Published on Sep 12, 2019 - 5 min read
Duloxetine helps treat depression in adults by affecting chemicals in the brain. Learn about its dosage, precautions, and side effects.
Duloxetine belongs to the serotonin-norepinephrine reuptake inhibitors (SNRI) group of drugs. It is used to treat depression, anxiety, diabetic neuropathy, and pain in osteoarthritis and fibromyalgia. It acts on the central nervous system and is a neuropathic pain agent. It works on the unbalanced chemical in the brain in people suffering from depressive disorder and generalized anxiety disorder.
Duloxetine is available only as a capsule, which you need to take orally.
The brand names are Cymbalta and Irenka.
It should be used only if prescribed by your doctor.
Avoid driving or operating heavy machinery while under treatment, as it can cause drowsiness.
It can result in severe drug interaction if taken 5 days before or 14 days after using MAO inhibitors.
It can cause serotonin syndrome, which is a medical emergency.
Do not stop taking the drug abruptly.
This drug can cause orthostatic hypotension.
It is available as an oral capsule, which helps treat:
Major depressive disorder.
Pain in fibromyalgia.
Chronic muscle or joint pain.
Diabetic nerve pain.
Scientists believe that Duloxetine works by affecting the activity of serotonin and norepinephrine. Serotonin is a neurotransmitter present in the brain, which helps regulate mood, perception of pain, and other functions. Norepinephrine (noradrenaline) is a neurotransmitter and a hormone, which regulates the “fight-or-flight” reaction in the body. This “flight-or-fight” response regulates how the body responses to stress, pain, emotions, and it also affects the mood, thinking, and cognition.
Even though it is not proved, Duloxetine is believed to treat depression and anxiety by blocking the reuptake of serotonin and norepinephrine. And it reduces pain by blocking the sodium ion channel.
It is available as oral delayed-release capsules of strengths 20 mg, 30 mg, 40 mg, and 60 mg. Avoid taking this medicine unless prescribed by a registered physician. The dosage may vary depending on the severity of your condition and its purpose, but the general dosage for adults is:
Starting dosage - 30 to 60 mg/day.
Maintenance dosage - 40 mg/day (20 mg twice a day) or 60 mg/day (30 mg twice a day or 60 mg once a day).
Maximum dosage - 120 mg/day.
This medicine should be avoided in the following conditions:
Allergy to Duloxetine.
If you are taking any other medicine.
Children below 7 years.
Liver or kidney disease.
Pregnancy and breastfeeding.
Always take it exactly as prescribed by your doctor. And for more information, read all medication guides or instruction sheets. Do not use Duloxetine in higher doses than prescribed, as it may increase side effects.
Do not crush, chew, break, or open the capsule, and swallow the capsule whole. You can take it with or without food. Do not stop taking it abruptly, and it will take up to 4 weeks before your symptoms improve. Your doctor will keep checking your blood pressure.
If you stop using the drug suddenly, you could have symptoms like dizziness, irritability, anxiety, and nausea. Consult a doctor now to know safer ways to stop this medicine.
Xerostomia (dry mouth).
Loss of appetite.
Right side abdominal pain.
Blood pressure changes:
Feeling dizzy on standing.
Rise or drop in blood pressure.
Increased risk of bruising and bleeding.
Pain and edema around the eyes.
Drop in blood sodium levels.
Reduced urine flow.
Interaction with other drugs might alter the way the Duloxetine works or result in side effects or might prevent it from working well. Always inform your doctor if you are taking any supplements or herbal medicines. The drugs that can cause interactions are:
Selective serotonin reuptake inhibitors (SSRIs) - Fluoxetine.
Serotonin-norepinephrine reuptake inhibitors (SSNRIs) - Venlafaxine.
Opioids - Tramadol.
Monoamine oxidase inhibitors (MAOIs) - Selegiline.
Tricyclic antidepressants (TCAs) - Amitriptyline.
Nonsteroidal anti-inflammatory drugs (NSAIDs) - Ibuprofen, Naproxen.
Anticoagulant drugs - Warfarin, Clopidogrel.
Antibiotics - Ciprofloxacin.
If you abruptly stop taking this drug, it might result in withdrawal symptoms like:
The symptoms of overdose are:
Loss of consciousness.
Rise in blood pressure.
If you develop any of these symptoms, get immediate medical help.
Even after using this medicine, if your symptoms are getting worse, it is best you consult your doctor. You can also consult experienced doctors online through phone or video consultation.
The most common side effects of Duloxetine are fatigue, dizziness, nausea, stomach pain, dry mouth, constipation, and excess sweating.
Take the tablet as prescribed by your doctor at the same time every day. You can take it either in the morning or evening.
Stopping the drug suddenly can result in symptoms like sweating, dizziness, anxiety, irritability, sleep problems, and vomiting.
Duloxetine is used to reduce pain in cases of diabetic neuropathy, osteoarthritis, chronic back and joint pain, and fibromyalgia.
Loss of appetite is a common side effect of Duloxetine, which makes people lose weight rather than gain it. But long-term use is said to cause weight gain.
Take the capsule as prescribed by your doctor. Cymbalta should not be taken more than 120 mg per day. You can split the dosage for the day by taking it twice, but not more than what your doctor prescribed.
Yes. People with a known liver condition should not take Duloxetine, as it increases the risk for further liver damage.
Cymbalta will not make your anxiety worse, as it is used in treating generalized anxiety disorder.
Some patients do experience urinary problems like difficulty in emptying bladder, weak urine stream, urinary dribbling, and urinary hesitancy.
The dose is gradually decreased over at least 4 weeks before stopping the medicine. To know more, consult a doctor.
Query: Hello doctor,I started taking Flonase at night for hay fever and when I wake up in the morning I am having wheezing and my chest is tight. I do not want to stop taking it because it is so helpful for my allergy symptoms but I am really worried about this side-effect. Current medications are Cymbalta... Read Full ¬Ľ
Query: Hi doctor, I am 21 year old. I am taking tablet Cymbalta 60 mg and tablet Citalopram 10 mg daily for depression and anxiety. Recently, I got a blood test for vitamin B12 and the results turned out to be pretty high at 1344 pg/mL. I am aware that the normal range of vitamin B12 is 200-900 pg/mL. My¬... Read Full ¬Ľ
Query: Hi doctor, I am under treatment for OCD and anxiety symptoms. I have had very hard months with extreme anxiety, panic attacks and depersonalization. Now, I am on¬†Duloxetine 60 mg (will stop in the next 7 weeks),¬†Paroxetine 20 mg (will be reduced in the following weeks),¬†Clomipramine hydrochloride... Read Full ¬Ľ
Do you have a question on Duloxetine or ?Ask a Doctor Online