Difference between revisions of "Fluvoxamine-doxepine"

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* '''Day 1:''' reduce dosage of fluvoxamine to a maximum of 25 mg/day.  
 
* '''Day 1:''' reduce dosage of fluvoxamine to a maximum of 25 mg/day.  
 
| start =  
 
| start =  
Caution is necessary
+
 
 
* '''Day 1:''' simultaneously start administration of doxepin in a low dosage of 25 mg/day.  
 
* '''Day 1:''' simultaneously start administration of doxepin in a low dosage of 25 mg/day.  
 
* '''Day 8:''' stop administration of fluvoxamine and continue administration of doxepin only. If necessary, increase dosage of doxepin.
 
* '''Day 8:''' stop administration of fluvoxamine and continue administration of doxepin only. If necessary, increase dosage of doxepin.
 
| info =  
 
| info =  
* Fluvoxamine slows the metabolism of doxepin via CYP2D6, and possibly via CYP1A2 too.
+
* Fluvoxamine is an inhibitor of CYP1A2, CYP2C19 and CYP3A4 (moderate), which metabolize doxepin.
 
* "Start low, go slow" is not required, but caution is necessary.}}
 
* "Start low, go slow" is not required, but caution is necessary.}}

Revision as of 15:16, 26 March 2010

Fluvoxamine
Type Antidepressant
Group SSRI
links
Medscape Fluvoxamine
PubChem 5324346
PubMed Fluvoxamine
Kompas (Dutch) Fluvoxamine
Wikipedia Fluvoxamine
Doxepin
Type antidepressant
Group TCA
links
ATC-code N06AA12
Medscape Doxepin
PubChem 3158
PubMed Doxepin
Drugs.com doxepin
Kompas (Dutch) Doxepin
Wikipedia Doxepin

Switch medication from fluvoxamine to doxepin.[2] [3]

Nietinrijdenbord.png Stop fluvoxamine
  • Before day 1: gradually reduce dosage of fluvoxamine to a maximum of 50 mg/ day when this dosage is > 50 mg/day.
  • Day 1: reduce dosage of fluvoxamine to a maximum of 25 mg/day.
Eenrichtingbord.png Start doxepin
  • Day 1: simultaneously start administration of doxepin in a low dosage of 25 mg/day.
  • Day 8: stop administration of fluvoxamine and continue administration of doxepin only. If necessary, increase dosage of doxepin.
Infobord.png More information
  • Fluvoxamine is an inhibitor of CYP1A2, CYP2C19 and CYP3A4 (moderate), which metabolize doxepin.
  • "Start low, go slow" is not required, but caution is necessary.
  1. 1.0 1.1 1.2 1.3 1.4 KNMP; Informatorium Medicamentorum 2023; Monografie "doxepine" (Dutch)
  2. Switches are based on literature references on this page and expert opinions of the authors. The authors have used pharmacokinetic and receptor affinity properties to determine the switch schedules
  3. Stahl, S. M. (2013). Stahl's essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). Cambridge University Press.
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