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Duloxetine Brand Names
Cymbalta | Drizalma | Irenka
What is Duloxetine
Duloxetine is an oral serotonin norepinephrine reuptake inhibitor (SNRI).
Duloxetine is indicated for the treatment of major depressive disorder, diabetic peripheral neuropathic pain, and chronic musculoskeletal pain (e.g., chronic low back pain and chronic pain due to osteoarthritis) in adults, fibromyalgia in adults and adolescents 13 years and older, and generalized anxiety disorder (GAD) in adults and pediatric patients 7 years and older.
Efficacy was not demonstrated in clinical trials of pediatric patients with major depressive disorder (MDD).
Duloxetine has demonstrated a modest benefit in treating female stress urinary incontinence (SUI) and is used off-label in the U.S. for this condition; the drug is approved for SUI treatment in several European countries.
Product labels for all antidepressants contain a boxed warning related to an increased risk of suicidality in children, adolescents, and young adults during the initial stages of therapy when treating depression or other conditions; therefore, the necessity of pharmacologic therapy versus the potential risks should be carefully considered in these populations
Indications
- depression
- diabetic neuropathy
- fibromyalgia
- generalized anxiety disorder (GAD)
- musculoskeletal pain
- osteoarthritis
- urinary incontinence
Side Effects
- abdominal pain
- abnormal dreams
- agitation
- anaphylactoid reactions
- angioedema
- anorexia
- anxiety
- asthenia
- back pain
- bleeding
- blurred vision
- cardiomyopathy
- chills
- cholestasis
- colitis
- confusion
- constipation
- contact dermatitis
- cough
- dehydration
- depression
- diarrhea
- diplopia
- dizziness
- drowsiness
- Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)
- dysarthria
- dysgeusia
- dyskinesia
- dyspepsia
- dysuria
- ecchymosis
- ejaculation dysfunction
- elevated hepatic enzymes
- epistaxis
- eructation
- erythema
- erythema multiforme
- fatigue
- flatulence
- flushing
- galactorrhea
- gastritis
- GI bleeding
- halitosis
- hallucinations
- headache
- hematoma
- hepatic failure
- hepatitis
- hepatomegaly
- hot flashes
- hyperbilirubinemia
- hypercholesterolemia
- hyperglycemia
- hyperhidrosis
- hyperkalemia
- hyperprolactinemia
- hypertension
- hypertensive crisis
- hypoesthesia
- hypokalemia
- hyponatremia
- hypotension
- hypothyroidism
- impotence (erectile dysfunction)
- increased urinary frequency
- infection
- influenza
- insomnia
- irritability
- jaundice
- laryngitis
- lethargy
- libido decrease
- malaise
- mania
- menstrual irregularity
- muscle cramps
- musculoskeletal pain
- myalgia
- mydriasis
- myocardial infarction
- myoclonia
- nausea
- neonatal abstinence syndrome
- night sweats
- nightmares
- nocturia
- ocular hypertension
- orgasm dysfunction
- orthostatic hypotension
- otalgia
- palpitations
- pancreatitis
- peptic ulcer
- petechiae
- pharyngitis
- photosensitivity
- platelet dysfunction
- polydipsia
- polyuria
- postpartum hemorrhage
- pruritus
- rash
- restless legs syndrome (RLS)
- seizures
- serotonin syndrome
- SIADH
- sinus tachycardia
- Stevens-Johnson syndrome
- stomatitis
- suicidal ideation
- supraventricular tachycardia (SVT)
- syncope
- teeth grinding (bruxism)
- tinnitus
- tremor
- trismus
- urinary retention
- urticaria
- vaginal bleeding
- vasculitis
- vertigo
- visual impairment
- vomiting
- weight gain
- weight loss
- withdrawal
- xerophthalmia
- xerostomia
- yawning
Monitoring Parameters
- blood pressure
Contraindications
- abrupt discontinuation
- alcoholism
- anticoagulant therapy
- bipolar disorder
- bleeding
- breast-feeding
- cardiac disease
- children
- closed-angle glaucoma
- dehydration
- diabetes mellitus
- driving or operating machinery
- eclampsia
- electroconvulsive therapy (ECT)
- ethanol ingestion
- geriatric
- growth inhibition
- hepatic disease
- hepatitis
- hepatotoxicity
- hypertension
- hyponatremia
- hypotension
- hypovolemia
- increased intraocular pressure
- jaundice
- mania
- MAOI therapy
- neonates
- obstetric delivery
- orthostatic hypotension
- pregnancy
- renal failure
- renal impairment
- seizure disorder
- serious rash
- suicidal ideation
- syncope
- thrombolytic therapy
- urinary retention
Interactions
- Abciximab
- Acebutolol
- Acetaminophen; Aspirin, ASA; Caffeine
- Acetaminophen; Butalbital; Caffeine; Codeine
- Acetaminophen; Caffeine; Dihydrocodeine
- Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
- Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
- Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
- Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
- Acetaminophen; Codeine
- Acetaminophen; Dextromethorphan
- Acetaminophen; Dextromethorphan; Doxylamine
- Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
- Acetaminophen; Dextromethorphan; Phenylephrine
- Acetaminophen; Dextromethorphan; Pseudoephedrine
- Acetaminophen; Hydrocodone
- Acetaminophen; Oxycodone
- Acetaminophen; Pentazocine
- Acetaminophen; Tramadol
- Alfentanil
- Aliskiren
- Aliskiren; Amlodipine
- Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
- Aliskiren; Hydrochlorothiazide, HCTZ
- Aliskiren; Valsartan
- Alteplase
- Ambrisentan
- Aminosalicylate sodium, Aminosalicylic acid
- Amiodarone
- Amitriptyline
- Amitriptyline; Chlordiazepoxide
- Amlodipine
- Amlodipine; Atorvastatin
- Amlodipine; Benazepril
- Amlodipine; Celecoxib
- Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
- Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
- Amlodipine; Olmesartan
- Amlodipine; Telmisartan
- Amlodipine; Valsartan
- Amphetamine; Dextroamphetamine Salts
- Anagrelide
- Angiotensin II receptor antagonists
- Angiotensin-converting enzyme inhibitors
- Antithrombin III
- Apixaban
- Argatroban
- Aripiprazole
- Artemether; Lumefantrine
- Asenapine
- Aspirin, ASA
- Aspirin, ASA; Butalbital; Caffeine
- Aspirin, ASA; Butalbital; Caffeine; Codeine
- Aspirin, ASA; Caffeine; Dihydrocodeine
- Aspirin, ASA; Caffeine; Orphenadrine
- Aspirin, ASA; Carisoprodol
- Aspirin, ASA; Carisoprodol; Codeine
- Aspirin, ASA; Citric Acid; Sodium Bicarbonate
- Aspirin, ASA; Dipyridamole
- Aspirin, ASA; Omeprazole
- Aspirin, ASA; Oxycodone
- Aspirin, ASA; Pravastatin
- Atazanavir; Cobicistat
- Atenolol
- Atenolol; Chlorthalidone
- Atomoxetine
- Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
- Azilsartan
- Azilsartan; Chlorthalidone
- Benazepril
- Benazepril; Hydrochlorothiazide, HCTZ
- Bendroflumethiazide; Nadolol
- Benzhydrocodone; Acetaminophen
- Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
- Benzphetamine
- Betaxolol
- Betrixaban
- Bismuth Subsalicylate
- Bismuth Subsalicylate; Metronidazole; Tetracycline
- Bisoprolol
- Bisoprolol; Hydrochlorothiazide, HCTZ
- Bivalirudin
- Bosentan
- Brexpiprazole
- Brimonidine; Timolol
- Brompheniramine; Dextromethorphan; Guaifenesin
- Brompheniramine; Dextromethorphan; Phenylephrine
- Brompheniramine; Guaifenesin; Hydrocodone
- Brompheniramine; Hydrocodone; Pseudoephedrine
- Buprenorphine
- Buprenorphine; Naloxone
- Bupropion
- Bupropion; Naltrexone
- Buspirone
- Calcium-channel blockers
- Candesartan
- Candesartan; Hydrochlorothiazide, HCTZ
- Cannabidiol
- Captopril
- Captopril; Hydrochlorothiazide, HCTZ
- Carbinoxamine; Dextromethorphan; Pseudoephedrine
- Carbinoxamine; Hydrocodone; Phenylephrine
- Carbinoxamine; Hydrocodone; Pseudoephedrine
- Carteolol
- Carvedilol
- Celecoxib
- Central-acting adrenergic agents
- Chlorpheniramine; Codeine
- Chlorpheniramine; Dextromethorphan
- Chlorpheniramine; Dextromethorphan; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
- Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Hydrocodone
- Chlorpheniramine; Hydrocodone; Phenylephrine
- Chlorpheniramine; Hydrocodone; Pseudoephedrine
- Chlorpromazine
- Chlorthalidone; Clonidine
- Choline Salicylate; Magnesium Salicylate
- Cilostazol
- Cimetidine
- Cinacalcet
- Ciprofloxacin
- Citalopram
- Clevidipine
- Clomipramine
- Clonidine
- Clopidogrel
- Clozapine
- Cobicistat
- Cocaine
- Codeine
- Codeine; Guaifenesin
- Codeine; Phenylephrine; Promethazine
- Codeine; Promethazine
- Cyclobenzaprine
- Dabigatran
- Dacomitinib
- Dalteparin
- Danaparoid
- Darifenacin
- Darunavir; Cobicistat
- Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
- Desipramine
- Desirudin
- Desvenlafaxine
- Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
- Dexmethylphenidate
- Dextromethorphan
- Dextromethorphan; Diphenhydramine; Phenylephrine
- Dextromethorphan; Guaifenesin
- Dextromethorphan; Guaifenesin; Phenylephrine
- Dextromethorphan; Guaifenesin; Potassium Guaiacolsulfonate
- Dextromethorphan; Guaifenesin; Pseudoephedrine
- Dextromethorphan; Promethazine
- Dextromethorphan; Quinidine
- Diazoxide
- Diclofenac
- Diclofenac; Misoprostol
- Diflunisal
- Dihydrocodeine; Guaifenesin; Pseudoephedrine
- Diltiazem
- Diphenhydramine; Hydrocodone; Phenylephrine
- Diphenhydramine; Ibuprofen
- Diphenhydramine; Naproxen
- Dipyridamole
- Disulfiram
- Diuretics
- Dolasetron
- Dorzolamide; Timolol
- Doxazosin
- Doxepin
- Doxercalciferol
- Doxorubicin
- Dutasteride; Tamsulosin
- Edoxaban
- Eliglustat
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
- Enalapril, Enalaprilat
- Enalapril; Felodipine
- Enalapril; Hydrochlorothiazide, HCTZ
- Enoxaparin
- Eplerenone
- Epoprostenol
- Eprosartan
- Eprosartan; Hydrochlorothiazide, HCTZ
- Eptifibatide
- Ergot alkaloids
- Escitalopram
- Esmolol
- Esomeprazole; Naproxen
- Estrogens
- Ethanol
- Etodolac
- Famotidine; Ibuprofen
- Felodipine
- Fenfluramine
- Fenoldopam
- Fenoprofen
- Fentanyl
- Fluoxetine
- Fluoxetine; Olanzapine
- Fluphenazine
- Flurbiprofen
- Fluvoxamine
- Fondaparinux
- Fosinopril
- Fosinopril; Hydrochlorothiazide, HCTZ
- Gefitinib
- Givosiran
- Granisetron
- Guaifenesin; Hydrocodone
- Guaifenesin; Hydrocodone; Pseudoephedrine
- Guanabenz
- Guanfacine
- Haloperidol
- Heparin
- Homatropine; Hydrocodone
- Hydralazine
- Hydralazine; Hydrochlorothiazide, HCTZ
- Hydralazine; Isosorbide Dinitrate, ISDN
- Hydrochlorothiazide, HCTZ; Irbesartan
- Hydrochlorothiazide, HCTZ; Lisinopril
- Hydrochlorothiazide, HCTZ; Losartan
- Hydrochlorothiazide, HCTZ; Methyldopa
- Hydrochlorothiazide, HCTZ; Metoprolol
- Hydrochlorothiazide, HCTZ; Moexipril
- Hydrochlorothiazide, HCTZ; Olmesartan
- Hydrochlorothiazide, HCTZ; Propranolol
- Hydrochlorothiazide, HCTZ; Quinapril
- Hydrochlorothiazide, HCTZ; Telmisartan
- Hydrochlorothiazide, HCTZ; Valsartan
- Hydrocodone
- Hydrocodone; Ibuprofen
- Hydrocodone; Phenylephrine
- Hydrocodone; Potassium Guaiacolsulfonate
- Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
- Hydrocodone; Pseudoephedrine
- Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
- Ibuprofen
- Ibuprofen; Oxycodone
- Ibuprofen; Pseudoephedrine
- Iloperidone
- Iloprost
- Imipramine
- Indomethacin
- Iobenguane I 131
- Irbesartan
- Isoniazid, INH
- Isoniazid, INH; Pyrazinamide, PZA; Rifampin
- Isoniazid, INH; Rifampin
- Isradipine
- Ketoprofen
- Ketorolac
- Labetalol
- Lansoprazole; Naproxen
- Lasmiditan
- Leflunomide
- Lepirudin
- Levomilnacipran
- Linezolid
- Lisdexamfetamine
- Lisinopril
- Lithium
- Loperamide
- Loperamide; Simethicone
- Lorcaserin
- Losartan
- Macitentan
- Magnesium Salicylate
- Maprotiline
- Mecamylamine
- Meclofenamate Sodium
- Mefenamic Acid
- Meloxicam
- Meperidine
- Meperidine; Promethazine
- Mesoridazine
- Methamphetamine
- Methenamine; Sodium Acid Phosphate; Methylene Blue; Hyoscyamine
- Methyldopa
- Methylene Blue
- Methylphenidate
- Metoprolol
- Milnacipran
- Minoxidil
- Mirabegron
- Mirtazapine
- Moexipril
- Monoamine oxidase inhibitors
- Morphine
- Morphine; Naltrexone
- Nabumetone
- Nadolol
- Naproxen
- Naproxen; Pseudoephedrine
- Naproxen; Sumatriptan
- Nebivolol
- Nebivolol; Valsartan
- Nefazodone
- Netupitant, Fosnetupitant; Palonosetron
- Nicardipine
- Nifedipine
- Nimodipine
- Nisoldipine
- Nitroglycerin
- Nitroprusside
- Nonsteroidal antiinflammatory drugs
- Nortriptyline
- Olanzapine
- Olmesartan
- Ondansetron
- Oritavancin
- Oxaprozin
- Oxycodone
- Oxymorphone
- Ozanimod
- Palonosetron
- Paroxetine
- Peginterferon Alfa-2b
- Penbutolol
- Pentazocine
- Pentazocine; Naloxone
- Pentosan
- Perindopril
- Perindopril; Amlodipine
- Perphenazine
- Perphenazine; Amitriptyline
- Phenoxybenzamine
- Phentermine
- Phentermine; Topiramate
- Phentolamine
- Pimozide
- Pindolol
- Piroxicam
- Prasugrel
- Prazosin
- Procarbazine
- Prochlorperazine
- Propranolol
- Protriptyline
- Quetiapine
- Quinapril
- Quinidine
- Ramipril
- Ranolazine
- Rasagiline
- Remifentanil
- Reserpine
- Reteplase, r-PA
- Riociguat
- Rivaroxaban
- Rofecoxib
- Rolapitant
- Sacubitril; Valsartan
- Safinamide
- Salicylates
- Salsalate
- Selexipag
- Serotonin-Receptor Agonists
- Sertraline
- Sibutramine
- Sildenafil
- Solriamfetol
- St. John’s Wort, Hypericum perforatum
- Streptokinase
- Sulindac
- Tacrine
- Tadalafil
- Tamsulosin
- Tapentadol
- Tedizolid
- Telmisartan
- Tenecteplase
- Terazosin
- Terbinafine
- Teriflunomide
- Theophylline, Aminophylline
- Thiethylperazine
- Thioridazine
- Thrombolytic Agents
- Ticagrelor
- Ticlopidine
- Timolol
- Tinzaparin
- Tipranavir
- Tirofiban
- Tolmetin
- Tramadol
- Trandolapril
- Trandolapril; Verapamil
- Trazodone
- Treprostinil
- Tricyclic antidepressants
- Trifluoperazine
- Trimipramine
- Urokinase
- Valdecoxib
- Valerian, Valeriana officinalis
- Valsartan
- Vemurafenib
- Venlafaxine
- Verapamil
- Vilazodone
- Vorapaxar
- Vortioxetine
- Warfarin
- Zileuton
- Zolpidem
