Duloxetine-fluvoxamine

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

Start fluvoxamine

Day 11: start fluvoxamine 50 mg.
Day 15: increase administration of fluvoxamine.

More information

Fluvoxamine inhibits the metabolism of duloxetine through CYP1A2.^[3]
Occurrence of the serotonin syndrome is not likely, but theoretically possible, so caution is necessary.

↑ 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.
↑ Lobo et al. In vitro and in vivo evaluations of cytochrome P450 1A2 interactions with duloxetine. Clin Pharmacokinet. 2008;47(3):191-202

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[1] 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

[2] Stahl, S. M. (2013). Stahl's essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). Cambridge University Press.

[DuloCYP1A2-3] Lobo et al. In vitro and in vivo evaluations of cytochrome P450 1A2 interactions with duloxetine. Clin Pharmacokinet. 2008;47(3):191-202

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Duloxetine-fluvoxamine

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