Low-Dose Paroxetine for Hot Flashes: What the Label Says
Menopause & HormonesArticleA 7.5 mg bedtime dose of paroxetine is FDA-approved for moderate to severe hot flashes, a nonhormonal option. It's an SSRI at a much lower dose than for depression, with important interactions, including with tamoxifen.
In this article
If hormone therapy isn’t right for you, your clinician may mention a low dose of paroxetine. A 7.5 mg capsule taken at bedtime is FDA-approved for moderate to severe hot flashes and night sweats from menopause.1 Here is what the label covers.
What makes it different
Paroxetine is a selective serotonin reuptake inhibitor (SSRI), a type of antidepressant. The 7.5 mg capsule uses a much lower dose than is used for depression or anxiety, and it isn’t approved or effective for treating those conditions.1 If you need treatment for depression or anxiety, your clinician would use a different product and dose.1
How it’s taken
One 7.5 mg capsule once a day at bedtime, with or without food.1
Interactions to check
- Tamoxifen: paroxetine may make tamoxifen less effective.1 If you take tamoxifen after breast cancer, ask your oncologist before starting.
- Bleeding: the risk rises with NSAID pain relievers, aspirin or other medicines that affect clotting.1 Our guide to ibuprofen and naproxen covers those pain relievers.
- Not to be combined with MAOI antidepressants (or within 14 days of them), thioridazine or pimozide.1
- Serotonin syndrome is a risk, especially with other medicines that raise serotonin, but it can happen with paroxetine alone.1
Bring a full list of medicines and supplements to your pharmacist.
Other warnings on the label
- A boxed warning about suicidal thoughts and behavior with SSRIs.1
- Low sodium, especially in older adults.1
- An association between SSRIs and fractures.1
- Angle-closure glaucoma in people with narrow eye angles.1
- Sexual side effects.1
- Caution if you’ve had seizures.1
- Not for use in pregnancy.1
Questions to ask
- Is hormone therapy an option, or is a nonhormonal medicine better for me?
- Do any of my medicines interact, especially tamoxifen or blood thinners?
- How long before we know it’s working?
- What should I do if I want to stop? Ask before stopping on your own.
Our guides to hot flash help without hormones, gabapentin for hot flushes and elinzanetant compare other options.
Try: “My hot flashes wake me every night and I can’t take estrogen. Would low-dose paroxetine work with my other medicines, including tamoxifen?”
My Body Changed. Now What? includes a Visit Brief. Use it to list your hot flashes, sleep and every medicine and supplement you take. See the book.
This article is for general educational purposes only and is not medical advice. It isn't a substitute for diagnosis or treatment from a qualified healthcare professional who knows your health history. Please don't stop or change a prescribed medicine without talking to your prescriber. Seek urgent care for thoughts of self-harm (call or text 988 in the U.S.), confusion, fever with muscle stiffness or tremor, eye pain with vision changes, or unusual bleeding. If you think you may be having a medical emergency, call 911 or your local emergency number right away. This article discusses a prescription medicine and its FDA-approved label. Girl Playbook does not endorse any specific product, test, or provider.
Girl Playbook sells this book. It provides education and worksheets, not individualized medical care.
Sources
The research behind this article, in the order it’s cited. How we source our articles.
- DailyMed, National Library of MedicineParoxetine capsules 7.5 mg: prescribing information (opens in a new tab)abcdefghijklmno
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