Meds and you

27 September 2013

Duloxetine

Duloxetine is an anti-depressant. Anti-depressants are drugs that lift mood and, therefore, are used to prevent or reduce depression.

0

Duloxetine is the active ingredient of Cymbalta capsules (Nappi code:703911-001, 703910-001).

General information
Duloxetine is an anti-depressant. Anti-depressants are drugs that lift mood and, therefore, are used to prevent or reduce depression.

In South Africa duloxetine is registered for the treatment of depression, a mental state characterised by a pessimistic sense of inadequacy and a despondent lack of activity.

It can be used as a treatment on its own, or in combination with other medications used to treat depression.

For this medication to be effective it has to be taken regularly, even if you do not notice an immediate effect. Treatment should not be stopped abruptly, especially if you have been taking this drug for a prolonged period of time. To prevent withdrawal and a return of symptoms you should decrease your dose gradually only as directed by your doctor.

This medication does not cure the underlying condition, but simply keeps the symptoms under control.

It should be noted that because this drug may cause dizziness, light-headedness and/or sedation, driving and any hazardous tasks should be avoided until you know how this medication affects you.

How does duloxetine work? Duloxetine acts on two chemical messengers in the brain, serotonin and noradrenaline, which, amongst others, act to lighten mood. Depression is thought to occur when those of us prone to depression, can’t sufficiently replenish levels of these chemicals after they are reabsorbed into the nerve cells. Duloxetine works by preventing the reabsorption of these chemicals, thereby keeping levels of serotonin and noradrenaline at a sufficient level to avoid depression.

Fast facts

Drug schedule: schedule 5
Available as: duloxetine is available as capsules
What does it do? Duloxetine lifts mood and, therefore, prevents or reduces depression
Overdose risk: medium
Dependence risk: low
Is duloxetine available as a generic? no
Is duloxetine available on prescription only? yes

User information

Onset of effect: the full benefit of this medication may only be seen after a few weeks of treatment.
Stopping this medicine: do not stop using this medication abruptly as it may cause a recurrence of the original symptoms being treated. It is advised that you decrease your dose gradually as directed by your doctor.

Special precautions Consult your doctor before using this drug if:

  • you have liver or kidney disease
  • you are currently being, or in the last 14 days have been, treated with monoamine oxidase inhibitor antidepressants
  • you have a history of manic episodes, or if you have been diagnosed with bipolar disorder
  • you have glaucoma
  • you have had suicidal thoughts
  • you have high blood pressure
  • you have been diagnosed with a cardiovascular disorder
  • you have a history of seizures
  • you are taking medication to reduce blood clotting i.e. warfarin

Pregnancy: avoid. It is unknown how this medication may affect your baby. Consult your doctor before using this drug, or if you are planning to fall pregnant.
Breastfeeding: avoid. This medication is passed through breast milk and may affect your baby adversely. Consult your doctor before use.
Porphyria: avoid. It is unknown how this medication may affect your condition. Consult your doctor before use.
Infants and children: this medication is not intended for use in children under the age of 18 years.
The elderly: caution is advised in the elderly as side effects are more likely to occur.
Driving and hazardous work: this medication should be avoided as it may cause extreme sedation.
Alcohol: avoid concomitant use of alcohol with this medication.

Possible side effects

Side Effect
Frequency
Consult your doctor

Common
Rare
Only if severe
In all cases
constipation
X

X

dry mouth
X

X

nausea/vomiting
X

X

diarrhoea
X

X

heartburn
X

X

fatigue
X

X

muscle rigidity

X

X
weight loss

X
X

loss of appetite

X
X

diabetes insipidus
X

X

headache
X

X

dizziness
X

X

lethargy

X
X

tremor

X

X
insomnia
X

X

libido changes
X

X

anorgasmia
X

X

anxiety

X
X

yawning

X
X

sweating

X
X

hot flushes

X
X

skin rash

X

X
eye pain

X

X
palpitations

X

X
agitation

X

X

Interactions

Drug interactions

ciprofloxacin risk of duloxetine toxicity
fluvoxamine risk of duloxetine toxicity
SSRI antidepressants risk of dangerously high levels of serotonin
venlafaxine risk of dangerously high levels of serotonin
sumatriptan risk of dangerously high levels of serotonin
warfarin increased risk of bleeding
non-steroidal anti-inflammatory drugs increased risk of bleeding
risperidone increased risk risperidone toxicity
tricyclic antidepressants increased risk of toxicity of these agents

Overdose action
A small overdose is no cause for concern. In case of intentional large overdose seek emergency medical attention.

Recommended dosage
Adults, oral: 30 - 60 mg once daily.

Interesting fact
In some countries duloxetine is indicated to treat stress urinary incontinence (SUI) in women. SUI is the accidental leakage of urine when pressure in the bladder is increased suddenly, for example by coughing, sneezing, laughing, lifting or exercise.

This material is not intended to substitute medical advice, but is for informational purposes only. Please consult a physician for specific treatment and recommendations.

 
 

Read Health24’s Comments Policy

Comment on this story
0 comments
Comments have been closed for this article.