Difference between revisions of "Hypericum-doxepine"

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| to = doxepin  
 
| to = doxepin  
 
| stop =  
 
| stop =  
* Administration of hypericum can be stopped abruptly.
+
* '''Day 1-14:'''Gradually decrease the dosage of hypericum.
| start =  
+
* '''Day 15:''' stop administration of hypericum.
* '''Day 1-7:''' a wash-out period of one week is necessary.
+
| start =
* '''Day 8:''' start administration of doxepin in a dosage of 25 mg/day.
+
* '''Day 15-30:''' a wash-out period of at least two weeks is necessary.  
* If necessary, increase dosage of doxepin to 50 mg/day.
+
* '''Day 31:''' start doxepin 50 mg/day.
* Start low, go slow.
 
 
| info =  
 
| info =  
* Hypericum slows the metabolism of doxepin via CYP3A4. This effect may persist up to two weeks after stopping hypericum, so caution is necessary.}}
+
* Occurrence of the serotonin syndrome is possible without wash-out period.
 +
* Hypericum induces enzymes of the CYP P-450 type and P-gp.
 +
* Hypericum probably has MAO-inhibiting properties.}}

Revision as of 16:58, 13 July 2009

Hypericum
Type Antidepressant
Group other
links
EMEA 10130408en
PubMed Hypericum
Kompas (Dutch) hypericum extract
Wikipedia St John's wort
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 hypericum to doxepin.[2] [3]

Nietinrijdenbord.png Stop hypericum
  • Day 1-14:Gradually decrease the dosage of hypericum.
  • Day 15: stop administration of hypericum.
Eenrichtingbord.png Start doxepin
  • Day 15-30: a wash-out period of at least two weeks is necessary.
  • Day 31: start doxepin 50 mg/day.
Infobord.png More information
  • Occurrence of the serotonin syndrome is possible without wash-out period.
  • Hypericum induces enzymes of the CYP P-450 type and P-gp.
  • Hypericum probably has MAO-inhibiting properties.
  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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