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duloxetine

Drug Class: Commonly Known As: Category:
Serotonin and Noradrenaline Reuptake Inhibitors (SNRI) cymbalta Adult

duloxetine - What is it for

Duloxetine belongs to a class of medications known as Serotonin and Noradrenaline Reuptake Inhibitors (SNRI). It is used to treat symptoms of depression (low mood) such as:

  • Feeling sad
  • Feeling hopeless or useless
  • Feeling bad about yourself
  • Thoughts of ending your life
  • Poor sleep, energy or appetite.

It may also be used to treat symptoms of anxiety such as:

  • Feeling uncontrollably or constantly worried
  • Very fast heartbeat
  • Uncontrolled shaking of body parts such as hands (tremors) 
  • Sweating
  • Nervousness

It may also be used to reduce nerve pain in patients with diabetes, urinary incontinence (unable to control urine from leaking out) or for other conditions. Check with your healthcare professional if you are unsure why you are given this medication.

duloxetine - Side Effects, Precautions, and Contraindications

What side effects can duloxetine cause?

Side effects which generally affect up to 10% of patients include:

  • Nausea or vomiting
    • Take the medication with or after food. Take small but frequent meals and avoid fatty or spicy food.
    • Take small but frequent meals and avoid fatty or spicy food.
  • Difficulty sleeping
    • Discuss with your doctor and take the medication in the morning instead.
    • Avoid daytime naps, listen to relaxing music at bedtime
    • Limit caffeine intake at least 8 hours before bedtime.
    • Avoid over eating and drinking just before bed
  • Drowsiness or feeling tired
    • Avoid driving, or taking part in activities that requires concentration. Discuss with your doctor if you can take your medication at a different time of the day if it affects you.
  • Dry mouth
    • Chew sugar-free gum, suck on sugar-free hard candies or ice chips, sip water regularly
  • Constipation
    • Drink more water (if you do not have any fluid restriction), eat more high- fibre foods, and exercise regularly
    • Consult your doctor or pharmacist if you need medication to relieve your condition.
  • Diarrhoea
    • Drink plenty of water to replace the loss of fluids
  • Dizziness
    • Get up slowly from a sitting or lying down position
  • Mild nervousness
    • May occur at the start of treatment and improves over time.
  • Headache, loss of appetite, weight loss, increased blood pressure, increased sweating, decreased sexual drive or ability
    • Speak to your doctor if any of these affect your daily life.

Most of the side effects listed here will improve with time. Speak with your doctor if they continue, get worse or are affecting your daily life.

Very rarely (affect less than 1% of patients) this medication may cause:

  • Unexplained fever, confusion, fast heartbeat, feeling weak, uncontrolled movements or twitching of muscles (signs and symptoms of Serotonin syndrome)
  • Very bad agitation or confusion
  • Fits (seizures) 
  • Yellowing of skin or eyes, pain in your upper stomach or dark brown urine and/or pale grey/clay-coloured stools (signs and symptoms of liver damage)
  • Unusual bruising or bleeding

The symptoms of a drug allergy include one or more of the following:

  • Swollen face/eyes/lips/tongue
  • Difficulty in breathing
  • Itchy rashes on your skin over your whole body

If you experience any of these symptoms, you should stop your medication and see your healthcare professional immediately.

Before taking duloxetine, what precautions must I follow?

Inform your healthcare professional if:

  • You are allergic to this medication or any of the other ingredients of this medication
  • You are pregnant, planning to become pregnant, or breastfeeding. If you are pregnant or breastfeeding, your doctor would have discussed the potential benefits and side-effects with you and should you have further questions or concerns, do consult your doctor.
  • You have or have ever had:
    • Other drug allergies
    • Heart, kidney or liver disease
    • Medical conditions such as high blood pressure, fits (seizures), increased eye pressure (glaucoma), low sodium in the blood (hyponatremia)or bleeding problems
    • Other mental health conditions such as bipolar disorder or mania (abnormally high or excited mood)
    • Been taking other medication for your low mood in the past 2 weeks.

IMPORTANT:

If you notice any changes in your mental condition especially in the first few weeks of treatment and during dose changes, you need to check with your doctor immediately. Do watch for any of the following changes in mental condition:

  • New or increasing thoughts of harming yourself
  • Worsening anxiety, restlessness, violent behaviour, or
  • Other negative or abnormal changes in mood or behaviour.

Be sure that your family or caregiver are also aware of the above symptoms so they can call your doctor if you are unable to seek treatment on your own.

What food or medicine must I avoid when I take duloxetine?

Avoid drinking alcohol while taking Duloxetine as it may make you feel very drowsy. This medication may interact with other medications. If you intend to take any over the counter medication, supplements, herbal remedy or traditional Chinese medicine, consult your doctor or healthcare professional first to confirm that it is safe to take with Duloxetine.

duloxetine - Dosage and How to Use

How should duloxetine be used?

  • Follow the instructions on your medication label and take this medication as prescribed by your doctor.
  • You may take Duloxetine with or without food. Swallow Duloxetine whole, do NOT chew or crush it.
  • This medication needs to be taken regularly for a few weeks before you feel its full benefits. You should not stop taking this medication even if you do not feel better at the beginning. Continue to take this medication even after you feel better to prevent your symptoms from returning.
  • Do check with your doctor on how long you will have to be on this medication.
  • Do not stop taking your medication without checking with your healthcare professional. You may experience unpleasant effects such as dizziness, headache, difficulty sleeping, irritability, and nausea if you suddenly stop taking the medication on your own.

What should I do if I miss a dose?

​If you forget to take a dose, take it as soon as you remember. However, if it is more than half of the time to the next dose, skip the missed dose and take the next dose at the usual timing. Do not take two doses to make up for the missed dose.

What should I do if I overdose?

duloxetine - Handling

How should I handle duloxetine safely?

duloxetine - Storage

How should I store duloxetine?

Keep away from children;#Keep in a cool, dry place, away from direct sunlight;#

How should I dispose of duloxetine safely?

Pack this medication into a black trash bag and seal it tightly before throwing into the rubbish chute or bin.

duloxetine - Additional Information

  • Tags: Duloxetine, Venlafaxine
  • Updated on Tuesday, June 30, 2020
  • Article contributed by PSS National Medication Information Workgroup PSS National Medication Information Workgroup

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