III. Contraindications

IV. Mechanism

  1. Strong Serotonin and Norepinephrine reuptake inhibitor
  2. Also with minor Dopamine reuptake inhibitor properties

V. Preparations

  1. Duloxetine Hydrochloride delayed release tablets (20g, 30 mg, 60 mg)

VI. Dosing

  1. Start: 20 mg orally twice daily or 30 mg orally daily
  2. Advance to 60 mg daily (or divided twice daily)
  3. Maximum: 120 mg/day

VII. Drug Interactions

  1. Metabolized by CYP1A2 and CYP2D6
    1. Avoid with strong CYP1A2 or CYP2D6 Inhibitors
  2. Monoamine Oxidase Inhibitors (MAO Inhibitor), including Linezolid
    1. Do not use Duloxetine concurrently or within 14 days of last dose of MAO Inhibitors
  3. Avoid with Methylene Blue, Thioridazine

VIII. Safety

  1. Unknown safety in Lactation
  2. Pregnancy Category: C
  3. Black box warning as for all Antidepressants for Suicidality in teens

IX. Adverse Effects

XI. References

  1. (2023) Med Lett Drugs Ther 62(1592): 25-32
  2. Olson (2020) Clinical Pharmacology, Medmaster Miami, p. 38-9
  3. Hamilton (2020) Tarascon Pocket Pharmacopoeia
  4. Jaouen and Lovecchio (2021) Crit Dec Emerg Med 31(12): 24

Images: Related links to external sites (from Bing)

Related Studies

Cost: Medications

duloxetine (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
DULOXETINE HCL DR 20 MG CAP Generic $0.10 each
DULOXETINE HCL DR 30 MG CAP Generic $0.10 each
DULOXETINE HCL DR 40 MG CAP Generic $1.70 each
DULOXETINE HCL DR 60 MG CAP Generic $0.12 each
cymbalta (on 1/1/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
CYMBALTA 30 MG CAPSULE Generic $0.10 each
CYMBALTA 60 MG CAPSULE Generic $0.12 each