Duloxetine

Description

Duloxetine is a serotonin-norepinephrine reuptake inhibitor (SNRI) used primarily to treat major depressive disorder, generalized anxiety disorder, fibromyalgia, and chronic pain conditions. It works by increasing the levels of serotonin and norepinephrine, neurotransmitters that help regulate mood and pain perception, in the brain.

Uses / Indications

• Major depressive disorder (MDD)
• Generalized anxiety disorder (GAD)
• Fibromyalgia
• Neuropathic pain associated with diabetic peripheral neuropathy
• Chronic musculoskeletal pain
• Management of chronic pain conditions

Dosage and Administration

Adults:
Recommended starting dose is usually 30 mg once daily, which may be increased to 60 mg once daily, depending on the individual’s response and tolerability.

For elderly patients or those with liver impairment:
A lower starting dose may be required, typically 30 mg once daily.

Note: Dosage may vary based on medical condition and doctor’s advice.

How It Works (Mechanism of Action)

Duloxetine works by inhibiting the reuptake of two key neurotransmitters, serotonin and norepinephrine, in the brain. This action helps to improve mood and alleviate pain by restoring the balance of these chemical messengers.

Side Effects

Common side effects:

• Nausea
• Dry mouth
• Somnolence (sleepiness)
• Fatigue
• Constipation

Rare/serious side effects:

• Serotonin syndrome (confusion, hallucination, seizure)
• Liver damage (symptoms include yellowing skin/eyes and dark urine)
• Increased blood pressure

Seek medical attention if serious side effects occur.

Precautions / Warnings

• Inform your doctor if you have a history of liver disease, kidney problems, or bipolar disorder.
• Exercise caution if combining with other medications that affect serotonin levels.
• May increase suicidal thoughts in younger adults; monitor closely when first starting treatment.

Drug Interactions

Duloxetine may interact with:

• Monoamine oxidase inhibitors (MAOIs)
• Other SNRIs or SSRIs (may increase serotonin levels)
• NSAIDs and anticoagulants (increased risk of bleeding)
• Alcohol (may worsen side effects)

Always inform your healthcare provider about any other medications or supplements you’re taking.

Storage Instructions

• Store at room temperature (20°C–25°C / 68°F–77°F)
• Keep away from moisture, heat, and direct light
• Keep out of reach of children

Missed Dose / Overdose

Missed a dose?
Take it as soon as you remember. If it’s almost time for your next dose, skip the missed one. Do not double up.

Overdose symptoms:

• Severe drowsiness
• Nausea or vomiting
• Increased heart rate
• Seizures

Contact a poison control center or seek emergency medical help immediately.

Contraindications

• Allergic to Duloxetine or any of its components
• Active liver disease or significant impairment
• Use of MAO inhibitors within 14 days

Brand Names / Alternatives

• Cymbalta
• Drizalma Sprinkle
• Generic name: Duloxetine