Duloxetine is used to treat depression and anxiety.
This medicine is also used to treat nerve pain in people with diabetes or fibromyalgia (a condition in which there are severe fatigue and muscle aches).
Duloxetine may be used to treat other conditions as decided by your doctor.
Take Duloxetine exactly as directed by your doctor or according to the instructions on the label. Do not take more or less than instructed by your doctor.
You may take Duloxetine with or without food. Try to take it at the same time each day.
If you are taking the delayed-release or gastro-resistant type of capsule, swallow it whole. Do not divide, chew or crush the capsule.
Duloxetine must be taken regularly for it to be effective. Continue taking this medicine even when you feel better. Do not stop taking it suddenly as this may worsen your condition.
Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.
DO NOT double a dose under any circumstances.
If you often forget to take your medicine, let your doctor and pharmacist know.
Alert your doctor if you have:
- severe kidney disease
- liver disease
- uncontrolled high blood pressure
as Duloxetine may not be suitable for you.
Do not give this medicine to children below 18 years old unless instructed to do so by the doctor.
Do not take Duloxetine if you are currently taking or have taken a medicine that is used to treat depression known as a monoamine oxidase inhibitor (MAOI) such as isocarboxazid, phenelzine and tranylcypromine in the last 14 days. Do not take Duloxetine with medicines used to treat bacterial infections such as ciprofloxacin, enoxacin and linezolid, and medicine used to treat depression such as fluvoxamine and thioridazine.
Inform your doctor if you have the following conditions:
- mood disorders including bipolar disorder (mania and hypomania)
- thoughts of suicide
- glaucoma (increased pressure in the eye)
- history of seizures
- history of bleeding disorders
- high blood pressure
- kidney disease
- heart disease
Let your doctor know if you are pregnant or breastfeeding.
Be sure to check with your doctor or pharmacist before giving this medicine to the elderly. Elderly people may be more sensitive to the side effects.
Notify your doctor if you consume large amounts of alcohol, if you are a frequent drinker.
Medicines for depression such as Duloxetine may increase the risk of suicidal thoughts and behaviour. As depression and some psychiatric disorders are themselves associated with an increased risk of suicide, it is important for you or your family members to monitor your condition especially at the start of treatment and if your dosage is still being adjusted. If you experience new or sudden changes in mood, behaviour, thoughts or feelings or a worsening of your depression with suicidal thoughts or attempts, harm to self or harm to others, contact your doctor immediately.
What lifestyle changes should I make to cope with depression?
Regular exercise and eating a healthy diet will help increase energy and hormones in the body such as serotonin, endorphins and other feel-good chemicals that minimise mood swings. Get enough sleep, as lack of sleep may cause irritability, moodiness, sadness, and tiredness.
Why is it important to keep my appointments with the doctor?
Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.
- Routine tests (e.g. liver and kidney function, sugar or sodium levels) may be done while you are being treated with this medicine.
- Your blood pressure may rise to unsafe levels without you noticing it. Monitor your blood pressure before and during treatment.
- Regular monitoring for signs of suicidal thoughts and unusual changes in behaviour or mood may also be needed.
Your doctor will advise you about how often you need to have these tests.
Duloxetine may cause dizziness or drowsiness. If affected, do not drive or take part in any activity in which you need to be alert.
Other side effects include any of the following: nausea, headache, tiredness, weakness, dry mouth, diarrhoea, constipation, indigestion, vomiting, difficulty sleeping, increased sweating, rash, decreased appetite, weight loss and stomach pain.
Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:
- unusual bruising or nosebleed
- rashes with skin peeling or blisters/rashes with peeling of the skin or blistering of the lips, mouth or eyes accompanied by fever
- yellowing of the eyes or skin, dark urine
- falls and bone fractures
- changes in sex drive
- difficulty passing urine
- hallucinations, agitation, delirium
- very fast, irregular or pounding heartbeat
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Do not take Duloxetine if you are currently taking or have taken a medicine to treat depression known as a monoamine oxidase inhibitor (MAOI) such as isocarboxazid, phenelzine and tranylcypromine in the last 14 days.
Do not take Duloxetine if you are taking any of these medicines:
- certain antibiotics e.g. ciprofloxacin, enoxacin, linezolid
- thioridazine (medicine for mood disorder)
- fluvoxamine (medicine to treat depression)
Inform your doctor and pharmacist if you are taking any of these medicines:
- other medicines for depression e.g. amitriptyline, nortriptyline, imipramine, paroxetine, fluoxetine
- medicines for irregular heartbeat e.g. flecainide, propafenone, quinidine
- strong painkillers e.g. tramadol, pethidine, fentanyl
- St. John's wort (herbal medicine)
- blood-thinning medicines e.g. warfarin, aspirin
- NSAIDs (medicines for pain and inflammation) e.g. ibuprofen, naproxen
This list does not include all medicines that may interact with Duloxetine.
Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements and medicines that you buy without a prescription.
Store in a cool, dry place away from the reach of children.
Medicines must not be used past the expiry date.