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Switch medication from doxepin to tranylcypromine.[2] [3]
Stop doxepin - Before day 0: gradually reduce dosage of doxepin to a maximum of 100 mg/day.
- Day 1: reduce dosage of doxepin to 50 mg/day.
- Day 8: reduce dosage of doxepin to 25 mg/day.
- Day 15: stop administration of doxepin.
Start tranylcypromine- Day 15-28: a wash-out period is necessary.
- Day 29: start administration of tranylcypromine in a low dosage of 20 mg/day for one week.
- Day 35: after this week the dosage of tranylcypromine can be increased if necessary.
Cave- Occurrence of the serotonin syndrome is possible without wash-out period.
- ↑ 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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