Duloxetine is a serotonin norepinephrine reuptake inhibitor (SNRI) that is commonly prescribed treatment for depression and anxiety. Better known by its brand name, Cymbalta, duloxetine capsules are also commonly used as a nerve pain agent in people with diabetes or fibromyalgia. It is also FDA approved to treat chronic musculoskeletal pain. People commonly experience some minor side effects, such as nausea, constipation, and low appetite.
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Duloxetine overview
BRAND NAMES:
Cymbalta, Drizalma Sprinkle
Generic Names:
Duloxetine HCl
Uses:
Treats depression, anxiety, nerve pain due to diabetic nerve damage and fibromyalgia, and chronic bone and muscle pain
Therapeutic Classes:
Serotonin-norepinephrine reuptake inhibitor (SNRI), antidepressant, anxiolytic, neuropathic pain agent
Forms:
Delayed-release capsule
How it’s taken:
By mouth
What is Duloxetine used for?
The FDA has approved duloxetine as a treatment for major depressive disorder and generalized anxiety disorder. As a nerve pain agent, duloxetine is also used to treat nerve pain as a result of diabetic nerve damage and fibromyalgia. Healthcare providers also prescribe it for chronic bone and muscle pain.
Key takeaways
Duloxetine can increase the risk of suicidal thoughts and actions in children, teenagers, and young adults. The risk is greatest when you first start taking the drug or when your dose is increased. Your risk may also be higher if you have a history of bipolar disorder. If you’re having thoughts of harming yourself or notice any changes in your mood or behavior, talk with a healthcare provider right away.
You should not stop taking duloxetine without consulting your healthcare provider. Stopping duloxetine too suddenly can cause withdrawal symptoms, such as dizziness, irritability, and anxiety. To reduce this risk, your healthcare provider will gradually lower your dose until it’s safe for you to stop duloxetine entirely.
Duloxetine can interact with several other medications. These interactions can result in an increased risk of side effects, or they can make duloxetine less effective. In some cases, combining duloxetine with other drugs can make other drugs less effective. To prevent drug interactions, tell your healthcare provider about all of the over-the-counter and prescription medications, vitamins, and supplements you take.
Combining alcohol and duloxetine can increase your risk of serious liver problems. If you have questions about drinking alcohol while taking duloxetine, talk to your healthcare provider for medical advice.
What form(s) does Duloxetine come in
Delayed-release capsule
20 mg
30 mg
40 mg
60 mg
What are common Duloxetine doses?
For major depressive disorder in adults: 40–60 mg daily
For generalized anxiety disorder in adults: 60 mg daily
For diabetic peripheral neuropathy in adults: 60 mg daily
For chronic musculoskeletal pain in adults: 60 mg daily
For fibromyalgia in adults: 60 mg daily
Common Duloxetine prescriptions
DULoxetine HCl
90 capsules delayed release particles bottleDULoxetine HCl
20mg capsule delayed release particlesDULoxetine HCl
30mg capsule delayed release particlesDULoxetine HCl
40mg capsule delayed release particlesDULoxetine HCl
60mg capsule delayed release particles
How to take Duloxetine
Take this medicine as directed. The prescriber may periodically change the dose to find the most effective dose.
This medication comes with a Medication Guide. Please read it before starting treatment.
The capsule can be taken with or without food.
Swallow the capsule whole. Do not crush or chew it. Do not open it or mix the contents with food or liquids.
Store duloxetine capsules at room temperature.
What to do if you miss a dose of Duloxetine
Take a missed dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose.
Do not take extra medicine to make up for a missed dose.
Duloxetine contraindications
This medicine is not right for everyone.
Duloxetine should not be taken by people who have had an allergic reaction to duloxetine.
Duloxetine should not be taken with drugs that belong to the class known as monoamine oxidase inhibitors (MAOIs). If you take an MAOI or have taken an MAOI within the last 14 days, you should not take duloxetine.
Duloxetine warnings
Tell any doctor or other healthcare provider who treats you that you are using this medicine.
Your doctor may perform lab tests at regular visits to monitor the effects of this medicine. Keep all appointments.
Duloxetine increases the risk of suicidal thoughts in children, teens, and young adults. Anyone who starts taking duloxetine should be monitored closely for worsening depression and suicidal thoughts.
Do not stop taking this medication without first consulting with a healthcare provider.
Before taking duloxetine, tell the prescribing doctor if you have any of the following medical conditions:
Heart problems
High blood pressure
Diabetes
Kidney problems
Liver problems
Glaucoma
A history of seizures
Bipolar disorder or mania
Low sodium
Bleeding problems
Delayed stomach emptying
Tell the prescribing healthcare provider if you are pregnant, planning to become pregnant, breastfeeding, or planning to breastfeed.
Duloxetine can cause serious problems, including:
Liver problems
Bleeding
Elevated blood pressure
Low blood pressure when standing, resulting in fainting, falls, and injury
Serotonin syndrome, a potentially life-threatening side effect
Glaucoma
Seizures
Activation of mania or hypomania
Severe skin reactions, such as Stevens-Johnson syndrome
Sexual dysfunction
Problems with urination
This medicine may make you dizzy, drowsy, or lightheaded. It could also change your blood pressure so that you feel faint when you change position. Do not drive or do anything else that’s risky until you know how this medicine affects you.
Duloxetine interactions
To avoid potentially hazardous drug interactions, tell the prescribing healthcare provider about all prescription drugs, over-the-counter medicines, and supplements you are using before taking atorvastatin.
Tell other healthcare providers you are using this medicine before they prescribe new medications.
Do not use this medicine and an MAO inhibitor (MAOI) within 14 days of each other.
Drugs like duloxetine can create bleeding problems, so tell your doctor if you are taking NSAIDs (such as aspirin) or blood thinners (such as warfarin).
Duloxetine can make you sleepy or impaired, so tell your doctor if you’re using other drugs that make you sleepy, such as opioids or allergy medications.
Some medicines can affect how duloxetine works or increase the risk of side effects. In some cases, duloxetine can make other medications less effective. Make sure to tell the prescriber if you are regularly taking:
Blood pressure medication
Drugs that make you pee (diuretics)
Drugs that make you sleep or confused
Heart rhythm drugs
Drugs that treat mood disorders or other psychiatric problems
Migraine headache medications called triptans
The antibiotics ciprofloxacin or enoxacin
The stomach acid reducer cimetidine
The bronchodilator theophylline
Duloxetine side effects
Talk to a healthcare provider if you notice any possible side effects, including:
Serious side effects
Unusual moods or behaviors, worsening depression, thoughts about hurting yourself, trouble sleeping
Lightheadedness when standing up, fainting, falling
Dark urine or pale stools, nausea, vomiting, loss of appetite, stomach pain, yellow skin or eyes
Anxiety, restlessness, fever, fast heartbeat, sweating, muscle spasms, diarrhea, seeing or hearing things that are not there
Seizures
Unusual bleeding or bruising
Confusion, weakness, muscle twitching, headache
Feeling more energetic than usual, racing thoughts, dangerous behaviors, grandiose ideas, pressured talking
Decrease in how much or how often you urinate
Eye pain, vision changes, swelling, or redness around the eyes
Blistering, peeling, red skin rash
Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
Less serious, but common side effects
Nausea
Dry mouth
Headache
Weight loss
Vomiting
Appetite loss
Drowsiness
Fatigue
Constipation
Sources:
Cymbalta duloxetine delayed-release capsule prescribing information, DailyMed, NIH National Library of Medicine
Drizalma Sprinkle duloxetine delayed-release capsule prescribing information, DailyMed, NIH National Library of Medicine
Duloxetine delayed-release capsule prescribing information, DailyMed, NIH National Library of Medicine
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