Does Paxil make your urine smell? (3+ factors)

In this article, we will answer the question “Does Paxil make your urine smell?”. We will also discuss various factors which can cause urine odour and what to do if your urine odour does not subside.

Does Paxil make your urine smell?

No, Paxil (Paroxetine) does not make your urine smell. Urine odour is not a common side effect reported from Paxil. Paxil is almost completely metabolised and two-thirds of the metabolites are excreted in the urine. The remaining metabolites are eliminated through faeces. Only 3% of Paroxetine is excreted in the unchanged form (1). 

Paxil is a commonly prescribed antidepressant which belongs to the class of selective serotonin reuptake inhibitors (SSRIs). It is used for the treatment of many depressive disorders. Over the years many different side effects of Paroxetine have been documented but urine odour is not a commonly reported side effect.

Normally, if a medication is present as an unchanged drug in large amounts in urine it can be the cause of an unusual odour. As that is not the case with Paxil, it is highly unlikely that any pungent or unusual smell in urine is due to Paxil. However, some other factors that can make your urine smell unusual are dehydration, certain foods and beverages, urinary tract infections (UTIs) or underlying health conditions. 

If you find that your urine has an unusual colour or odour, it is best to consult a doctor regarding your condition so any underlying problem can be addressed.

Any possible effects of Paxil on urine?

Paxil has not been reported to directly have any effect on urine odour. However, it can indirectly impact urine colour and odour. Paxil has a side effect of diarrhoea. It also has been found to cause dehydration. These factors when combined can cause urinary retention and decreased frequency or amount of urine.

Dehydration can result in a change of colour and odour of urine. As two-thirds of the medication is excreted in the urine, the concentrated urine can give off some odour. This is not a common phenomenon and has not been reported much. However, any changes in urine colour and odour should be brought to the attention of your healthcare provider.

What factors can affect urine odour while on Paxil?

Some factors that can affect urine odour whether you are taking Paxil therapy or not, are as follows (2,3):

Diet changes and hydration levels

Hydration plays a very important role in the frequency and quantity of urine. If you are dehydrated, you may have a dark and strong-smelling urine. It is important to keep drinking adequate amounts of water to avoid this problem.

Sometimes diet can also have an important role in imparting odour to urine. Certain foods like asparagus, garlic, onions and coffee can cause a strong smell in your urine. So if you have recently consumed a sufficient amount of any such food, your urine may temporarily smell a bit different.

Medical conditions

Sometimes underlying medical conditions can make a patient more prone to urine odour. Infections like UTIs are known to cause foul-smelling urine. Bacteria present in the urine are the main reason for urine odour.

Renal and hepatic impairment can also cause some individuals to experience this odour. Other conditions like kidney stones, diabetes, yeast infections, sexually transmitted infections (STIs), isovaleric acidemia, hypermethioninemia or maple syrup urine disease can also change the odour of your urine.


As individuals age their urine may start to smell a bit different. This is due to the reason that the elderly may have different chronic underlying medical conditions and are more prone to dehydration, which may affect urine odour.


Women may experience a change in urine odour if they are pregnant or undergoing menopause. Altered hormonal levels and a heightened sense of smell may be a reason for foul-smelling urine in pregnancy, while in menopause, normally changing hormonal levels are the culprit.


If you are taking vitamins or other medications along with Paxil your urine odour can be caused due to the other medications as well. Vitamin D and B can cause urine odour. Medications like amoxicillin, sulfonamide antibiotics and medications for diabetes and rheumatoid arthritis can also change the odour of your urine.

The change can be a temporary effect of any of these factors and may go away if the underlying problem is addressed. However, if the smell does not subside, you should consult your doctor.

How to prevent having odour in the urine?

Some tips that can help you prevent having odour in your urine are as follows:

Hydration and diet

You should have an adequate intake of water. Drinking less water can cause urine to become concentrated hence causing a pungent odour. Staying hydrated is very important for health. Drinking adequate fluids can help prevent and manage foul-smelling urine.

You should try altering your diet. Foods like asparagus, garlic, onions and coffee tend to give urine a strong smell. Avoiding such foods can prevent urine odour from increasing. Adding cranberry juice to your fluid intake can also help with urine odour.

Avoid urinary retention

You should try to avoid urinary retention by changing your bathroom habits and visiting the restroom as soon as you have the urge to go. You should try strengthening your pelvic floor muscles with proper exercise to avoid urinary retention.

Medications and assessment for infections

If you are taking vitamins or medications that can cause a pungent smell in urine, you should talk to your doctor if alternatives are available. You should also get checked for any possible UTIs or STIs.

Keep in mind that these tips are only to help you manage or prevent your symptoms, and if these do not help you should consult your doctor for proper assessment.

What to do if your urine smells while on Paxil?

If your urine has a pungent odour while you are on Paxil therapy you should make sure to keep yourself well hydrated. Sometimes monitoring your food choices can also help you resolve this problem. If you have diabetes make sure to check your diabetes regularly and manage it with exercise and a healthy diet. 

If the problem is not resolved, or you think you may have a UTI or STI you should consult with a healthcare provider regarding your concerns. Your doctor may run some tests to check for any underlying issue which can cause urine odour.


In this article, we answered the question “Does Paxil make your urine smell?”. We also discussed factors that may affect urine odour and what you should do if any such problem occurs. In my opinion, urine odour is not caused by Paxil, but other medications, vitamins and certain foods can affect urine odour. Health conditions like diabetes, UTIs and STIs can also be a cause of foul-smelling urine.

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Foster RH, Goa KL. Paroxetine: a review of its pharmacology and therapeutic potential in the management of panic disorder. CNS drugs. 1997 Aug;8(2):163-88.


Fogazzi GB. Urinalysis. InComprehensive clinical nephrology 2010 Jan 1 (pp. 39-55). Mosby.


Midthun SJ, Paur R, Lindseth G. Urinary tract infections: does the smell really tell?. Journal of gerontological nursing. 2004 Jun 1;30(6):4-9.

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