Switch medication from mirtazapine to fluvoxamine.[1]
[2]
Stop mirtazapine
- Before day 1: gradually reduce dosage of mirtazapine to a maximum of 30 mg/ day.
- Day 1: reduce a dosage of 30 mg/day to 15 mg/day.
- Day 8: stop administration of mirtazapine.
Start fluvoxamine
- Day 11: start fluvoxamine in a normal dosage of 50 mg/day.
- Day 14: If necessary, increase dosage of fluvoxamine to 100 mg/day and later even more.
More information
- Caution with this switch is necessary, because fluvoxamine slows the metabolism of mirtazapine via CYP1A2, CYP2C9, CYP2D6 and CYP3A4.
- This switch is currently being reviewed.
- ↑ 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 mirtazapine 
Start fluvoxamine
More information