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Duloxetine

Generic Name: Duloxetine [du-LOX-e-teen du-LOXetine].
The Brand Names are: Cymbalta, Drizalma Sprinkle, and Irenka.
Dosage Format: Oral delayed-release capsule (20 mg; 30 mg; 40 mg; 60 mg).
Drug Class: Serotonin-norepinephrine reuptake inhibitors.

What is Duloxetine?

Duloxetine can be described as a selective serotonin and norepinephrine reuptake inhibitor (SSNRI) antidepressant. Duloxetine influences the production of chemicals in the brain, which could be imbalanced in patients with depression.

Duloxetine can be used to treat major depression in adults. It can also be employed to address general anxiety disorders in children and adults who are at least 7 years old. Duloxetine can also be used in adults to relieve nerve pain that is caused by diabetic neuropathy or chronic joint or muscle pain (such as back pain as well as osteoarthritis-related pain). Certain brands of duloxetine can also be used to treat the symptoms of fibromyalgia (a chronic pain condition). Drizalma has been developed as a brand for treating fibromyalgia in adults. Cymbalta can be used to treat fibromyalgia symptoms in children aged between 12 and thirteen years of age.

Warnings

Don't take duloxetine in the first 5 days prior to or 14 days following the time you've used the MAO inhibitors, like linezolid and isocarboxazid, as well as the methylene blue injector, phenelzine, tranylcypromine, and others. A potentially dangerous interaction between drugs could be a possibility. Patients suffering from mental illness or depression may be prone to thoughts of suicide. Certain young people may experience more suicidal thoughts after taking medication to treat depression. Talk to your doctor immediately if you notice any abrupt changes in your mood or behavior. You may also have thoughts concerning suicide. Stop taking duloxetine without consulting your physician.

Before you take this drug

It is best not to use duloxetine if you have an allergy to it. Don't take duloxetine for at least 5 days prior to or 14 days following the last time you took the MAO inhibitor, for example, linezolid and isocarboxazid, as well as methylene blue injections, phenelzine, or tranylcypromine. A potentially dangerous interaction between drugs could happen.

Inform your physician if you are also taking stimulant medications such as opioids, herbal remedies, or medications to treat mental illness, depression, or Parkinson's disease. Also, you may have chronic infections or need to prevent vomiting and nausea. Duloxetine interactions could result in a serious illness known as serotonin syndrome. Duloxetine is not permitted for use by anyone older than 7 years of age. To ensure duloxetine is safe for you, ask your doctor if you suffer from:

  • Heart issues, high blood pressure.
  • kidney or liver disease.
  • Slow digestion.
  • A seizure.
  • Bleeding issues.
  • Sexual issues.
  • Narrow-angle glaucoma.
  • Bipolar disorder (manic depression).
  • Addiction to drugs or suicidal ideas.
  • If you drink a lot of alcohol.

People suffering from mental illness or depression may be prone to thoughts of suicide. Certain young people may experience more suicidal thoughts after taking medication to treat depression. Keep an eye on any changes in your mood or signs. Family members or caregivers are also required to be on the lookout for abrupt changes in your behavior.

The use of an SNRI antidepressant at the end of your pregnancy may increase your chances of having excessive bleeding following the birth of your baby and could cause serious medical problems in the infant. But stopping the medication is not always safe in the event of a relapse of depression. Do not begin or stop taking duloxetine without consulting your physician. If you're expecting, your name might be included on the pregnancy registry to monitor Duloxetine's effects on your baby. If you're nursing, inform your doctor if there are issues with your feeding and a slow weight gain for the infant who is nursing.

How to take Duloxetine?

Follow the exact dosage of duloxetine as recommended by your physician. Follow all instructions on your prescription label and go through all medication guides and instruction sheets. The doctor might alter your dosage. Dosing duloxetine at higher doses or for longer periods than recommended will not increase its effectiveness, as it may increase the risk of adverse negative effects. Take the capsule in its entirety and don't crush, chew on, break, or break it open. You can take duloxetine with or without food. Your cardiovascular health should be checked on a regular basis. Talk to your doctor if you notice any changes in your sexual functioning, such as a loss of interest in sexual activity or having trouble with an orgasm, as well as (in males) issues with erections or ejaculation. Certain sexual issues can be addressed. The symptoms you experience may not improve for up to four weeks. Don't stop taking duloxetine abruptly, or you may experience unpleasant side effects (such as anxiety and confusion, as well as tingling or electric shock symptoms). Consult your physician before stopping the medication. Maintain at room temperature and away from heat and moisture.

Details on dosage

Usual Adult Dose for Depression: Initial dosage: 20 mg to 30 mg orally, 2 times per day.
Maintenance dosage: 60 mg per day, taken at least once per day, or 30 mg orally two times every day.
Maximum dose: 120 mg/day.

Usual Adult Dose for Fibromyalgia: Initial dosage: 30 mg orally every day for at least a week.
Maintenance dosage: 30–60 mg once orally, every day.

Usual Adult Dose for Generalized Anxiety Disorder: Initial dose: 60 mg taken orally every day, once
Maintenance dosage: 60 to 120 mg once orally, every day.
Maximum dose: 120 mg/day.

Usual Adult Dose for Pain: Initial dosage: 30–60 mg once orally every day.
Maintenance dosage: 60 mg taken orally at least once per day.

Usual Adult Dose for Neuropathic Pain: Initial dosage: 30–60 mg once orally every day.
Maintenance dose: 60 mg every day.

Usual Adult Dose for Chronic Pain: Initial dosage: 30–60 mg taken orally, once a day.
Maintenance dose: 60 mg every day.

Usual Geriatric Dose for Generalized Anxiety Disorder: Initial dosage: 30 mg daily, orally for at least two weeks.
Dosage for maintenance 60 mg taken orally, once every day
Maximum dose: 120 mg/day.

Usual Pediatric Dose for Generalized Anxiety Disorder:

7–17 years old:
Initial dosage: 30 mg taken every day, taken orally, for a minimum of 2 weeks.
Maintenance dose 30–60 mg taken orally, once per day
Maximum dose: 120 mg/day.

Usual Pediatric Dose for Fibromyalgia:

Ages 13 and over:
Initial dosage: 30 mg daily, orally for at most one week.
Maintenance dosage: 30–60 mg once orally daily.

What happens if I miss a dose?

You should take the medication as quickly as you are able, but avoid your missed dose if it's nearing the time to take the next dose. Don't take two doses at once.

What happens if I overdose?

Get medical attention in an emergency or contact the poison help line at 1-800-222-1222. Vomiting, dizziness or sleepiness, seizures, fast heartbeats, fainting, or coma are all possible overdose symptoms.

What should be avoided?

Talk to your physician prior to using a nonsteroidal anti-inflammatory medication (NSAID) like naproxen, aspirin, ibuprofen, Advil, Aleve, Motrin, and many more. When you take an NSAID that contains duloxetine, it could cause bleeding or bruises easily. Avoid driving and other hazardous activities until you are aware of the effects of duloxetine on your body. The way you react could be affected. The fainting or dizziness can lead to accidents, falls, or serious injuries. Be careful not to get up too fast from a lying or seated position, as you could be dizzy. Drinking alcohol could increase the risk of damage to your liver, particularly if you are taking Drizalma.

Side effects of Duloxetine

Contact emergency medical attention when you notice symptoms warning of an allergic response to duloxetine (hives, breathing difficulties, or swelling in your throat or face) or an extreme skin reaction (fever, sore throat, eye burning, irritation, or an ailment that is purple or red with peeling and blisters). Inform your physician right now if you experience any recent or sudden changes in your mood or behavior, which include more or less severe anxiety or depression, panic attacks, trouble sleeping, or if you find yourself irritable, moody, or agitated. You may also feel hostile, angry, active, restless, or more talkative or active, or you may be thinking about suicide or harming yourself.

Consult your doctor right away if you have any of the following symptoms:

  • Beats of your heart, or the sound of a fluttering chest.
  • A lightheaded sensation, similar to passing out.
  • Easily bleeding, unusual bruising.
  • Vision change.
  • Urination that is painful or difficult.
  • Liver issues stomach problems: right-sided upper stomach discomfort, itching, dark urine, jaundice (yellowing of the eyes or skin).
  • Lower blood sodium, low blood sodium headache and confusion, problems with memory or thinking, weakness, unsteadiness.
  • Manic episodes include racing thoughts, higher energy levels, a lower need to sleep, taking risks, being anxious, or talking.

Get immediate medical attention. If you experience signs that suggest serotonin syndrome, which include hallucinations, agitation, sweating, fever, chills, shivering, rapid heart rate, muscle stiffness and twitching, loss of coordination, nausea, vomiting, or diarrhea.

Common duloxetine side effects may include:

  • Drowsiness.
  • Dizziness, constipation, and lack of appetite.
  • Dry mouth.
  • Increased sweating.

This is not an exhaustive list of probable adverse effects; more may occur. Contact your physician for advice regarding medical adverse effects. You can report any side effects to the FDA at 1-800-FDA-1088.

Interaction with other drugs

Certain medications should not be taken at the same time in some cases. Certain medications can alter the blood levels and the other medications you are taking, which could cause more side effects or make the medication less effective. Talk to your doctor prior to taking a nonsteroidal antiinflammatory drug (NSAID) like naproxen, aspirin, ibuprofen, Advil, Aleve, Motrin, and more. When you take an NSAID that contains duloxetine, it could cause bleeding or bruises easily. A variety of drugs interact with duloxetine. This includes over-the-counter and prescription medications, vitamins, and herbal supplements. The interactions between these products are not included in this list. Discuss with your physician all other medications you take.