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Switch medication from duloxetine to amitriptyline.[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 amitriptylineA wash-out period of one week is necessary.
- Day 8-14: wash-out period.
- Day 15: start administration of amitriptyline in a low dosage of 25 mg/day.
More information- Start low, go slow for amitriptyline!
- ↑ 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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- Duloxetine is a moderate inhibitor of CYP2D6, which metabolizes amitriptyline