Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Riva Paroxetine.
Abnormal bleeding: Paroxetine, like other similar medications, may cause abnormal bleeding, including bleeding in the stomach or intestines. People who have or have had a history of bleeding disorders should discuss with their doctor how Riva Paroxetine may affect their medical condition, how their medical condition may affect the dosing and effectiveness of Riva Paroxetine, and whether any special monitoring is needed.
Report any unusual bruising or bleeding to your doctor, especially if you are taking other medications that affect blood clotting. These medications include acetylsalicylic acid (Asa), Clopidogrel, Dipyridamole, nonsteroidal anti-inflammatory drugs (NSAIDs; e.g., Ibuprofen or Naproxen), other anticoagulant medications (e.g., Warfarin), and certain antipsychotic medications.
Bone fracture: Riva Paroxetine may increase the risk of bone fractures (breaks) when taking this medication. If you have Osteoporosis or any other illness that increases your risk for breaking bones, or are at risk for developing osteoporosis, discuss with your doctor how Riva Paroxetine may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Riva Paroxetine, and whether any special monitoring is needed.
Drowsiness/reduced alertness: Although paroxetine is not known to cause drowsiness, it is advisable to avoid driving or operating hazardous machinery until you determine how paroxetine affects your ability to do these things safely.
Glaucoma: Paroxetine can cause an increase in the pressure in the eye, making symptoms of glaucoma worse. If you have narrow-angle glaucoma, discuss with your doctor how Riva Paroxetine may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Riva Paroxetine, and whether any special monitoring is needed.
Heart disease: If you have heart disease, discuss with your doctor how Riva Paroxetine may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Riva Paroxetine, and whether any special monitoring is needed.
Kidney function: People with Kidney Disease may need lower doses of Riva Paroxetine. If you have kidney disease or reduced kidney function, discuss with your doctor how Riva Paroxetine may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Riva Paroxetine, and whether any special monitoring is needed.
Liver function: Liver disease or reduced liver function may cause Riva Paroxetine to build up in the body, causing side effects. If you have liver problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Riva Paroxetine, and whether any special monitoring is needed. Your doctor may want to test your liver function regularly with blood tests while you are taking Riva Paroxetine.
If you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.
Mania: Paroxetine may cause symptoms of mania to worsen or return. If you have a history of mania or bipolar disorder, discuss with your doctor how Riva Paroxetine may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Riva Paroxetine, and whether any special monitoring is needed.
Seizures: There have been occasional reports of seizures occurring with paroxetine. If you have a history of seizures discuss with your doctor how Riva Paroxetine may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Riva Paroxetine, and whether any special monitoring is needed. Anyone who develops seizures should seek immediate medical attention.
Serotonin syndrome: Severe reactions are possible when paroxetine is combined with other medications that act on serotonin, such as tricyclic antidepressants, "triptan" medications for migraine and some medications to treat nausea due to chemotherapy. These combinations should be avoided. Symptoms of a reaction may include muscle rigidity and spasms, difficulty moving, changes in mental state including delirium and agitation. Coma and death are possible.
If you are taking other medications that affect serotonin, discuss with your doctor how Riva Paroxetine may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Riva Paroxetine, and whether any special monitoring is needed.
Stopping the medication: Stopping Riva Paroxetine suddenly may lead to side effects such as dizziness, abnormal dreams, numbness or tingling sensations, agitation, anxiety, nausea, vomiting, sweating, or other symptoms. If you are thinking of stopping the medication, check with your doctor first. Your doctor may want you to decrease the dose of the medication gradually when it is time to stop taking paroxetine.
Suicidal or agitated behaviour: People taking Riva Paroxetine may feel agitated (restless, anxious, aggressive, emotional, and feeling not like themselves), or they may want to hurt themselves or others. These behavioural changes may be more likely to occur in children and adolescents, however they are possible for all age groups that use Riva Paroxetine. These symptoms may occur within several weeks after starting Riva Paroxetine. If you experience these side effects or notice them in a family member who is taking Riva Paroxetine, contact your doctor immediately. You should be closely monitored by your doctor for emotional and behaviour changes while taking Riva Paroxetine.
Pregnancy: Riva Paroxetine should not be used during pregnancy unless the benefits outweigh the risks. Paroxetine has been reported to cause an increase in birth defects, primarily of the heart, in babies born to women who have taken it in the first trimester. It has also been reported that babies born to women who took medications of this kind during the last trimester of their pregnancy may experience adverse effects (such as breathing problems, seizures, trouble feeding, vomiting, low blood sugar, shaking, jitteriness, irritability, and constant crying) that result in an increase in the length of hospital stay. If you become pregnant while taking Riva Paroxetine, contact your doctor immediately.
Breast-feeding: Riva Paroxetine passes into breast milk. If you are a breast-feeding mother and are taking paroxetine, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.
Children and adolescents: The safety and effectiveness of paroxetine for those less than 18 years of age have not been established. The use of Riva Paroxetine by children and adolescents less than 18 years old may cause behavioural and emotional changes, such as suicidal thoughts and behaviour.
Seniors: Seniors may need lower doses of Riva Paroxetine, and they should be closely monitored by their doctor when taking paroxetine.
