Switch medication from fluvoxamine to mirtazapine.[1]
[2]
Stop fluvoxamine
- Before day 1: gradually reduce dosage of fluvoxamine to a maximum of 50 mg/ day, when this dosage is > 50 mg/day.
- Day 1: reduce fluvoxamine to a dosage of 25 mg/day.
- Day 8: stop administration of fluvoxamine.
Start mirtazapine
- Day 8: start administration of mirtazapine in a low dosage of 15 mg/day for one week.
- Day 15: increase dosage of mirtazapine to normal (30 mg/day).
More information
- Caution with this switch is necessary, because fluvoxamine slows the metabolism of mirtazapine via CYP1A2, CYP2C9, CYP2D6 and CYP3A4. The inhibiting effect of fluvoxamine can continue up to two weeks after stopping administration.
- ↑ 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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Stop fluvoxamine 
Start mirtazapine
More information