Duloxetine Hydrochloride
Generic Details
Generic Name
Duloxetine Hydrochloride
Other Names
- Cymbalta
- Irenka
Drug Class
- Serotonin-Norepinephrine Reuptake Inhibitor (SNRI)
Chemical Formula
C18H19NOS.HCl
Molecular Weight
333.88 g/mol
Mechanism of Action
- Inhibits the reuptake of serotonin and norepinephrine in the central nervous system
Indications
- Major Depressive Disorder
- Generalized Anxiety Disorder
- Diabetic Peripheral Neuropathic Pain
- Fibromyalgia
- Chronic Musculoskeletal Pain
Common Dosage Forms
- Capsules
- Delayed-release Capsules
Typical Dosage
- 40-60 mg once daily for most indications
Pediatric Dosage
- Safety and efficacy not established in children under 7 years
Geriatric Dosage
- Consider dose reduction in elderly patients due to decreased clearance
Side Effects
- Nausea
- Dry Mouth
- Somnolence
- Constipation
- Decreased Appetite
- Sweating
- Fatigue
Contraindications
- Hypersensitivity to duloxetine
- Uncontrolled narrow-angle glaucoma
Pregnancy Category
- Category C - Risk cannot be ruled out
Lactation Safety
- Limited data available, caution advised. Small amounts may pass into breast milk.
Drug Interactions
- MAOIs
- SSRIs
- SNRIs
- Triptans
- Tramadol
- Warfarin
Overdose Symptoms
- Nausea
- Vomiting
- Tachycardia
- Tremor
- Seizures
Antidote for Overdose
- There is no specific antidote, treatment is supportive and symptomatic
Storage Conditions
- Store at controlled room temperature (15-30°C)
Pharmacokinetics
- Absorption: Rapidly absorbed after oral administration
- Distribution: Highly bound to plasma proteins
- Metabolism: Extensively metabolized in the liver
- Excretion: Primarily excreted in urine
Precautions
- Monitor for worsening of depression or emergence of suicidal thoughts
- Monitor for serotonin syndrome
Warnings
- Increased risk of suicidal thinking and behavior in children, adolescents, and young adults
Others
- May take several weeks for full therapeutic effect to be seen