Duloxetine-hypericum

Duloxetine Type Antidepressant Group SNRI links Medscape Duloxetine PubChem 60835 PubMed Duloxetine Kompas (Dutch) Duloxetine Wikipedia Duloxetine more info

Hypericum Type Antidepressant Group other links EMEA 10130408en PubMed Hypericum Kompas (Dutch) hypericum extract Wikipedia St John's wort more info

Switch medication from duloxetine to hypericum.

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 30 mg/day.
• Day 8: stop administration of duloxetine.

Start hypericum

• Day 8-15: a wash-out period is necessary.
• Day 16: start administration of hypericum in a dosage of 300 mg three times a day (900 mg/day).

Cave

• Occurrence of the serotonin syndrome is possible without wash-out period.

More information

• Hypericum induces enzymes of the CYP P-450 type and P-gp type.
• Hypericum might have MAO-inhibiting and/or COMT-inhibiting properties.
• Many studies reported that hypericin is the main source of pharmacological effects of hypericum. However the IC50 of hypericin to inhibit MAO A and MAO B is 100- to 1000-fold higher than accessible Cmax values of hypericin after oral administration of hypericum.
  

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