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Antidepressant (SNRI - serotonin-noradrenaline reuptake inhibitor)

Duloxetine: uses, side effects & precautions

Also known as Cymbalta, Yentreve.

Deze informatie is uitsluitend bedoeld als algemene richtlijn en vormt geen medisch advies. Raadpleeg altijd een gekwalificeerde zorgprofessional voor persoonlijke medische vragen. Bel in geval van nood uw lokale alarmnummer.

What it is used for

  • Depression
  • Generalised anxiety disorder
  • Nerve pain (diabetic neuropathy)
  • Fibromyalgia
  • Long-term musculoskeletal pain
  • Stress urinary incontinence (in some regions)

How it works

Duloxetine raises levels of serotonin and noradrenaline in the brain and spinal cord by reducing their reuptake. This is thought to help mood and anxiety and to dampen certain pain signals.

How it is taken

Usually available as gastro-resistant (delayed-release) capsules taken by mouth. The capsules are normally swallowed whole. Take it exactly as your doctor or pharmacist directs and follow the label; do not stop suddenly because withdrawal effects can occur.

No doses here on purpose. The right strength and schedule depend on you — only a doctor or pharmacist should set them. Always follow your prescription and the label.

Common side effects

  • Nausea
  • Dry mouth
  • Constipation
  • Drowsiness or trouble sleeping
  • Headache
  • Dizziness
  • Reduced appetite
  • Sweating
  • Sexual difficulties
  • Tiredness

Serious effects — get help

  • New or worsening suicidal thoughts, especially early on (seek urgent help)
  • Liver problems: yellowing of skin or eyes, dark urine, severe abdominal pain
  • Serotonin syndrome: agitation, fever, muscle twitching, confusion
  • Raised blood pressure
  • Severe allergic or skin reactions
  • Unusual bleeding
  • Signs of low sodium: confusion, weakness

If a reaction is severe — for example trouble breathing, swelling of the face or throat, or collapse — go to the nearest emergency room now or call your local emergency number. Do not wait for an online consultation.

Interactions to watch

  • MAOI antidepressants (must not be combined)
  • Other serotonin-raising medicines (triptans, tramadol, St John's Wort)
  • Blood thinners, aspirin and NSAIDs (bleeding risk)
  • Some medicines processed by the liver
  • Alcohol (added liver risk and drowsiness)

Who should take care

  • Avoid heavy alcohol use because of added liver risk
  • Tell your clinician if you are pregnant, planning pregnancy or breastfeeding
  • Use with caution with liver or kidney problems, high blood pressure, glaucoma or bleeding disorders
  • Do not stop suddenly; taper under medical guidance
  • Closer monitoring may be needed for people under 25

Frequently asked questions

Why is duloxetine used for pain as well as mood?
The same chemical messengers it affects, serotonin and noradrenaline, are involved in how the body processes some pain signals. This is why it is used for certain nerve and long-term pain conditions as well as depression and anxiety.
Can I drink alcohol with it?
Regular or heavy alcohol use is best avoided because both can affect the liver. Discuss your alcohol use with your clinician or pharmacist.
How long until it helps?
Mood and anxiety usually improve over a few weeks; pain relief can also take some weeks. Keep taking it as prescribed and review progress.
Can I open the capsule?
The delayed-release capsules are designed to be swallowed whole. Do not open, crush or chew them unless your pharmacist specifically advises how, as this can change how the medicine works.
Is Duloxetine safe to take?
For most people it is safe when taken exactly as a doctor or pharmacist advises and as printed on the label. Tell your clinician about your other medicines and health conditions, and seek urgent care for any serious reaction.

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