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Switch medication from fluvoxamine to nortriptyline.[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 dosage of fluvoxamine to a maximum of 25 mg/day.
Start nortriptylineCaution is necessary.
- Day 1: simultaneously start administration of nortriptyline in a low dosage of 25 mg/day.
- Day 8: stop administration of fluvoxamine and continue administration of nortriptyline in a dosage of 50 mg/day.
More information- Fluvoxamine slows the metabolism of nortriptyline via CYP2D6.
- "Start low, go slow" is not required, but caution is necessary.
- 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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