Difference between revisions of "Fluvoxamine-amitriptyline"

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| from = fluvoxamine  
 
| from = fluvoxamine  
 
| to = amitriptyline  
 
| to = amitriptyline  
| stop =  
+
| stop = {{StopSSRI,SNRI}}
* '''Before day 1:''' gradually reduce dosage of fluvoxamine to a maximum of 100 mg/day when the dosage is > 100 mg/day.
 
* '''Day 1:''' reduce dosage of fluvoxamine to a maximum of 50 mg/day.
 
* '''Day 8:''' stop administration of fluvoxamine
 
 
| start =  
 
| start =  
* '''Day 1:''' simultaneously start administration of amitriptyline in a low dosage of 25 mg/day.
+
* '''Day 1:''' start administration of amitriptyline in a low dosage of 25 mg/day.  
* '''Day 8:''' continue administration of amitriptyline in a dosage of 50 mg/day.  
+
* '''Day 8:''' increase dosage of amitriptyline to a dosage of 50 mg/day.
* Start low, go slow!
 
 
| info =  
 
| info =  
* Fluvoxamine is an inhibitor of CYP1A2, CYP2C19 and CYP3A4 (moderate), which metabolize amitriptyline.
+
* fluvoxamine slows the metabolism of amitriptyline via CYP2C19 inhibition.  
* {{theorSS}}
+
* {{SSCYPinh}}
{{review}}
+
* {{TCAplasmalevelmonitoring}}
 
}}
 
}}

Latest revision as of 17:12, 30 June 2023

Fluvoxamine
Type Antidepressant
Group SSRI
links
Medscape Fluvoxamine
PubChem 5324346
PubMed Fluvoxamine
Kompas (Dutch) Fluvoxamine
Wikipedia Fluvoxamine
Amitriptyline
Type Antidepressant
Group TCA
links
ATC-code N06AA09
Medscape Amitriptyline
PubChem 2160
PubMed Amitriptyline
Kompas (Dutch) Amitriptyline
Wikipedia Amitriptyline

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

Nietinrijdenbord.png Stop fluvoxamine
  • Day 1: Decrease dose to 50%
  • Day 8: Stop
Eenrichtingbord.png Start amitriptyline
  • Day 1: start administration of amitriptyline in a low dosage of 25 mg/day.
  • Day 8: increase dosage of amitriptyline to a dosage of 50 mg/day.
Infobord.png More information
  • fluvoxamine slows the metabolism of amitriptyline 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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