Duloxetine-fluvoxamine
From Psychiatrienet
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Switch medication from duloxetine to fluvoxamine.[1] [2]
Stop duloxetine - Before day 1: gradually reduce dosage of duloxetine to a maximum of 60 mg/ day, when this dosage is > 60 mg/day.
- Day 1: reduce dosage of duloxetine to a maximum of 30 mg/day.
- Day 8: stop administration of duloxetine.
Start fluvoxamine- Day 11: start fluvoxamine 50 mg.
- Day 15: increase administration of fluvoxamine.
More information- Fluvoxamine inhibits the metabolism of duloxetine through CYP1A2.[3]
- Occurrence of the serotonin syndrome is not likely, but theoretically possible, so caution is necessary.
- ↑ 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
- ↑ Stahl, S. M. (2013). Stahl's essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). Cambridge University Press.
- ↑ Lobo et al. In vitro and in vivo evaluations of cytochrome P450 1A2 interactions with duloxetine. Clin Pharmacokinet. 2008;47(3):191-202
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