Difference between revisions of "Hypericum-imipramine"

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| to = imipramine  
 
| to = imipramine  
 
| stop =  
 
| stop =  
* Administration of hypericum can be stopped abruptly.
+
* '''Day 1-14:'''Gradually decrease the dosage of hypericum.
| start =  
+
* '''Day 15:''' stop administration of hypericum.
* '''Day 1-7:''' a wash-out period of one week is necessary.
+
| start =
* '''Day 8:''' start administration of imipramine in a dosage of 25-50 mg/day.
+
* '''Day 15-30:''' a wash-out period of at least two weeks is necessary.  
* If necessary, increase dosage of imipramine to 50-75 mg/day.
+
* '''Day 31:''' start imipramine 50 mg/day.
* Start low, go slow.
 
 
| info =  
 
| info =  
* Hypericum slows the metabolism of imipramine via CYP3A4. This effect may persist up to two weeks after stopping hypericum, so caution is necessary.}}
+
* Occurrence of the serotonin syndrome is possible without wash-out period.
 +
* Hypericum induces enzymes of the CYP P-450 type and P-gp.
 +
* Hypericum probably has MAO-inhibiting properties.}}

Revision as of 08:48, 15 July 2009

Hypericum
Type Antidepressant
Group other
links
EMEA 10130408en
PubMed Hypericum
Kompas (Dutch) hypericum extract
Wikipedia St John's wort
Imipramine
Type Antidepressant
Group TCA
links
Medscape Imipramine
PubChem 3696
PubMed Imipramine
Kompas (Dutch) Imipramine
Wikipedia Imipramine

Switch medication from hypericum to imipramine.[1] [2]

Nietinrijdenbord.png Stop hypericum
  • Day 1-14:Gradually decrease the dosage of hypericum.
  • Day 15: stop administration of hypericum.
Eenrichtingbord.png Start imipramine
  • Day 15-30: a wash-out period of at least two weeks is necessary.
  • Day 31: start imipramine 50 mg/day.
Infobord.png More information
  • Occurrence of the serotonin syndrome is possible without wash-out period.
  • Hypericum induces enzymes of the CYP P-450 type and P-gp.
  • Hypericum probably has MAO-inhibiting properties.
  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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