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General Information
 
Uses
 
What should I know before taking this drug
 
Precautions
 
Dosage information
  
Adverse reactions
 
Storage
 
Additional information if any
 
 
 

DULOT cap® [Lupin]
DUPACT cap® [Wockhardt]

Duloxetine is a prescription drug available from your pharmacy store only with the prescription of a qualified medical practitioner.

Duloxetine is pronounced as: du LOX e teen

Duloxetine is an Anti depressant belonging to a group of drugs called as Selective Serotonin & Norepinephrine Re-uptake Inhibitors (SSNRIs).

Duloxetine is used in the treatment of following conditions

  • Depression
  • Anxiety disorder
  • Nerve pain in Diabetic neuropathy
  • Chronic pain in Fibromyalgia
  • Take duloxetine exactly as prescribed by your doctor. If do not understand these instructions ask your pharmacist, nurse or doctor to explain them to you.
  • Take duloxetine at regular intervals as advised by your doctor for it to be effective.
  • Do not crush or chew the extended release tablet as it may cause release of large dose at a time.
  • Duloxetine may take up to 3-4 wks to show its full beneficial effects. However continue to take it as advised.
  • Do not take the medication in larger amounts or for longer duration than recommended by your doctor.
  • Do not skip doses or stop taking duloxetine without consulting your doctor as it may worsen your symptoms. 
  • Duloxetine has to be stopped gradually over a period of time as it may cause withdrawal symptoms.
  • Always remember to inform your health expert if you are currently taking any OTC or prescription drugs like,
    1. Tramadol
    2. Oral anticoagulant like warfarin
    3. Lithium (mood stabilizer)
    4. Antibiotics like Ciprofloxacin
    5. Digoxin (heart failure medicine)
    6. Anti histamine like Terfenadine , Astemizole, cimetidine 
    7. Anti arrhythmic like Propafenone, Flecainide
    8. Other anti depressants like Amitriptyline, Imipramine, fluoxetine
  • Inform your doctor if you have following medical diseases , as Duloxetine should be used cautiously in these conditions
    1. Bipolar disorder (manic depression)
    2. Bleeding or blood disorder
    3. History of suicide attempt or thoughts
    4. Seizure disorder
    5. Liver or kidney disease
    6. Glaucoma
    7. Diabetes

Do not use Duloxetine if you have taken Mono amine Oxidase inhibitors (MAO) like Phenelzine, Selegiline, rasagiline, Linezolid etc as it may cause life threatening reaction. Wait for at least 14 days after stopping MAO inhibitors to start taking the new medication.

Children:

Old people: Duloxetine should be used cautiously in older people as they more prone for side effects like muscle stiffness, involuntary movements etc

Pregnant woman: Duloxetine belongs to FDA pregnancy category C. This means that duloxetine may harm an unborn baby if used during pregnancy but potential benefit may warrant use of the drug in pregnant woman despite potential risks. Always inform your doctor if you are pregnant or are planning for conception.
 
Lactating women: It is not known whether duloxetine passes into breast milk or if it could harm the baby. Do not take duloxetine with out first talking to doctor if you are breast feeding a baby.
 
Other: Avoid alcohol and other sedative drugs as it may increase side effects due to duloxetine
 

Duloxetine is available in the form of tablets, capsules.

Use as directed by your physician, your physician prescribes depending on the severity of disease. Use the complete course of medication as prescribed by your physician even though you feel better after one or two days of usage of medication.

If it is almost the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not take two doses at same time to cover up the missed dose.

In case of overdose contact your nearest poison control centre or emergency medical centre for immediate care by physician.

The overdose symptoms of Duloxetine include
  • Delirium, confusion
  • Hallucination 
  • Nausea, vomiting, diarrhoea
  • Agitation 
  • Loss of consciousness 
  • Fast heart rate

Duloxetine may cause following side effects

  • Anxiety, nervousness
  • Weight gain
  • Drowsiness 
  • Dryness of mouth
  • Decrease in sexual drive or performance
  • Difficulty in sleeping (insomnia)
  • Diarrhoea

Consult your doctor immediately if notice following symptoms.

  • Allergic reaction like swollen lips, hives, difficulty in breathing, rashes. Peeling of skin etc
  • Easy bruising or bleeding
  • Black, tarry stools; brown colour vomiting
  • Jaundice (yellowing of skin or eyes)
  • Uncontrolled movements of the hands, legs, tongue, face
  • Suicidal thoughts or attempts
  • Worsening of agitation, aggressiveness, depression
  • Hallucination, delirium
  • Severe mental or mood changes
  • Visual disturbances

Store duloxetine at room temp (15 – 30 degrees C). Avoid excessive heat, moisture or direct sunlight, never store in the bathroom.
Keep it out of reach of children. Make sure that any leftover portion is disposed off safely.

  • Duloxetine increases the risk for suicidal thoughts or actions, worsening of depression, mood and behavioural changes especially in teenagers, young adults < 25 yrs. Care givers and family members should watch the patients closely and consult the doctor immediately if they notice any such symptoms.
  • If you are a diabetic on duloxetine medication, keep a close watch on your blood sugar levels.
  • Duloxetine may rarely cause a group of symptoms called as Serotonin syndrome especially when used concurrently with MAO inhibitors which is characterised by nausea, vomiting, diarrhoea, sweating, tremors, fever, rapid irregular heart rate, agitation, confusion, hallucination etc, stop the drug immediately and consult your doctor.
  • Duloxetine causes giddiness, drowsiness and visual disturbances as side effects. Therefore when affected do not drive, operate heavy machinery or perform unsafe tasks.
  • Regular monitoring of your blood pressure and liver function tests are required when on duloxetine to look for possible side effects.
It is imp to read manufacturing packaging instruction carefully if available and always do not hesitate to consult pharmacist or physician for any information.
 
Written by: Healthplus24 team
Date last updated: April 04, 2012