Hypericum-doxepine

Hypericum
Type Antidepressant
Group other
links
EMEA 10130408en
PubMed Hypericum
Kompas (Dutch) hypericum extract
Wikipedia St John's wort
Doxepin
Type antidepressant
Group TCA
links
ATC-code N06AA12
Medscape Doxepin
PubChem 3158
PubMed Doxepin
Drugs.com doxepin
Kompas (Dutch) Doxepin
Wikipedia Doxepin

Switch medication from hypericum to doxepin.

Nietinrijdenbord.png Stop hypericum
  • Day 1-14:Gradually decrease the dosage of hypericum.
  • Day 15: stop administration of hypericum.
Eenrichtingbord.png Start doxepin
  • Day 15-22: a wash-out period of at least one week is necessary.[3][4][5][1]
  • Day 23: start doxepin 25 mg/day.Increase the dose with about 25% of the target dose every 3 days.
Infobord.png More information
  • 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.[6]
  • The T1/2 of hypericum is 19 - 37 hour.[1]
  1. ↑ 1.01.11.21.31.41.51.6 KNMP; Informatorium Medicamentorum 2015; Monografie "doxepine" (Dutch) Cite error: Invalid <ref> tag; name "informatorium" defined multiple times with different content
  2. ↑ NVZA; Toxicology.org; Monografie 63 (dutch)
  3. ↑ 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.
  4. ↑ Wurglics M, Schubert-Zsilavecz M. Hypericum perforatum: a 'modern' herbal antidepressant: pharmacokinetics of active ingredients. Clin Pharmacokinet. 2006;45(5):449-68.
  5. ↑ 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.
  6. ↑ 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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