitation, confusion, sweating, hallucinations, overactive reflexes, involuntary muscle jerk, shivering, fast heart rate and tremor)
• glaucoma
• bleeding in the stomach
• severe skin reactions
• priapism (a prolonged erection)
• swelling in the arms or legs

Frequency not known:

• suicidal ideation, suicidal behaviour and aggression, teeth grinding
• tinnitus (ringing in the ear)

If you have any questions about taking paroxetine please get in touch by emailing [email protected] or if you feel unwell and feel you need urgent medical attention please call NHS 111 or attend your nearest accident and emergency department.