Duloxetine belongs to the class of medications called selective serotonin and norepinephrine reuptake inhibitors (SSNRIs). It is used to treat depression and generalized anxiety disorder. It can also be used to treat diabetes-related nerve pain, fibromyalgia, chronic low back pain, and chronic pain from osteoarthritis of the knee. For depression and anxiety, duloxetine works by affecting the balance of chemicals in the brain and other parts of the body. For certain types of pain, duloxetine works by affecting the balance of chemicals in the brain and spinal cord that are involved in the experience of pain. This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. 40-60 mg/day PO initially (in single daily dose or divided q12hr for 1 week if patient needs to adjust to therapy) Titrate dose in increments of 30 mg/day over 1 week as tolerated Target dosage: 60 mg/day PO (in single daily dose or divided q12hr); not to exceed 120 mg/day (safety of dosages Treatment of chronic musculoskeletal pain, including discomfort from osteoarthritis and chronic lower back pain 30 mg/day PO initially for 1 week to allow for therapy adjustment Target dosage: 60 mg/day PO; not to exceed 60 mg/day Dosages ≥60 mg/day have not been shown to offer additional benefits Major depressive disorder and generalized anxiety disorder: Acute episodes often necessitate several months of sustained therapy Diabetic peripheral neuropathic pain: Efficacy for 12 weeks has not been studied; if diabetes is complicated by renal disease, consider lower starting dosage with gradual increase to effective dosage Fibromyalgia: Efficacy for ≥12 weeks has not been studied; continue treatment on basis of individual patient response Chronic musculoskeletal pain: Efficacy for ≥13 weeks has not been studied Uncontrolled narrow-angle glaucoma: Use not recommended due to increased risk of mydriasis Constipation (10%) Dizziness (10%) Insomnia (10%) Diarrhea (9-10%) Anorexia (8%) Decreased appetite (7-8%) Abdominal pain (6%) Hyperhidrosis (6%) Increased sweating (6%) Agitation (5%) Nasopharyngitis (5%) Vomiting (3-5%) Male sexual dysfunction (2-5%) Abdominal pain (4%) Decreased libido (4%) Musculoskeletal pain (4%) Upper respiratory tract infection (URTI) (4%) Abnormal orgasm (3%) Agitation (3%) Anxiety (3%) Blurred vision (3%) Cough (3%) Influenza (3%) Muscle spasms (3%) Tremor (3%) Abnormal dreams (2%) Dyspepsia (2%) Hot flushes (2%) Nausea (2%) Oropharyngeal pain (2%) Palpitations (2%) Paresthesia (2%) Weight loss (2%) Yawning (2%) Dysuria ( General: Anaphylactic reaction, angioneurotic edema, hypersensitivity Cardiovascular: Hypertensive crisis, supraventricular arrhythmia, myocardial infarction, tachycardia, Takotsubo cardiomyopathy Endocrine: Galactorrhea, gynecologic bleeding, hyperglycemia, hyperprolactinemia Neurologic: Restless legs syndrome, seizures upon treatment discontinuance, extrapyramidal disorders Ophthalmic: Glaucoma Otic: Tinnitus (upon treatment discontinuance) Psychiatric: Aggression and anger (particularly early in treatment or after treatment discontinuance), hallucinations Musculoskeletal: Trismus, muscle spasm Skin: Serious skin reactions (eg, erythema multiforme and Stevens-Johnson syndrome) necessitating drug discontinuance or hospitalization, urticaria, rash Gastrointestinal: Colitis (microscopic or unspecified),cutaneous vasculitis (sometimes associated with systemic involvement), acute pancreatitis Antidepressants increased the risk of suicidal thoughts and behavior in children, adolescents, and young adults in short-term studies These studies did not show an increase in the risk of suicidal thoughts and behavior with antidepressant use in patients 24 yr There was a reduction in risk with antidepressant use in patients ≥65 yr In patients of all ages who are started on antidepressant therapy, monitor closely for worsening, and for emergence of suicidal thoughts and behaviors Advise families and caregivers of the need for close observation and communication with the prescriber CYP1A2 inhibitors or thioridazine should not be coadministered Use caution in severe renal impairment, ESRD Heavy alcohol use Suicidality; monitor for clinical worsening and suicide risk, especially in children, adolescents and young adults (18-24 years) during early phases of treatment and alterations in dosage Serotonin syndrome or neuroleptic malignant syndrome-like reactions may occur; discontinue and initiate supportive therapy; closely monitor patients concomitantly receiving triptans, antipsychotics and serotonin precursors Neonates exposed to serotonin-noreponephrine reuptake inhibitors (SNRIs) or selective serotonin reuptake inhibitors (SSRIs) late in 3rd trimester of pregnancy have developed complications necessitating prolonged hospitalization, respiratory support, and tube feeding Screen patients for bipolar disorder; risk of mixed/manic episodes is increased in patients treated with antidepressants May cause activation of mania or hypomania Increased risk of hepatotoxicity, sometimes fatal; monitor for abdominal pain, hepatomegaly, elevations in hepatic transaminases exceeding 20 times upper limit of normal; jaundice; cholestatic jaundice with minimal elevations of hepatic transaminases have also been reported; use not recommended in patients with substantial alcohol use or chronic liver disease SSRIs and SNRIs may impair platelet aggregation and increase the risk of bleeding events, ranging from ecchymoses, hematomas, epistaxis, petechiae, and GI hemorrhage to life-threatening hemorrhage; concomitant use of aspirin, NSAIDs, warfarin, other anticoagulants, or other drugs known to affect platelet function may add to this risk Severe skin reactions (eg, erythema multiforme and Stevens-Johnson syndrome); discontinue at first appearance of blisters, peeling rash, mucosal erosions, or any other sign of hypersensitivity if no other etiology can be identified Orthostatic hypotension and syncope, especially during week 1 of therapy; monitor patients taking drugs that increase risk of orthostatic hypotension; consider dose reduction or discontinue therapy in patients who experience symptomatic orthostatic hypotension, falls and/or syncope Hyponatremia due to syndrome of inappropriate antidiuretic hormone (SIADH); cases of serum sodium Exact mechanism of action unknown; inhibits reuptake of serotonin and norepinephrine; weakly inhibits reuptake of dopamine; has no MAOI activity; has no significant activity for histaminergic H1 receptor or alpha2-adrenergic receptor The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information. Metformin timing Duloxetine neuropathic pain Cialis for sale toronto Buy kamagra online in australia Mar 10, 2015. Results provide evidence that duloxetine, compared to placebo, may reduce the accurate recognition of sadness. Drug effects were driven by. Nov 29, 2018. This effect of Cymbalta alleviates depression and anxiety and decrease pain signals in the brain, spinal cord, and nerves. It has also been. Background The efficacy and safety of duloxetine, a dual reuptake inhibitor of serotonin and norepinephrine at the recommended starting dose, have been. Review question Does duloxetine work to treat pain generated by nerves when they have been damaged in disease, or the pain caused by fibromyalgia? Background Duloxetine is a drug used to treat depression and urinary urge incontinence (leakage of urine) and it can be also be useful for certain types of pain. Pain can arise spontaneously when there is damage to nerves that carry pain information to the brain (neuropathic pain). When this damage is to nerves outside the spinal cord it is called a of all sorts. Study characteristics We looked at all the published scientific literature and found 18 trials, involving a total of 6407 participants, that were of sufficient quality to include in this . Eight trials tested the effect of duloxetine on painful diabetic neuropathy and six on the pain of fibromyalgia. Three trials treated painful physical symptoms associated with depression and one small investigated duloxetine for the pain from strokes or diseases of the spinal cord (central pain). Prescribed antidepressants are a common treatment option for panic disorder to help reduce the symptoms of panic attacks and anxiety. Cymbalta (duloxetine) is one type of antidepressant that's frequently prescribed for people who have been diagnosed with panic disorder. Because it's an antidepressant, Cymbalta can also help relieve symptoms of depression if you have been diagnosed with that as well. Cymbalta is a medication that belongs to a category of antidepressants called serotonin and norepinephrine reuptake inhibitors (SNRIs). Originally used to treat mood disorders like depression and bipolar disorder, SNRIs were later found to be an effective treatment option for anxiety disorders, such as panic disorder, generalized anxiety disorder (GAD), specific phobias, and social anxiety disorder (SAD), as well as agoraphobia. Additionally, these medications are prescribed to treat other mental health conditions such as post-traumatic stress disorder (PTSD), body dysmorphic disorder, and obsessive-compulsive disorder (OCD). SNRIs can also be effective in treating pain associated with certain medical conditions like fibromyalgia, diabetic peripheral neuropathy, and chronic fatigue syndrome (CFS). Duloxetine effects Cymbalta duloxetine dosing, indications, interactions, adverse effects., Cymbalta for Osteoarthritis Pain - Verywell Health Best online pharmacy to buy viagra Sep 9, 2018. Cymbalta is an antidepressant that's used to treat mood and anxiety disorders, including panic disorder. Here's how it works, side effects, and. Cymbalta Duloxetine for Panic Disorder - Verywell Mind. Urinary Side Effects of Duloxetine in the Treatment of Depression and.. Duloxetine cymbalta - Johns Hopkins Medicine. Find a comprehensive guide to possible side effects including common and rare side effects when taking Cymbalta Duloxetine Hcl for healthcare professionals. Duloxetine Find the most comprehensive real-world treatment information on Duloxetine at PatientsLikeMe. 3212 patients with fibromyalgia, multiple sclerosis. Jan 3, 2014. In fibromyalgia, there is lower quality evidence that duloxetine is. Minor side effects are common and more common with duloxetine 60 mg.