Switch medication from clomipramine to fluvoxamine.[1]
[2]
Stop clomipramine
- Before day 1: gradually reduce dosage of clomipramine to a maximum of 75 mg/day.
- Day 1: reduce dosage of clomipramine to 50 mg/day.
- Day 3: reduce dosage of clomipramine to 25 mg/day.
Start fluvoxamine
- Day 1: simultaneously start administration of fluvoxamine in a normal dosage of 50 mg/day.
- Day 8: stop administration of clomipramine and continue administration of fluvoxamine in a dosage of 50-100 mg/day.
More information
- Occurrence of serotonin syndrome is theoretically possible, so caution is necessary.
- Fluvoxamine is an inhibitor of CYP1A2, CYP2C19 and CYP3A4 (moderate), which metabolize clomipramine.
- ↑ 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.
The editors of psychiatrienet.nl take the greatest care to provide up-to-date and accurate information on this site. Nevertheless, mistakes and omissions cannot be entirely excluded. No rights devolve from the information provided. The editors and other providers of information to this site accept no responsibility for the content of this site or for the information provided therein; neither do they accept responsibility for possible damages which may derive from the use of the information on this site or from the linked sites. The editorial board accepts no responsibility for the content of the (linked) sites, for access to them, or for the products and services on these sites, nor for the occurrence of errors, viruses, and/or disruptions in service.
Stop clomipramine 
Start fluvoxamine
More information