Paroxetine Darifenacin

PAROXETINE ANTIMUSCARINICS - DARIFENACIN, PROCYCLIDINE t levels of these antimuscarinics Inhibition of metabolism Watch for early features of toxicity... 

Paroxetine and cimetidine cause small, clinically irrelevant, increases in darifenacin levels. Darifenacin increases imipramine levels, and caution is required with this and other tricyclics. Darifenacin does not significantly affect the pharmacokinetics of midazolam or combined oral contraceptives. 

The manufacturers note that, in a study in healthy subjects, paroxetine 20 mg daily increased the steady-state AUC of darifenacin 30 mg once daily by 33%. - This change is unlikely to be clinically relevant, and no dosage adjustments are recommended by the US manufacturers in the presence of CYP2D6 inhibitors. However, the UK manufacturers recommend that the dose of darifenacin should be started at 7.5 mg daily and, if well tolerated, titrated to 15 mg daily in the presence of CYP2D6 inhibitors (they name paroxetine, terbinafine and quinidine). This seems a cautious approach. For a list ofCYP2D6 inhibitors, see Table 1.3 , (p.6). 

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See also in sourсe #XX -- [ ]

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