IXTIN
DULOXETINE · by CARAWAY
Composition
Cap 20 mg/30 mg/40 mg/60 mg: Duloxetine HCI 20 mg/30 mg/40 mg/60 mg.
Indications & Dosage
Major depressive disorder: Adult: 60 mg once daily. Generalized anxiety disorder: Adult: Initially 30 mg once daily, increased if necessary to 60 mg once daily; max. 120 mg per day. Diabetic neuropathy: Adult: 60 mg once daily, discontinue if inadequate response after 2 months; review treatment at least every 3 months, max. dose to be given in divided doses; max. 120 mg per day. Moderate to severe stress urinary incontinence: Adult (female): 40 mg twice daily, patient should be assessed for benefit and tolerability after 2-4 weeks, alternatively initially 20 mg twice daily for 2 weeks, this can minimise side effects, then increased to 40 mg twice daily, the patient should be assessed for benefit and tolerability after 2-4 weeks.
Contraindications
Hepatic or severe renal impairment, narrow-angle glaucoma.
Precautions
Cardiac disease, bleeding disorders, elderly, history of mania or seizures, hypertension (avoid if uncontrolled), raised intra-ocular pressure, susceptibility to angle-closure glaucoma, hypomania, renal impairment, concomitant use with other antidepressants, elderly, liver transaminase elevations.
Interactions
Drugs metabolised by CYP2D6 (e.g. flecalnide, vinblastine, carbamazepine, tricyclic antidepressants). Potent CYP1A2 inhibitors/inducers. CNS-`active drugs e.g. diazepam, imipramine, phenytoin, haloperidol, alcohol.
Pregnancy
Avoid unless potential benefit outweighs risk
Lactation
Contraindicated, avoid
Side Effects
Abnormal dreams, anorexia, anxiety, bruxism, decreased appetite, diarrhoea, dizziness, drowsiness, dry mouth, dyspepsia, fatigue, flatulence, headache, hot flush, insomnia, nausea, nervousness, palpitation, paraesthesia, pruritus, sexual dysfunction, sweating, tremor, visual disturbances, vomiting, weakness, weight changes, dysphagia, gastritis, stomatitis, halitosis, hepatitis, hypertension, hypothyroidism, movement disorders, muscle twitching, musculoskeletal pain, photosensitivity, postural hypotension, raised cholesterol, syncope, tachycardia, taste disturbance, thirst, urinary disorders, vertigo. Rare: Mania, angle-closure glaucoma