Difference between revisions of "Hypericum-doxepine"

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* '''Day 15:''' stop administration of hypericum.
 
* '''Day 15:''' stop administration of hypericum.
 
| start =   
 
| start =   
* '''Day 15-30:''' a wash-out period of at least two weeks is necessary.  
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* '''Day 15-22:''' a wash-out period of at least one week is necessary.<ref>{{Pubmed|18294328|Imai H, Kotegawa T, Tsutsumi K, Morimoto T, Eshima N, Nakano S, Ohashi K. The recovery time-course of CYP3A after induction by St John's wort administration.  Br J Clin Pharmacol. 2008 May;65(5):701-7.}}</ref><ref>{{Pubmed|16640452|Wurglics M, Schubert-Zsilavecz M. Hypericum perforatum: a 'modern' herbal antidepressant: pharmacokinetics of active ingredients. Clin Pharmacokinet. 2006;45(5):449-68.}}</ref><ref>{{Pubmed|19593191|Derijks HJ, Janknegt R, Heerdink ER, De Koning FH, Krekels MM, Looij BJ, Egberts AC. Influence of antidepressant use on glycemic control in patients with diabetes mellitus: an open-label comparative study. J Clin Psychopharmacol. 2009 Aug;29(4):405-8.}}</ref><ref name="informatorium">{{KNMP|doxepine}}</ref>
* '''Day 31:''' start doxepin 25 mg/day.
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* '''Day 23:''' start doxepin 25 mg/day.Increase the dose with about 25% of the target dose every 3 days.
| info =
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| caveat =
 
* Occurrence of the serotonin syndrome is possible without wash-out period.
 
 
| info =
 
| info =
 
{{HypericumInfo}}
 
{{HypericumInfo}}
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{{caveSS}}
 
}}
 
}}

Latest revision as of 10:21, 14 October 2015

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 15-22: a wash-out period of at least one week is necessary.[4][5][6][1]
  • Day 23: start doxepin 25 mg/day.Increase the dose with about 25% of the target dose every 3 days.
Infobord.png More information
  • Hypericum induces enzymes of the CYP P-450 type and P-gp type.
  • Hypericum might have MAO-inhibiting and/or COMT-inhibiting properties.
  • Many studies reported that hypericin is the main source of pharmacological effects of hypericum. However the IC50 of hypericin to inhibit MAO A and MAO B is 100- to 1000-fold higher than accessible Cmax values of hypericin after oral administration of hypericum.[7]
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