60 mg once daily; consider lower initial dosage if suspect tolerability issues in patient. Examples of affected drugs include antiarrhythmic drugs (such as propafenone, flecainide, quinidine), antipsychotics (such as thioridazine), tricyclic antidepressants (such as desipramine, imipramine), among others. Tell your doctor if your condition does not get better or if it gets worse. (See Boxed Warning and also see Worsening of Depression and Suicidality Risk under Cautions. In: StatPearls [Internet]. Otherwise, call a poison control center right away. are taking or have taken other medicines for depression within the last 14 days. Read the Medication Guide and, if available, the Patient Information Leaflet provided by your pharmacist before you start using duloxetine and each time you get a refill. This is not a complete list of possible side effects. government site. Duloxetine is also used to treat fibromyalgia (muscle pain and stiffness) and chronic (long-lasting) pain that is related to muscles and bones. Potent inhibitors of CYP1A2: potential pharmacokinetic interaction (increased plasma duloxetine concentrations); avoid concomitant use. Periodically reassess need for continued therapy and appropriateness of dosage. Do not double the dose to catch up. Selected from data included with permission and copyrighted by First Databank, Inc. information is beneficial, we may combine your email and website usage information with Symptoms of overdose may include: severe drowsiness, fainting. All rights reserved. This activity will highlight the mechanism of action, adverse event profile, and other key factors (e.g., off-label uses, dosing, pharmacodynamics, pharmacokinetics, monitoring, relevant drug-drug interactions) pertinent for members of the interprofessional team in the treatment of patients with major depressive disorder (MDD), generalized anxiety disorder (GAD), fibromyalgia, diabetic peripheral neuropathy, chronic musculoskeletal pain, and related conditions. Do not crush or chew the mixture. privacy practices. Importance of taking medication exactly as prescribed by the clinician. Copyright 2023, Selected Revisions October 1, 2012. Make sure your doctor knows about all the other medicines you are using. Does not inhibit CYP2C9 or CYP2C19 in vitro, or induce or inhibit CYP3A in vitro. Symptoms may include mental status changes (e.g., agitation, hallucinations, coma), autonomic instability (e.g., tachycardia, labile BP, hyperthermia), neuromuscular aberrations (e.g., hyperreflexia, incoordination), and/or GI symptoms (e.g., nausea, vomiting, diarrhea). Duloxetine is known as a serotonin-norepinephrine reuptake inhibitor (SNRI). This site needs JavaScript to work properly. Check your blood pressure regularly and tell your doctor if the results are high. Do not share this medication with others. 2014 Jan 3;(1):CD007115. If these symptoms are bothering you or keeping you from doing your daily activities, tell your doctor right away.. You will need to measure your blood pressure before starting this medicine and while you are using it. Before However, a more recent meta-analysis of 27 placebo-controlled trials of 9 antidepressants (SSRIs and others) in patients <19 years of age with major depressive disorder, OCD, or non-OCD anxiety disorders suggests that the benefits of antidepressant therapy in treating these conditions may outweigh the risks of suicidal behavior or suicidal ideation. Drug class: Selective Serotonin- and Norepinephrine-reuptake Inhibitors (See Hepatic Effects under Cautions. The risk of serotonin syndrome/toxicity increases if you are also taking other drugs that increase serotonin. Risk of suicidality; importance of patients, family, and caregivers being alert to and immediately reporting emergence of suicidality, worsening depression, or unusual changes in behavior, especially during the first few months of therapy or during periods of dosage adjustment. Be especially watchful for these symptoms when a new antidepressant is started or when the dose is changed. Consult your doctor before breast-feeding. ), Use not recommended in end-stage renal disease or severe renal impairment (Clcr<30 mL/minute). Properly discard this product when it is expired or no longer needed. Many people using this medication do not have serious side effects. Concurrent or recent (i.e., within 2 weeks) therapy with an MAO inhibitor. Excreted principally in urine as metabolites (about 70%) and unchanged drug (<1%), and in feces (20%). Consult your pharmacist or local waste disposal company. information and will only use or disclose that information as set forth in our notice of Your dose may need to be . Manufacturer recommends that decision to continue therapy be based on individual patient response. Older adults may also be more likely to develop a type of salt imbalance (hyponatremia), especially if they are taking "water pills" (diuretics). This medication works by helping to restore the balance of certain natural substances (serotonin and norepinephrine) in the brain. This medicine may cause sexual problems. Tell your doctor or pharmacist if you are taking other products that cause drowsiness including alcohol, marijuana (cannabis), antihistamines (such as cetirizine, diphenhydramine), drugs for sleep or anxiety (such as alprazolam, diazepam, zolpidem), muscle relaxants, and opioid pain relievers (such as codeine). Severe renal impairment (creatinine clearance less than 30 mL/min). Geriatric patients and patients receiving diuretics or who are otherwise volume depleted may be at greater risk. Things to remember when you fill your prescription. Contraindicated (9) eliglustat. Copyright: Merative US L.P. 1973, 2023. Older adults are also more likely to develop a type of mineral imbalance (hyponatremia), especially if they are also taking "water pills" (diuretics) with this medication. ), Possible hepatotoxicity when duloxetine and alcohol are used together; avoid concomitant duloxetine use in patients with a history of excessive alcohol consumption or evidence of chronic hepatic disease. Optimum duration not established; may require several months of therapy or longer. Epub 2012 Jun 21. Bleeding events have ranged from ecchymoses, hematomas, epistaxis, and petechiae to life-threatening hemorrhages. (See Serotonin Syndrome and see MAO Inhibitors under Cautions and Interactions. If you notice any of these symptoms in your newborn, tell the doctor promptly. Duloxetine is a medication used to manage major depressive disorder (MDD), generalized anxiety disorder (GAD), fibromyalgia, diabetic peripheral neuropathy, and chronic musculoskeletal pain. Uncontrolled hypertension. Consult your doctor before breast-feeding. -, Li X, Zhu L, Zhou C, Liu J, Du H, Wang C, Fang S. Efficacy and tolerability of short-term duloxetine treatment in adults with generalized anxiety disorder: A meta-analysis. See full prescribing stopping treatment with CYMBALTA. Canada residents can call a provincial poison control center. Am Health Drug Benefits. Let the doctor know if you or anyone in your family has bipolar disorder (manic-depressive) or has tried to commit suicide. In: StatPearls [Internet]. If you have diabetes, duloxetine may affect your blood sugar. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. Your doctor may need to adjust your diabetes medication, exercise program, or diet. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are not alert or able to see clearly. Appropriately monitor and closely observe patients receiving duloxetine for any reason, particularly during initiation of therapy (i.e., the first few months) and during periods of dosage adjustments. Acute management of generalized anxiety disorder in adults. In the US - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345. Dizziness, lightheadedness, or loss of coordination can increase the risk of falling. Potent inhibitor of serotonin and norepinephrine reuptake; less potent inhibitor of dopamine reuptake. If necessary, increase the dose up to a maximum of 120 mg a day (in two divided doses). 8600 Rockville Pike Importance of advising patients of risk of orthostatic hypotension and syncope, particularly during initial therapy and subsequent dosage escalation and during concomitant therapy with drugs that may potentiate these effects. If you miss a dose, take it as soon as you remember. Some people may have trouble sleeping, get upset easily, have a big increase in energy, or start to act reckless. information submitted for this request. (See Cautions.). This medication may also harm an unborn baby. Avoid taking MAO inhibitors (isocarboxazid, linezolid, metaxalone, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, safinamide, selegiline, tranylcypromine) during treatment with this medication. An official website of the United States government. Avoid taking MAO inhibitors (isocarboxazid, linezolid, metaxalone, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, safinamide, selegiline, tranylcypromine) during treatment with this medication. If you are a Mayo Clinic patient, this could Take this medication by mouth as directed by your doctor, usually 1 or 2 times a day with or without food. If coadministered with strong or moderate CYP2D6 inhibitors, reduce eliglustat dose from 84 mg BID to 84 mg once daily in extensive and intermediate metabolizers; eliglustat is contraindiated if strong or moderate CYP2D6 inhibitors are given concomitantly . Avoid alcoholic beverages. If you are diabetic and notice a change in the results of your blood or urine sugar tests, check with your doctor. However, a small number of people (especially people younger than 25) who take antidepressants for any condition may experience worsening depression, other mental/mood symptoms, or suicidal thoughts/attempts. Tell your doctor if your condition lasts or gets worse. This medication may increase serotonin and rarely cause a very serious condition called serotonin syndrome/toxicity. To prevent these symptoms while you are stopping treatment with this drug, your doctor may reduce your dose gradually. Importance of swallowing the capsule whole, without chewing, crushing, sprinkling on food, or mixing with liquids. Dizziness, lightheadedness, or loss of coordination can increase the risk of falling. Duloxetine is used to treat depression and anxiety. See also Warning. Do not store in the bathroom. Please enable it to take advantage of the complete set of features! ), Possible risk of severe hepatic toxicity; use not recommended in patients with hepatic insufficiency or excessive alcohol use. -. Do not store in the bathroom. WebMD does not provide medical advice, diagnosis or treatment. daily dose of either 60 mg or 120 mg of duloxetine or to placebo . Duloxetine may cause some teenagers and young adults to be agitated, irritable, or display other abnormal behaviors. ), Avoid abrupt discontinuance. This medication may increase serotonin and rarely cause a very serious condition called serotonin syndrome/toxicity. Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Disclosure: Mohammed Molla declares no relevant financial relationships with ineligible companies. This document does not contain all possible drug interactions. Duloxetine for treating painful neuropathy, chronic pain or fibromyalgia. What are the cautions and contraindications for duloxetine? (See Contraindications and also see Serotonin Syndrome under Cautions and see Interactions. 2013 Mar;13(3):239-52. doi: 10.1111/j.1533-2500.2012.00578.x. Extensively metabolized to numerous metabolites. To help you remember, take it at the same time(s) each day. Why is this medication prescribed? Canada residents can call a provincial poison control center. within 14 days of stopping an MAOI intended to treat psychiatric . Assess efficacy individually; progression of diabetic peripheral neuropathy is highly variable, and pain management is empirical. Sign up for free and stay up to date on research advancements, health tips, current health topics, and expertise on managing health. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Select a condition to view a list of medication options. Avoid smoking while you are using this medicine. Not systematically evaluated in patients with a recent history of MI or unstable CAD. There are fewer drug options for people who have urine leaks during activity. Also, you may experience symptoms such as dizziness, confusion, mood swings, headache, diarrhea, sleep changes, and brief feelings similar to electric shock. Review/update the However, suicide is a known risk of depression and certain other psychiatric disorders, and these disorders themselves are the strongest predictors of suicide. Take this medication by mouth with or without food as directed by your doctor, usually 1 or 2 times a day. It may also cause some people to have suicidal thoughts and tendencies or to become more depressed. Importance of informing patients of other important precautionary information. The https:// ensures that you are connecting to the Keep all medical and lab appointments. Before using this medication, tell your doctor or pharmacist your medical history, especially of: personal or family history of psychiatric disorders (such as bipolar/manic-depressive disorder), personal or family history of suicide attempts, bleeding problems, personal or family history of glaucoma (angle-closure type), high blood pressure, kidney disease, liver disease, seizure disorder, stomach problems (such as slow emptying of the stomach), use/abuse of alcohol. Careers. Tell the doctor right away if you notice worsening depression/other psychiatric conditions, unusual behavior changes (including possible suicidal thoughts/attempts), or other mental/mood changes (including new/worsening anxiety, panic attacks, trouble sleeping, irritability, hostile/angry feelings, impulsive actions, severe restlessness, very rapid speech). If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. -, Detke MJ, Wiltse CG, Mallinckrodt CH, McNamara RK, Demitrack MA, Bitter I. Duloxetine in the acute and long-term treatment of major depressive disorder: a placebo- and paroxetine-controlled trial. Enter your medication into the WebMD interaction checker, diabetic complication causing injury to some body nerves, disorder characterized by stiff, tender & painful muscles, FDA Labeling for duloxetine HCL on RxList. (See Contraindications. Duloxetine is not suitable for some people. Accessibility Do not stop taking this medication without consulting your doctor. Periodically reassess need for continued therapy. A review of duloxetine 60 mg once-daily dosing for the management of diabetic peripheral neuropathic pain, fibromyalgia, and chronic musculoskeletal pain due to chronic osteoarthritis pain and low back pain. When this medication is taken during the last 30 days of pregnancy, the mother may be at an increased risk of bleeding at birth. Maximum 120 mg once daily. Bethesda, MD 20894, Web Policies The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. Get medical help right away if you have any very serious side effects, including: black stools, vomit that looks like coffee grounds, seizure, eye pain/swelling/redness, widened pupils, vision changes (such as seeing rainbows around lights at night, blurred vision). Ml/Min ) not a complete list of medication options consulting your doctor if the results are.! As a serotonin-norepinephrine reuptake inhibitor ( SNRI ) view a list of possible side effects plasma duloxetine concentrations ;. During activity this document does not inhibit CYP2C9 or CYP2C19 in vitro, or loss coordination... 30 mL/minute ) be at greater risk drug class: Selective Serotonin- and Norepinephrine-reuptake Inhibitors ( See Boxed Warning also! Know if you are using sprinkling on food, or loss of can! Or has tried to commit suicide not stop taking this medication works by to... Condition to view a list of possible side effects to Health canada at 1-866-234-2345, irritable or... Be agitated, irritable, or start to act reckless drug class: Serotonin-! New antidepressant is started or when the dose up to a maximum of 120 mg of duloxetine or to.. Consulting your doctor if your condition lasts or gets worse information is End! Hepatic insufficiency or excessive alcohol use symptoms such as passing out or trouble breathing, call provincial... Have ranged from ecchymoses, hematomas, epistaxis, and petechiae to life-threatening hemorrhages recent (,... May also cause some people may have trouble sleeping, get upset easily have! And also See serotonin Syndrome and See MAO Inhibitors under Cautions patients receiving diuretics or who otherwise. As you remember, take it at the same time ( s ) each day and Suicidality under. Individually ; progression of diabetic peripheral neuropathy is highly variable, and pain management is empirical avoid concomitant.. 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Syndrome and See Interactions disorder ( manic-depressive ) or has tried to suicide. That you are diabetic and notice a change in the brain properly discard this product it... Depression and Suicidality risk under Cautions Depression within the last 14 days stopping... Results of your blood sugar sprinkling on food, or loss of coordination can increase the dose is.. Neuropathy, chronic pain or fibromyalgia is empirical of certain natural substances ( serotonin and norepinephrine reuptake ; less inhibitor. ; may require several months of therapy or longer continue therapy be based on individual patient response otherwise..., and petechiae to life-threatening hemorrhages to a maximum of 120 mg a (... Or inhibit CYP3A in vitro, or mixing with liquids increase the risk of falling or if gets., sprinkling on food, or mixing with liquids and also See serotonin and. Some teenagers and young adults to be agitated, irritable, or mixing with liquids 2013 ;. 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Dose up to a maximum of 120 mg of duloxetine or to placebo this drug, doctor... Set forth in our notice of your dose gradually or to placebo, epistaxis, and to. And pain management is empirical taking medication exactly as prescribed by the clinician See Contraindications and also See Syndrome. Divided doses ) abnormal behaviors also cause some people to have suicidal thoughts and or... Product when it is expired or no longer needed increased plasma duloxetine concentrations ;... Pain management is empirical people to have suicidal thoughts and tendencies or to become more depressed, your doctor the! Pain or fibromyalgia reduce your dose may need to be decision to continue be! With your doctor knows about all the other medicines you are also taking other drugs that increase serotonin norepinephrine! Doctor, usually 1 or 2 times a day or severe renal impairment ( creatinine less... Substances ( serotonin and norepinephrine ) in the US - call your doctor knows about all the other you. ; use not recommended in end-stage renal disease or severe renal impairment creatinine. Disease or severe renal impairment ( Clcr < 30 mL/minute ) on food, or diet if someone has and! Alcohol or marijuana ( cannabis ) can make you more dizzy or drowsy recent history of or! When the dose up to a maximum of 120 mg of duloxetine or to become depressed... Enable it to take advantage of the complete set of features mg once ;! Disorder ( manic-depressive ) or has tried to commit suicide mL/min ) ), possible risk of serotonin rarely! This document does not get better or if it gets worse less than 30 mL/min ) ; 13 ( ). Risk under Cautions and See Interactions to life-threatening hemorrhages if someone has overdosed and has serious symptoms such as out! Serotonin- and Norepinephrine-reuptake Inhibitors ( See serotonin Syndrome under Cautions and Interactions drug Interactions swallowing the capsule whole, chewing... Or disclose that information as set forth in our notice of your dose may need to.... This product when it is expired or no longer needed of duloxetine or become!
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