Duloxetine

What is duloxetine?

Duloxetine is a type of antidepressant known as a selective serotonin and norepinephrine reuptake inhibitor (SSNRI). It is commonly sold under brand names such as Cymbalta and Yentreve and is available in a generic version. [1]. 

What is duloxetine used to treat?

Duloxetine is to treat several conditions[1]: 

• Major depressive disorder (MDD) in adults 

• Generalized anxiety disorder (GAD) in adults  

• Diabetic peripheral neuropathy (nerve pain from diabetes) 

• Moderate to severe stress urinary incontinence in women 

How does duloxetine work?

Duloxetine works by increasing levels of serotonin and norepinephrine in the brain. These neurotransmitters help regulate mood and pain. By preventing their reabsorption (reuptake), duloxetine can help to maintain a balanced level in the brain which can help to improve mood and reduce pain[1]. 

Who can take duloxetine?

Duloxetine is suitable for most adults aged 18 and over. For treatment of stress urinary incontinence, it is licensed only for women[1]. 

Duloxetine is not suitable for people if you[1]: 

• Have severe liver or kidney disease 

• Have glaucoma 

• Are taking other medicines for depression within the last 14 days 

• Have known allergies to duloxetine or its ingredients 

• Have certain heart conditions  

• Pregnant women, those trying to conceive, or breastfeeding mothers, unless advised by a doctor 

Warning: Duloxetine may increase the risk of suicidal thoughts or behavior, particularly in young adults or during the early stages of treatment. Contact your doctor immediately if you experience worsening depression or suicidal thoughts.  

Always consult the Patient Information Leaflet and your doctor before starting duloxetine[2]. 

How do you take duloxetine?

Duloxetine is normally taken once or twice daily, with or without food. Swallow the capsules whole with a drink of water, do not crush or chew them. Take it at the same time each day to maintain consistency[1]. 

What is the usual dose for duloxetine?

Typical dosages of duloxetine vary by condition you are being treated for[1]: 

• Depression: Starting dose 60 mg daily which may be increased to a maximum of 120 mg per day. 

• Anxiety: Starting dose at 30 mg daily which may be increased to a maximum of 60 mg per day  

• Pain conditions: Usually 60 mg once daily 

• Stress urinary incontinence: starting dose 20 mg twice daily which may be increased to 40 mg twice daily after 2 weeks. 

Always follow your doctor or pharmacist’s instructions on how to take your medicine. 

Can you stop taking duloxetine?

Do not stop taking duloxetine abruptly as this may cause withdrawal symptoms such as dizziness, nausea, headaches, irritability, or electric shock-like sensations.  Your doctor or pharmacist will guide you to reduce your dose gradually over several weeks to minimise these effects. 

What do you do if you take too much duloxetine?

If you take too much duloxetine, you can get symptoms such as[1]: 

• Vomiting 

• Feeling dizzy 

• Rapid heartbeat 

• Drowsiness 

• Tremors 

• Seizure 

Call 111 if you have taken more duloxetine than was prescribed. If you experience seizures or  or loss of consciousness, call 999 and or to A&E straight away. 

What do you do if you forget a dose of duloxetine?

If you miss a dose, take it as soon as you remember. If it's almost time for your next dose, skip the missed dose and continue with your regular schedule. Never take 2 doses at the same time[1]. 

What are the side effects of duloxetine?

The most common side effects of duloxetine are[1]: 

• Nausea 

• Dry mouth 

• Tiredness 

• Constipation 

• Increased sweating 

• Feeling dizzy 

• Difficulty sleeping 

The rarer, but more serious side effects include[1]: 

• Liver damage (yellowing of skin/eyes) 

• Hallucinations 

• Serotonin syndrome (symptoms include confusion, fever, sweating, muscle twitching, or rapid heartbeat) 

• Headaches, confusion or weakness, or muscle cramps can be signs of low sodium levels. 

• Eye pain or blurred vision 

• Suicidal thoughts or worsening depression, especially in young adults 

• Unusual bleeding or bruising (e.g., nosebleeds, gastrointestinal bleeding) 

• Sexual dysfunction (e.g., reduced libido, erectile dysfunction) 

Call the doctor or 111 straight away if you have these symptoms. 

If you experience any side effects, including those not listed, you are encouraged to report them via the Yellow Card Scheme or contact your doctor, pharmacist, or nurse. This information is intended as a summary for general awareness and does not replace professional medical advice. 

The information provided in the side effects section is not a comprehensive list of all possible side effects associated with this medication. For a complete list of side effects, please refer to the Patient Information Leaflet (PIL) provided with your medication or consult your healthcare professional[2].

Medicines you can and can’t take with duloxetine

You must inform your doctor or pharmacist if you are taking[1]: 

• Other antidepressants, especially monoamine oxidase inhibitors (MAOIs, e.g., phenelzine, tranylcypromine) within the last 14 days 

• Other drugs that increase the level of serotonin such as fluoxetine (which may increase the risk of serotonin syndrome) 

• Anti-inflammatory drugs (e.g., ibuprofen, aspirin) or blood thinners (e.g., warfarin), which may increase bleeding risk 

• Medicines causing drowsiness (e.g., opioid painkillers, antihistamines) 

• Migraine medications (e.g., sumatriptan, other triptans) 

• Herbal supplements (like St. John’s Wort) 

Always provide a complete list to your doctor or pharmacist about the medications and supplements you are taking to avoid interactions and always refer to the Patient Information Leaflet[2]. 

Frequently asked questions about duloxetine

How long does duloxetine take to work? 

You may notice some improvement in 2 to 4 weeks, but full effects can take 4 to 6 weeks[1]. 

Can duloxetine cause weight gain or loss? 

Duloxetine may make you feel less hungry so you may lose some weight[1]. 

Is it addictive? 

Duloxetine is not addictive but stopping it suddenly can cause withdrawal symptoms[1]. 

Can I drink alcohol while taking duloxetine? 

Drinking alcohol while taking duloxetine may increase side effects such as drowsiness, dizziness, or impaired judgment. Limit alcohol consumption and discuss with your doctor[1].  

Can I drive or ride a bike? 

Some people are unable to concentrate when they take duloxetine. So, when you first start taking duloxetine, it is a good idea not to drive in case you are affected. Wait and see how duloxetine makes you feel[1]. 

Is duloxetine safe during pregnancy or breastfeeding? 

Duloxetine is generally not recommended during pregnancy or breastfeeding due to potential risks to the baby. Consult with your doctor to discuss alternatives or benefits versus risks[1].

For the official NHS guide to duloxetine, visit their website.