Difference between revisions of "Fluoxetine-duloxetine"

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| to = duloxetine  
 
| to = duloxetine  
 
| stop =  
 
| stop =  
* Gradually reduce dosage of fluoxetine to a maximum of 20 mg/ day, when this dosage is > 20 mg/day.
+
{{stopfluox}}
* When a dosage of 20 mg/day is reached, stop administration.
+
| start = {{startnafluox}}
| start =  
 
No wash-out period is needed.
 
* '''Day 1:''' start duloxetine the next day in low dosage of 30 mg/day for one week.
 
* '''Day 28:''' increase dosage of duloxetine to normal, 60 mg/day.
 
 
| info =  
 
| info =  
* Desmethylfluoxetine has a halflife of at least 1 week: it takes therefore 1 month for elemination.
+
{{longt1/2fluvox}}
 +
* Safe target dose duloxetine =  60 mg
 
* Through CYP2D6 fluoxetine and duloxetine can mutually influence their metabolism.
 
* Through CYP2D6 fluoxetine and duloxetine can mutually influence their metabolism.
 
* {{theorSS}}
 
* {{theorSS}}
  
 
}}
 
}}

Latest revision as of 15:44, 24 February 2023

Fluoxetine
Type Antidepressant
Group SSRI
links
Medscape Fluoxetine
PubChem 3386
PubMed Fluoxetine
Kompas (Dutch) Fluoxetine
Wikipedia Fluoxetine
Duloxetine
Type Antidepressant
Group SNRI
links
Medscape Duloxetine
PubChem 60835
PubMed Duloxetine
Kompas (Dutch) Duloxetine
Wikipedia Duloxetine

Switch medication from fluoxetine to duloxetine.[1] [2]

Nietinrijdenbord.png Stop fluoxetine
  • Day 1: Stop fluoxetine
Eenrichtingbord.png Start duloxetine
  • Day 5: Start with 50% of the target dose
  • Day 10: Increase dose to 100% of the target dose
  • Day 11 and after: Gradually increase dose as necessary
Infobord.png More information
  • Fluoxetine and its metababolite desmethyl-fluoxetine have a very long elimination time of about 1 week; phasing out fluoxetine is therefore not necessary.
  • Safe target dose duloxetine = 60 mg
  • Through CYP2D6 fluoxetine and duloxetine can mutually influence their metabolism.
  • Occurrence of the serotonin syndrome is not likely, but theoretically possible, so caution is necessary.
  1. 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
  2. Stahl, S. M. (2013). Stahl's essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). Cambridge University Press.
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