Difference between revisions of "Maprotiline-fluoxetine"

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{{Drugswitch  
 
{{Drugswitch  
| from = maprotiline  
+
| from = maprotiline
| to = fluoxetine  
+
| to = fluoxetine
 
| stop =  
 
| stop =  
* '''Before day 0:''' gradually reduce dosage of maprotiline to a maximum of 75 mg/day.
+
{{TCAdecrease25p3d}}
* '''Day 1:''' reduce dosage of maprotiline to 50 mg/day.
 
* '''Day 3:''' reduce dosage of maprotiline to 25 mg/day.
 
 
| start =  
 
| start =  
* '''Day 3:''' simultaneously start administration of fluoxetine in a normal dosage of 20 mg/day.
+
* '''Day 6 and after''': At approximately 50-25% of the original TCA dosering start fluoxetine at 100% of the target dose.
* '''Day 8:''' stop administration of maprotiline and continue administration of fluoxetine.
+
* ''' After 3 weeks:''' If necessary, gradually increase dosage of fluoxetine.
 +
 
 
| info =  
 
| info =  
* Occurrence of serotonin syndrome is theoretically possible, so caution is necessary.
+
* Safe target dose fluoxetine = 20 mg
* Fluoxetine is a strong inhibitor of CYP2D6, which metabolizes maprotiline.
+
* Fluoxetine and norfluoxetine are inhibitors of CYP2D6 (strong), which metabolize maprotiline.
 
}}
 
}}

Latest revision as of 12:31, 8 March 2024

Maprotiline
Type Antidepressant
Group NRI
links
Medscape Maprotiline
PubChem 4011
PubMed Maprotiline
Kompas (Dutch) Maprotiline
Wikipedia Maprotiline
Fluoxetine
Type Antidepressant
Group SSRI
links
Medscape Fluoxetine
PubChem 3386
PubMed Fluoxetine
Kompas (Dutch) Fluoxetine
Wikipedia Fluoxetine

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

Nietinrijdenbord.png Stop maprotiline
  • Day 1: Decrease with about 25% of the original dose per 3 days.
Eenrichtingbord.png Start fluoxetine
  • Day 6 and after: At approximately 50-25% of the original TCA dosering start fluoxetine at 100% of the target dose.
  • After 3 weeks: If necessary, gradually increase dosage of fluoxetine.
Infobord.png More information
  • Safe target dose fluoxetine = 20 mg
  • Fluoxetine and norfluoxetine are inhibitors of CYP2D6 (strong), which metabolize maprotiline.
  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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