Duloxetine Side Effects

packaging of the antidepressant duloxetine

Serious side effects

Duloxetine can cause severe allergic reactions, with symptoms including rashes, difficult breathing and swelling of the face. Patients should consult a physician if any of these symptoms occur.

signs of liver damage including jaundice, dark and bloody urine, vomit that looks like coffee grounds and clay-colored or tarry stools
behavioral changes such as agitation, impulsiveness, abnormal excitement, fear, restlessness/nervousness, panic attacks and thoughts of suicide
hallucinations, confusion, lack of coordination, memory loss, severe and unusual weakness and overactive reflexes
fainting and increased dizziness, irregular heartbeat and tight chest, increased or abnormal sweating, especially at night, and trouble sleeping
blurred vision or blindness with eye pain, red or irritated/burning eyes, ringing in the ears, difficult swallowing and increased thirst/dry mouth with breath odor and loss of taste
skin complications including easy bruising/bleeding, skin pain, blistering or peeling rashes, red skin, hives/welts on face or appendages and sex organs, red lesions with a purple center and ulcers in the mouth
seizures and tremors, shallow and difficult breathing or wheezing, and high fever
changes and difficulty in urination with vomiting blood and flu-like symptoms including chills, cough and sore throat
severe headache with severe rigid muscles and severe joint pain

Common side effects

stomach problems including abdominal pain and swelling, indigestion, loss of appetite, constipation, severe and persistent vomiting/nausea and diarrhea, that can all cause weight change
mild dizziness and headaches with trouble sleeping and drowsiness
overall mild body aches and muscle aches or stiffness, with some swollen joints
feeling of pins and needles or tingling skin, or feeling warmth in the upper body and face
sexual complications including decreased interest/drive, and ability/performance changes like abnormal orgasms, problem/prolongation of ejaculation and loss of ability to have or keep an erection

Warnings & Recalls for Duloxetine

Black Box Warning

Duloxetine, as all other antidepressants, is mandated to include a black box warning. The black box warning for Duloxetine warns that antidepressants can increase the chances of suicide in patients younger than 25 years.

All patients should be on alert for changes in behavior, as well as thoughts of suicide. Those who experience these symptoms should seek immediate medical attention. Duloxetine users are at a higher risk for suicide if anyone in their family has had mental or mood disorders, therefore these conditions should be disclosed to a medical professional.

Other warnings

Those who are allergic to duloxetine or any of its ingredients (duloxetine hydrochloride, FD&C Blue No. 2, gelatin, hypromellose, hydroxypropyl methylcellulose acetate succinate, sodium lauryl sulfate, sucrose, sugar spheres, talc, titanium dioxide, triethyl citrate and iron oxide yellow) should not take this drug.

Patients who have had previous psychiatric disorders (or family who has had psychiatric disorders), history of suicidal thoughts, history of bleeding/clotting problems, glaucoma, kidney disease, liver disease, or have had a history of seizures, stomach/digestion problems, used street drugs, alcoholism, history of heart disease, diabetes, hypertension, low sodium levels and urination complications should consult a physician before taking Duloxetine.

Because Duloxetine can cause dizziness and drowsiness, patients are advised to not operate heavy machinery that requires alertness while taking the medication until they are aware of how the drug affects them.

Older patients can be more sensitive to the side effects of the drug, including increased bleeding and salt imbalance when mixed with diuretics.

Those who are younger than 18 years old should not receive Duloxetine, unless advised to do so by a physician.

Duloxetine can cause serotonin syndrome, which is when the body contains too much serotonin in the body. This can happen when duloxetine is used with other serotonin affecting drugs. Although the condition is extremely rare, patients and their physicians should proceed with caution, using regular tests as a gauge.

Contraindications:
Contraindications include thioridazines, isocarboxazid, phenelzine, selegiline, tranylcypromine, warfarin, amitriptyline, amoxapine, clomipramine, desipramine, doxepin, imipramine, nortriptyline, protriptyline, trimipramine, antihistamines, aspirin, ibuprofen, naproxen, cimetidine, diuretics, linezolid, amiodarone, flecainide, moricizine, propafenone, quinidine, methylene blue, tryptophan and almotriptan.

Eletriptan, frovatriptan, naratriptan, rizatriptan, sumatriptan, diclofenac, indomethacin, zolmitriptan, lithium, propranolol, lansoprazole, omeprazole, pantoprazole, etodolac, rabeprazole, ciprofloxacin, enoxacin, sedatives, fluoxetine, fluvoxamine, paroxetine, piroxicam, nabumetone, sibutramine, theophylline, tramadol, sleeping pills, St. John's wort, furazolidone, rasagiline, and any medications for anxiety, high blood pressure, mental illness, arthritis, fever, swelling, pain and nausea are also contraindicated.

Family Planning:
Duloxetine has been rated in pregnancy category C, and it is unknown if it will harm the fetus therefore it should only be used when necessary. Infants of mothers who have taken this drug during the last trimester of pregnancy have developed withdrawal symptoms. This medication should not be stopped without consulting with a physician first.

This drug passes into breast milk and harm nursing infants. Nursing mothers are advised to not breast-feed while on Duloxetine.

Duloxetine Treatment and Use

What is Duloxetine?

Duloxetine is an SSNRI (selective serotonin and norepinephrine reuptake inhibitor) antidepressant used to treat depression, anxiety, fibromyalgia, muscle/joint pain (arthritis) and pain caused by nerve damage in those with diabetes.

How does Duloxetine work?

Duloxetine works by increasing chemicals in the brain (serotonin and norepinephrine) helping balance signals in the brain. This drug prevents reuptake (process of the attachment and release of a neurotransmitter from a receptor site) after the serotonin and epinephrine has been released, causing an increased effect of the chemicals.

Dosage Information

Duloxetine is available in 20, 30 and 60 mg extended release capsules to be taken whole, either with or without food. Although dosages may vary, a physician will start the patient on a low dose and increase incrementally. Duloxetine can help the symptoms of the above complications, however it does not cure the conditions. It may take up to 4 weeks for Duloxetine to start working to its full potential.

Patients should continue taking the drug, even if they feel better, and should not stop taking the drug without consulting a physician as sudden discontinuation can cause withdrawal symptoms. This drug should be taken exactly as mandated by a physician, at the same time each day, without alterations by the patient.

Depression and anxiety are usually treated with 20 or 30 mg twice, or 60 mg once a day, where patients can be started with a low dose such as 20-30 mg and increased to 60 mg as the patient needs.

Those with diabetic nerve pain, fibromyalgia and arthritis normally take 30-60 mg of Duloxetine, depending on how the patient reacts to the drug.

The dosages for these conditions should not exceed 120 mg per day, as no benefit with a higher dosage has been recognized.

Other Names for Duloxetine

Duloxetine is also known as

Cymbalta

Ariclaim

Xeristar

Yentreve

Duzela