Switch medication from bupropion to hypericum.
- Before day 1: gradually reduce dosage of bupropion to a maximum of 300 mg/day, when this dosage is > 300 mg/day.
- Day 1: reduce dosage of bupropion to 150 mg/day.
- Day 8: stop administration of bupropion.
- Day 8: start administration of hypericum in a dosage of 300 mg three times a day (900 mg/day).
- Hypericum induces enzymes of the CYP P-450 type and P-gp type.
- Hypericum might have MAO-inhibiting and/or COMT-inhibiting properties.
- Many studies reported that hypericin is the main source of pharmacological effects of hypericum. However the IC50 of hypericin to inhibit MAO A and MAO B is 100- to 1000-fold higher than accessible Cmax values of hypericin after oral administration of hypericum.
- The T1/2 of hypericum is 19 - 37 hour.
- No severe interactions are known.
- Imai H, Kotegawa T, Tsutsumi K, Morimoto T, Eshima N, Nakano S, Ohashi K. The recovery time-course of CYP3A after induction by St John's wort administration. Br J Clin Pharmacol. 2008 May;65(5):701-7.
- Wurglics M, Schubert-Zsilavecz M. Hypericum perforatum: a 'modern' herbal antidepressant: pharmacokinetics of active ingredients. Clin Pharmacokinet. 2006;45(5):449-68.
- KNMP; Informatorium Medicamentorum 2015; Monografie "bupropion" (Dutch)
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- Wurglics M, Schubert-Zsilavecz M.Hypericum perforatum: a 'modern' herbal antidepressant: pharmacokinetics of active ingredients. Clin Pharmacokinet. 2006;45(5):449-68.
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