Nortriptyline-hypericum

Nortriptyline
Type Antidepressant
Group TCA
links
Medscape Nortriptyline
PubChem 4543
PubMed Nortriptyline
Kompas (Dutch) Nortriptyline
Wikipedia Nortriptyline
Hypericum
Type Antidepressant
Group other
links
EMEA 10130408en
PubMed Hypericum
Kompas (Dutch) hypericum extract
Wikipedia St John's wort

Switch medication from nortriptyline to hypericum.

Nietinrijdenbord.png Stop nortriptyline
  • Before day 1: gradually reduce dosage of nortriptyline to a maximum of 50 mg/ day, when this dosage is > 50 mg/day.
  • Day 1-3: reduce dosage of nortriptyline to 25 mg/day.
  • Day 4-7: reduce dosage of nortriptyline to 10 mg/day.
  • Day 8: stop administration of nortriptyline.
Eenrichtingbord.png Start hypericum
  • Day 8-15: a wash-out period of one week is necessary.
  • Day 16: start administration of hypericum in a dosage of 300 mg three times a day (900 mg/day).
Infobord.png More information
  • Occurrence of serotonin syndrome is theoretically possible, so caution is necessary.
  • 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.[1]
  • The T1/2 of hypericum is 19 - 37 hour.[2]
  1. ↑ Wurglics M, Schubert-Zsilavecz M.Hypericum perforatum: a 'modern' herbal antidepressant: pharmacokinetics of active ingredients. Clin Pharmacokinet. 2006;45(5):449-68.
  2. ↑ KNMP; Informatorium Medicamentorum 2015; Monografie "hypericum" (Dutch)
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