Can she take Paxil (paroxetine) 20mg at 5pm?

Paroxetine (Paxil) Administration Time

Yes, she can take Paxil 20mg at 5pm as it can be administered at any time of day with or without food, though morning administration is more common.

Dosing Guidelines for Paroxetine

According to the FDA drug label for Paxil, paroxetine should be administered as a single daily dose with or without food, usually in the morning 1. However, the timing is flexible and can be adjusted based on patient needs and side effect profile.

The standard dosing information for paroxetine includes:

• Initial dose: 20mg daily (which is also the recommended dose for depression and anxiety disorders) 1
• Maximum dose: 40-50mg daily for depression, 60mg daily for OCD and panic disorder 1
• Administration: Single daily dose, with or without food 1

Considerations for Evening Administration

When considering evening administration of paroxetine, there are several factors to consider:

Potential Benefits of Evening Administration

• May help manage daytime sedation if this is a side effect the patient experiences
• Could be beneficial if the patient has trouble remembering morning doses
• May help with sleep if insomnia is not a concern for this patient

Potential Drawbacks of Evening Administration

• Paroxetine can cause insomnia in some patients, which may be exacerbated by evening dosing 2
• In studies, paroxetine has been shown to cause more frequent awakenings and reduced total sleep, especially at higher doses 3
• When taken in the morning, paroxetine has been shown to increase slow-wave sleep 3

Recommendations for Administration

For this specific patient taking 20mg of paroxetine:

1. Evening administration at 5pm is acceptable according to the FDA label
2. Monitor for any sleep disturbances that may occur with this timing
3. If sleep problems develop, consider switching to morning administration
4. Consistency in timing is more important than the specific time of day

Important Monitoring Considerations

• Assess therapeutic response within 1-2 weeks of any change in medication timing 2
• Full therapeutic effect may take 4-8 weeks to become apparent 4
• If the patient experiences insomnia with evening dosing, switching to morning administration may be beneficial 2

In conclusion, while paroxetine is often recommended to be taken in the morning, taking it at 5pm is acceptable according to the FDA guidelines and may work well for this particular patient's schedule and needs. The most important factor is consistency in daily administration.