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Switch medication from fluoxetine to duloxetine.[1] [2]
Stop fluoxetine - Gradually reduce dosage of fluoxetine to a maximum of 20 mg/ day, when this dosage is > 20 mg/day.
- When a dosage of 20 mg/day is reached, stop administration.
Start duloxetineNo wash-out period is needed.
- Day 1: start duloxetine the next day in low dosage of 30 mg/day for one week.
- Day 28: increase dosage of duloxetine to normal, 60 mg/day.
More information- Desmethylfluoxetine has a halflife of at least 1 week: it takes therefore 1 month for elemination.
- Through CYP2D6 fluoxetine and duloxetine can mutually influence their metabolism.
- 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.
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