II. Indications
III. Contraindications
- Chronic Liver Disease (hepatic insufficiency or Cirrhosis)
- Serotonin Syndrome
- Glomerular Filtration Rate <30 ml/min
IV. Mechanism
- Strong Serotonin and Norepinephrine reuptake inhibitor
- Also with minor Dopamine reuptake inhibitor properties
V. Preparations
- Duloxetine Hydrochloride delayed release tablets (20g, 30 mg, 60 mg)
VI. Dosing
- Start: 20 mg orally twice daily or 30 mg orally daily
- Advance to 60 mg daily (or divided twice daily)
- Maximum: 120 mg/day
VII. Drug Interactions
- Metabolized by CYP1A2 and CYP2D6
- Avoid with strong CYP1A2 or CYP2D6 Inhibitors
-
Monoamine Oxidase Inhibitors (MAO Inhibitor), including Linezolid
- Do not use Duloxetine concurrently or within 14 days of last dose of MAO Inhibitors
- Avoid with Methylene Blue, Thioridazine
VIII. Safety
- Unknown safety in Lactation
- Pregnancy Category: C
- Black box warning as for all Antidepressants for Suicidality in teens
IX. Adverse Effects
- Nausea
- Xerostomia (Dry Mouth)
- Somnolence
- Constipation
- Decreased Appetite
- Hyperhidrosis
- Urinary Retention
- Hepatotoxicity
X. Resources
XI. References
- (2023) Med Lett Drugs Ther 62(1592): 25-32
- Olson (2020) Clinical Pharmacology, Medmaster Miami, p. 38-9
- Hamilton (2020) Tarascon Pocket Pharmacopoeia
- Jaouen and Lovecchio (2021) Crit Dec Emerg Med 31(12): 24
Images: Related links to external sites (from Bing)
Related Studies
| 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 4/19/2023 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| CYMBALTA 20 MG CAPSULE | Generic | $0.11 each |
| CYMBALTA 30 MG CAPSULE | Generic | $0.10 each |
| CYMBALTA 60 MG CAPSULE | Generic | $0.12 each |