Difference between revisions of "Fluvoxamine-clomipramine"

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| from = fluvoxamine  
 
| from = fluvoxamine  
 
| to = clomipramine  
 
| to = clomipramine  
| stop =  
+
| stop = {{StopSSRI,SNRI}}
* '''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.
 
 
| start =  
 
| start =  
Caution is necessary.
+
* '''Day 1:''' start administration of clomipramine in a low dosage of 37.5 mg/day.  
* '''Day 1:''' simultaneously start administration of clomipramine in a low dosage of 25-50 mg/day.
+
* '''Day 8:''' increase dosage of clomipramine to a dosage of 75 mg/day.
* '''Day 8:''' stop administration of fluvoxamine and continue administration of clomipramine in a dosage of 50-75 mg/day.  
 
* Start low, go slow!
 
 
| info =  
 
| info =  
* Fluvoxamine slows the metabolism of clomipramine via CYP1A2 and CYP2D6.
+
* fluvoxamine slows the metabolism of clomipramine via CYP2C19 inhibition.  
* {{theorSS}}
+
* {{SSCYPinh}}
 +
* {{TCAplasmalevelmonitoring}}
 
}}
 
}}

Latest revision as of 14:37, 30 June 2023

Fluvoxamine
Type Antidepressant
Group SSRI
links
Medscape Fluvoxamine
PubChem 5324346
PubMed Fluvoxamine
Kompas (Dutch) Fluvoxamine
Wikipedia Fluvoxamine
Clomipramine
Type Antidepressant
Group TCA
links
ATC-code N06AA04
Medscape Clomipramine
PubChem 2801
PubMed Clomipramine
Kompas (Dutch) Clomipramine
Wikipedia Clomipramine

Switch medication from fluvoxamine to clomipramine.[1] [2]

Nietinrijdenbord.png Stop fluvoxamine
  • Day 1: Decrease dose to 50%
  • Day 8: Stop
Eenrichtingbord.png Start clomipramine
  • Day 1: start administration of clomipramine in a low dosage of 37.5 mg/day.
  • Day 8: increase dosage of clomipramine to a dosage of 75 mg/day.
Infobord.png More information
  • fluvoxamine slows the metabolism of clomipramine via CYP2C19 inhibition.
  • Due to CYP inhibition a longer period of time is needed to reach steady state concentration. Please keep in mind when monitoring plasma levels
  • Plasma monitoring for TCA's is advisable, because of plasma-reponse relations, genetic polymorphism and under or overdosing.[3]
  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.
  3. (dutch) monografie.org tricyclische-antidepressiva
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