Duloxetine

Duloxetine belongs to a group of medicines called “serotonin and norepinephrine reuptake inhibitors” (SNRIs).  Duloxetine may be used to treat depression and anxiety.  Duloxetine is also used to treat different types of pain, such as diabetic nerve pain, fibromyalgia pain, chronic low back pain, and chronic osteoarthritis knee pain.

Duloxetine is a second-line agent for treatment of osteoarthritis of the knee that has not responded to acetaminophen or non-steroidal anti-inflammatory drugs (NSAIDs). Duloxetine has also shown benefit as an add-on medication for people who have had a partial response to acetaminophen or NSAIDs.
Duloxetine is not used to treat inflammatory arthritis.

Duloxetine interacts with a number of other medications. Please speak with your healthcare provider about whether any of the other medications you currently take interact with duloxetine.
Do not take duloxetine if you have an allergy to duloxetine. 
Duloxetine should be avoided if you have serious liver or kidney diseases or if you consume substantial amounts of alcohol (three or more drinks per day). 
 
Before taking duloxetine, tell your healthcare provider if you are pregnant or planning to become pregnant or are breastfeeding or planning to breastfeed. Currently there are no studies to assess the use of duloxetine during pregnancy and breastfeeding.  Your healthcare provider will discuss the risks and benefits of taking duloxetine while you are pregnant.

Nausea, constipation, dry mouth, fatigue, dizziness, drowsiness, headache (rarely), increased blood pressure/heart rate, sweating and decreased appetite.  If any of these symptoms become bothersome, please speak to your healthcare provider.

Suicidal thoughts or behavior, and self-injury have been very rarely reported in patients taking SNRI medications, like duloxetine.  Discuss these risks with your healthcare provider prior to starting duloxetine.  Contact your healthcare provider if you experience worsening depression or thoughts of suicide while taking duloxetine.

Do not discontinue or reduce your dosage of duloxetine without speaking with your healthcare provider.  Duloxetine should be discontinued slowly, typically over a week or two.

Initial side effects with duloxetine usually diminish 1 to 2 weeks after starting duloxetine.

Do not exceed the maximum recommended daily dose of duloxetine. Gradual dosage increases may help reduce some of the side effects. To reduce stomach upset, consider taking duloxetine with food.

If you experience drowsiness and sedation while taking duloxetine please be cautious about operating hazardous machinery, including automobiles, until your are reasonably certain that duloxetine therapy does not affect your ability to engage in such activities.

People who are experiencing drowsiness and sedation may consider taking the medication closer to bedtime.

Routine blood tests or monitoring are normally not required while taking duloxetine. Your healthcare provider may meet with you regularly to ensure that duloxetine is adequately controlling your pain and not causing adverse effects.

Your healthcare provider may also monitor your blood pressure to make sure duloxetine is not causing an increase.