What is Duloxetine Hcl: Uses, Warnings & Interactions

Duloxetine Hcl overview

BRAND NAMES:

  • Cymbalta, Drizalma Sprinkle

GENERIC NAMES:

  • Duloxetine HCl

USES:

  • Treats depression, anxiety, nerve pain due to diabetic nerve damage, and chronic bone and muscle pain

THERAPEUTIC CLASSES:

  • Serotonin-norepinephrine reuptake inhibitor (SNRI), antidepressant, anxiolytic, neuropathic pain agent

FORMS:

  • Delayed release capsule

HOW IT’S TAKEN:

  • By mouth

What is Duloxetine Hcl used for?

The FDA has approved duloxetine as a treatment for major depressive disorder and generalized anxiety disorder. As a nerve pain agent, duloxetine is also used to treat nerve pain as a result of diabetic nerve damage, chronic bone and muscle pain such as back pain, and fibromyalgia.

What form(s) does Duloxetine Hcl come in

  • Delayed release capsule
    • 20 mg
    • 30 mg
    • 40 mg
    • 60 mg

What are common Duloxetine Hcl doses?

  • For major depressive disorder in adults: 40–60 mg daily
  • For generalized anxiety disorder in adults: 60 mg daily
  • For diabetic peripheral neuropathy in adults: 60 mg daily
  • For chronic musculoskeletal pain in adults: 60 mg daily
  • For fibromyalgia in adults: 60 mg daily

Common Duloxetine Hcl prescriptions

  • DULoxetine HCl 90 capsules delayed release particles bottleDULoxetine HCl
    90 capsules delayed release particles bottle
  • DULoxetine HCl 20mg capsule delayed release particlesDULoxetine HCl
    20mg capsule delayed release particles
  • DULoxetine HCl 30mg capsule delayed release particlesDULoxetine HCl
    30mg capsule delayed release particles
  • DULoxetine HCl 40mg capsule delayed release particlesDULoxetine HCl
    40mg capsule delayed release particles
  • DULoxetine HCl 60mg capsule delayed release particlesDULoxetine HCl
    60mg capsule delayed release particles

How to take Duloxetine Hcl

  • Take this medicine as directed. The prescriber may periodically change the dose to find the most effective dose.
  • This medication comes with a Medication Guide. Please read it before starting treatment.
  • The capsule can be taken with or without food.
  • Swallow the capsule whole. Do not crush or chew it. Do not open it or mix the contents with food or liquids.
  • Store duloxetine capsules at room temperature.

What to do if you miss a dose of Duloxetine Hcl

  • Take a missed dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. 
  • Do not take extra medicine to make up for a missed dose.

Duloxetine Hcl contraindications

  • This medicine is not right for everyone. 
  • Duloxetine should not be taken by people who have had an allergic reaction to duloxetine or who have chronic liver disease.
  • People who drink excessively or frequently should not take duloxetine.

Duloxetine Hcl warnings

  • Tell any doctor or other healthcare provider who treats you that you are using this medicine.
  • Your doctor may do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.
  • Duloxetine increases the risk of suicidal thoughts in children, teens, and young adults. Anyone who starts taking duloxetine should be monitored closely for worsening depression and suicidal thoughts.
  • Do not stop taking this medication without first consulting with a healthcare provider. 
  • Before taking duloxetine, tell the prescribing doctor if you have any of the following medical conditions:
    • Heart problems
    • High blood pressure
    • Diabetes
    • Kidney problems
    • Liver problems
    • Glaucoma
    • A history of seizures
    • Bipolar disorder or mania
    • Low sodium
    • Bleeding problems
    • Delayed stomach emptying
  • Tell the prescribing healthcare provider if you are pregnant, planning to become pregnant, breastfeeding, or planning to breastfeed.
  • Duloxetine can cause serious problems including:
    • Liver problems
    • Bleeding
    • Elevated blood pressure
    • Low blood pressure when standing, resulting in fainting, falls, and injury
    • Serotonin syndrome, a potentially life-threatening side effect
    • Glaucoma
    • Seizures
    • Activation of mania or hypomania
    • Severe skin reactions
  • This medicine may make you dizzy, drowsy, or lightheaded. It could also change your blood pressure so that you feel faint when you change position. Do not drive or do anything else that’s risky until you know how this medicine affects you.

Duloxetine Hcl interactions

  • To avoid potentially hazardous drug interactions, tell the prescribing healthcare provider about all prescription drugs, over-the-counter medicines, and supplements you are using before taking atorvastatin.
  • Tell other healthcare providers you are using this medicine before they prescribe new medications.
  • Do not use this medicine and an MAO inhibitor (MAOI) within 14 days of each other.
  • Drugs like duloxetine can create bleeding problems, so tell your doctor if you are taking NSAIDs (such as aspirin) or blood thinners (such as warfarin).
  • Duloxetine can make you sleepy or impaired, so tell your doctor if you’re using other drugs that make you sleepy such as opioids or allergy medications.
  • Some medicines can affect how duloxetine works or increase the risk of side effects. In some cases, duloxetine can make other medications less effective. Make sure to tell the prescriber if you are regularly taking:
    • Blood pressure medication
    • Drugs that make you pee (diuretics)
    • Heart rhythm drugs
    • Drugs that treat mood disorders or other psychiatric problems
    • Migraine headache medications called triptans
    • The antibiotics ciprofloxacin or enoxacin
    • The stomach acid reducer cimetidine
  • The bronchodilator theophylline

Duloxetine Hcl side effects

Serious side effects

Talk to a doctor if you notice any signs or symptoms of a possible serious side effect, including:

  • Unusual moods or behaviors, worsening depression, thoughts about hurting yourself, trouble sleeping
  • Lightheadedness when standing up, fainting, falling
  • Dark urine or pale stools, nausea, vomiting, loss of appetite, stomach pain, yellow skin or eyes
  • Anxiety, restlessness, fever, fast heartbeat, sweating, muscle spasms, diarrhea, seeing or hearing things that are not there
  • Seizures
  • Unusual bleeding or bruising
  • Confusion, weakness, muscle twitching, headache
  • Feeling more energetic than usual, racing thoughts, dangerous behaviors, grandiose ideas, pressured talking
  • Decrease in how much or how often you urinate
  • Eye pain, vision changes, swelling or redness around the eyes
  • Blistering, peeling, red skin rash
  • Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing

Less serious side effects

  • Nausea
  • Dry mouth
  • Headache
  • Weight loss
  • Vomiting
  • Appetite loss
  • Drowsiness 
  • Fatigue
  • Constipation

Sources:

  • Cymbalta duloxetine delayed-release capsule prescribing information, DailyMed, NIH National Library of Medicine
  • Drizalma Sprinkle duloxetine delayed-release capsule prescribing information, DailyMed, NIH National Library of Medicine
  • Duloxetine delayed-release capsule prescribing information, DailyMed, NIH National Library of

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