Switch medication from hypericum to doxepin.[2]
[3]
Stop hypericum
- Administration of hypericum can be stopped abruptly.
Start doxepin
- Day 1-7: a wash-out period of one week is necessary.
- * Day 8: start administration of doxepin in a dosage of 25 mg/day.
- If necessary, increase dosage of doxepin to 50 mg/day.
- Start low, go slow.
More information
- Hypericum slows the metabolism of doxepin via CYP3A4. This effect may persist up to two weeks after stopping hypericum, so caution is necessary.
- ↑ 1.0 1.1 1.2 1.3 1.4 KNMP; Informatorium Medicamentorum 2023; Monografie "doxepine" (Dutch)
- ↑ 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.
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Stop hypericum 
Start doxepin
More information