Switch medication from bupropion to fluoxetine.[1]
[2]
Stop bupropion
- Before day 1: Gradually reduce dosage of bupropion to a maximum of 150 mg/ day.
- Day 1: Stop administration of bupropion
Start fluoxetine
- Day 2: * Start fluoxetine the next day in normal dosage of 20 mg/day.
- After 3 weeks: If necessary, increase the dosage gradually to 40-60 mg/day.
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- No wash-out period is needed.
- Bupropion and its metabolites have long elimination times, so plasma concentrations will reduce gradually.
- Bupropion slows the metabolism of fluoxetine by CYP2D6.
- The interaction by CYP2D6-inhibition is not relevant because of low dosages during the switch.
- Pharmacokinetic interaction is not important because of low plasma levels.
- ↑ 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 bupropion 
Start fluoxetine
More information