Switch medication from hypericum to fluvoxamine.
- Day 1-14: Gradually decrease the dosage of hypericum.
- Day 15: Stop administration of hypericum.
- Day 15-22: A wash-out period of at least one week is necessary.
- Day 23: Start fluvoxamine 50 mg/day.
- Day 44: If necessary increase dosage to 100 mg/day or more.
- 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.
- 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.
- Derijks HJ, Janknegt R, Heerdink ER, De Koning FH, Krekels MM, Looij BJ, Egberts AC. Influence of antidepressant use on glycemic control in patients with diabetes mellitus: an open-label comparative study. J Clin Psychopharmacol. 2009 Aug;29(4):405-8.
- KNMP; Informatorium Medicamentorum 2015; Monografie "fluvoxamine" (Dutch)
Cite error: Invalid
<ref>tag; name "informatorium" defined multiple times with different content
- Wurglics M, Schubert-Zsilavecz M.Hypericum perforatum: a 'modern' herbal antidepressant: pharmacokinetics of active ingredients. Clin Pharmacokinet. 2006;45(5):449-68.
- F. Borelli et al.Herb-drug interactions with St John's wort (Hypericum perforatum): an update on clinical observations. AAPS J. 2009 Dec;11(4):710-27
- Izzo AA. Drug interactions with St John's wort (Hypericum perforatum): a review of the clinical evidence. Int J Clin Pharmacol Ther. 2004 Mar;42(3):139-48
The editors of psychiatrienet.nl take the greatest care to provide up-to-date and accurate information on this site. Nevertheless, mistakes and omissions cannot be entirely excluded. No rights devolve from the information provided. The editors and other providers of information to this site accept no responsibility for the content of this site or for the information provided therein; neither do they accept responsibility for possible damages which may derive from the use of the information on this site or from the linked sites. The editorial board accepts no responsibility for the content of the (linked) sites, for access to them, or for the products and services on these sites, nor for the occurrence of errors, viruses, and/or disruptions in service.