What is Duloxetine: How to use, Side Effects, Dosage

What is Duloxetine: How to use, Side Effects, Dosage

What is Duloxetine

Duloxetine is used to treat major depressive disorder in adults.

Daloxetine is an antidepressant reuptake inhibitor serotonin and norepinephrine.

Duloxetine affects the brain chemicals that may be incompatible with those who have depression. It is also used to treat general anxiety disorder in adults and children who are at least 7 years of age.

Duloxetine is used to treat pain resulting from nerve damage in adults with diabetes (diabetic neuropathy). Duloxetine is also used in adults to treat fibromyalgia (chronic pain disorder), or chronic muscle or joint pain (such as back pain and pain of osteoarthritis).

Duloxetine hydrochloride is a white to slightly brownish white solid that dissolves slightly in water. Each capsule contains bullets coated with extracts 22.4, 33.7 or 67.3 mg duloxetine hydrochloride equivalent to 20, 30 or 60 mg duloxetine. These coated bullets are designed to prevent the destruction of the drug in the acidic stomach. Inactive materials include FD & C Blue No 2, gelatin, hyropomolysis, hydroxypropylmethyl cellulose acetate succinate, sodium lauryl sulfate, sucrose, sugar butter, talc, titanium dioxide and triethelic acid. Capsules of 20 and 60 mg also contain iron oxide yellow.

Please if you have any questions about Duloxetine, you can ask us by commenting below this text, we'll answer you as soon as possible.

How to use Duloxetine

You may take duloxetine with or without food.

Shake the long-term capsule, do not chew, break or open. Swallow it all.

It may take 1 to 4 weeks to improve your symptoms. Use medicine as told. Do not use a dose before talking to your doctor. If you stop taking this medicine suddenly, you may have unpleasant side effects.

Dosage of Duloxetine

Drug use for treating major depressive disorder

Take CYMBALTA at a dose of 40 mg per day (given 20 mg twice daily) to 60 mg per day (once daily or as 30 mg twice daily). For some patients, it may start taking 30 mg once a day for one week, so patients can reach the drug before increasing 60 mg once a day. While a dose of 120 mg per day was effective, there is no evidence that doses greater than 60 mg per day have more benefits. The safety of a high dose of 120 mg per day has not been adequately evaluated. A periodic review of the need for preservative treatment and the appropriate dose for such treatment is re-evaluated (see clinical studies).

Drug use to treat general anxiety disorder

For most patients, start CYMBALTA 60 mg once a day. For some patients, it may start taking 30 mg once a day for one week, so patients can reach the drug before increasing 60 mg once a day. While a dose of 120 mg once daily was effective, there is no evidence that doses greater than 60 mg per day have more benefits. However, if you decide to increase your dose Adults

by more than 60 mg once a day, increase the dose by increasing 30 mg once a day. The safety of doses above 120 mg once daily has not been adequately evaluated. Regularly re-evaluated to determine the continued need for preservative treatment and the appropriate dose for such treatment. [See clinical studies].

Elderly

Take CYMBALTA at a dose of 30 mg once a day for 2 weeks to increase your dose to 60 mg before taking the dose. Afterwards, patients may take more than 60 mg once a day. If you decide to increase the dose of more than 60 mg once daily, increase the dose by increasing 30 mg once a day. The maximum dose was 120 mg per day. Safety doses above 120 mg once daily have not been adequately evaluated [see clinical studies].

Kids (7 to 17 years old)

Take CYMBALTA at a dose of 30 mg once a day for 2 weeks to increase by 60 mg / day. The recommended dose is 30-60 mg once a day. Some patients may use more than 60 mg once a day. If you decide to increase the dose of more than 60 mg once daily, increase the dose by increasing 30 mg once a day. The maximum dose was 120 mg per day. Dose safety above 120 mg once a day has not been investigated (see clinical studies).

Use to treat diabetic peripheral neuropathic pain

Take CYMBALTA 60 mg once a day. There is no evidence that doses higher than 60 mg cause a significant increase, and a higher dose is clearly less tolerable (see clinical studies). For patients with anxiety, lower doses may be considered.

Since diabetes is often complicated with kidney disease, consider a lower initial dose and a gradual increase in doses in patients with renal impairment. [See Dosage in Certain People, Use in Certain People and Clinical Medicines].

Use to treat fibromyalgia

Take CYMBALTA 60 mg once a day. Starting treatment with 30 mg once daily for 1 week allows patients to reach the drug before increasing to 60 mg once a day. Some patients may respond to the initial dose. There is no evidence that doses higher than 60 mg / day have a positive effect, even in patients who do not respond to a dose of 60 mg, and higher doses are associated with a higher rate of side-effects (see clinical studies).

Consumption for the treatment of chronic musculoskeletal pain

Take CYMBALTA 60 mg once a day. Starting treatment with 30 mg for one week allows patients to reach a dose of 60 mg once a day before increasing it. There is no evidence that higher doses have higher benefits, even for patients who do not respond to a dose of 60 mg, and higher doses with a higher rate of side effects (see clinical studies).

Dosage in certain people

Liver Dysfunction

Avoid use in patients with chronic hepatitis or cirrhosis.

Symptoms of overdose

Keep all appointments for medical and psychiatric care on a regular basis. Laboratory tests and / or medical tests (such as blood pressure, liver function) should be done periodically to prevent your progress or to check for side effects. consult your doctor for details.

Side effects of Duloxetine

Report any new symptoms or worsening of your illness to your doctor, such as: mood or behavioral changes, anxiety, panic attacks, drowsiness, or if you feel irritable, irritable, disturbed, hostile, aggressive, restless, have too much (mentally or physically) depression, or have your thoughts about suicide or harm yourself.

Get your doctors help, if once you have:(copied by priority)

A feeling of dizziness, like you, may disappear;

Changes in vision, eye pain or swelling, redness of the eye.

Easy bruising, unusual bleeding;

Painful and difficult urine

Seizure;

Legendary part - rational thoughts, increased energy, reckless behavior, feeling very happy or irritable, talking excessively, severe sleep problems;

Hematologic problems - Top stomach pain on the right, itching, dark urine, jaundice (yellow skin or eyes);

Low levels of sodium in the body - headache, confusion, impatience, severe weakness, vomiting, loss of coordination, instability; or

Severe skin reaction - fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, then a red or purple skin rash that spreads especially in the face or body and causes flaking and the skin. Vectorized.

In the event of symptoms of serotonin syndrome, tell your doctor if you have symptoms of serotonin syndrome, including: irritation, hallucinations, fever, sweating, chills, fast heart rate, muscle stiffness, shaking, coordination, nausea, vomiting or diarrhea. See.

Elderly adults may be more susceptible to side effects.

Common side effects of duloxetine may include:

Dry mouth;

Drowsiness, dizziness;

feeling exhausted

Nausea, constipation, loss of appetite, weight loss; or

Boost sweat

This list is not the full list of side effects and others may occur.

The following serious side reactions are described below and in other labeling locations:

Suicidal thoughts and behaviors in children, adolescents and adults [See BOX WARNING and WARNINGS AND PREVENTION]

Liver toxicity

Orthospathic Hypotension, Waterfalls and Syncope

Serotonin Syndrome

Abnormal bleeding

Severe skin reactions

Discontinue treatment with CYMBALTA

Mania activation / Hypomyma

Closed-angle glaucoma

Seizures

Effects on Blood Pressure Common treatments for important drugs

Hypnotherapy

Nausea and vomiting of the urine

Duloxetine

Please if you have any questions about Duloxetine, you can ask us by commenting below this text, we'll answer you as soon as possible.

Drugs that may interact with Duloxetine

Many drugs would be given at a dose. All possible interactions are not listed here. Tell your doctor about all your current medications and start and stop everything, especially:(copied by the websites priority)

Any other type of antidepressant

Cimetidine;

Saint John's yeast;

Theophylline;

Tryptophan (sometimes called L-Tryptophan);

An amphetamine - Adderall, Focalin, Vyvanse, Ritalin, Concert, Strattera, and others;

Antibiotics - Ciprofloxacin, Enoxazine;

Blood Drinks - Warfarin, Coumadine, Yanoton;

Drug heart rhythm - Flaxainid, Propifenone, Quinidine and others;

Drugs - Fentanyl, Tramadol;

Medication for the treatment of mood disorders, thinking disorders, or mental illness - Bspron, Lithium, Tridizine and many more; or

Migraine headaches - Sumatriptan, Ratriptan, Sulmith Perment, and others.

The release of serotonin by platelets plays an important role in homeostasis. Epidemiologic study of case control and coordination design. The association between the use of psychotropic drugs that inhibits sertotonin absorption and the onset of upper gastrointestinal bleeding has shown that simultaneous use of NSAIDs or aspirin may increase the risk of bleeding. Concomitant administration of ritonavir (2 to 9 mg once daily) in steady states at doses of 60 and 120 mg once daily for up to 14 days in healthy subjects (15 patients) did not significantly change the INR from baseline (Average INR changes from 0.05 to 07.07). Chronic anticoagulant effects, including increased bleeding, have been reported when SSRIs or SNRIs are associated with warfarin. . The sum of Darfarin (drugs containing protein-bound drugs) (AUCτ, Ss, Cmax, ss or tmax, ss) for both drugs R and S have not changed due to the use of duloxetine. Due to the potential effect of ducklistin on platelets, patients who receive Darphurin therapy should start or stop duloxetine.

Tamazepam

Under stable conditions for duloxetine (20 mg qhs) and temazepam (30 mg qhs), the pharmacokinetics of duloxetine are not given by co-administration.

Lorazepam

Under the stable conditions for duloxetine (60 mg / hour for 12 hours) and lorazepam (2 mg / h for 12 hours), duloxetine was not treated.

Alcohol

When CYMBALTA and ethanol were separated for several hours so that the maximum concentration of each one coincided, CYMBALTA did not increase the disruption of alcohol and motor skills.

In the database of CYMBALTA trials, three patients treated with CYMBALTA showed liver damage due to ALT and increased total bilirubin with evidence of obstruction. In each of these cases, the use of interstitial ethanol was very important, and this may help to detect abnormalities.

Drugs that affect the acidity of the stomach

CYMBALTA has an antiseptic that resists to dissolve until it reaches a section of the digestive system where the pH is greater than 5.5. In very acidic conditions, CYMBALTA, which is not protected by antiseptic coating, may be hydrolyzed to produce naphthol. Caution is advised when using CYMBALTA in patients with conditions that may reduce gastric emptying (such as some diabetic patients). Drugs that increase the pH of the intestine may lead to the release of duloxetine. However, CYMBALTA simultaneously with alumina and magnesium (51 mm) or CYMBALTA with famotidine did not have a significant effect on duloxetine uptake or absorption after 40 mg oral dosing. It is not known whether simultaneous consumption of protein pump inhibitors affects the absorption of duloxetine.

Drugs metabolized by CYP1A2

In-vitro metabolism studies indicate that duloxin does not induce CYP1A2 activity. Therefore, an increase in the metabolism of the underlying CYP1A2 (e.g., theophylline, caffeine) is not anticipated due to induction, although clinical induction studies have not been performed. Duloxetine is an inhibitor of CYP1A2 in vitro studies and has increased in the two clinical trials (90% confidence interval) in theophylline AUC 7% (15-15%) and 20% (13-27%) when simultaneously Take the dose (60 mg twice daily).

Drugs metabolized by CYP2C9

The results of in vitro studies indicate that duloxetine does not inhibit activity. In a clinical study, the pharmacokinetics of S-warfarin, a substrate of CYP2C9, were not significantly affected by duloxetine.

Drugs metabolized by CYP2D6

Duloxetine is a moderate CYP2D6 inhibitor. When duloxetine (at a dose of 60 mg twice daily) with a single dose of 50 mg, only dysapamine, a CYP2D6 suppository, AUC, and dyspamine 3 fold.

Drugs metabolized by CYP3A

The results of in vitro studies indicate that duloxin does not inhibit or inhibit CYP3A activity. Therefore, increasing or decreasing the CYP3A subtype metabolism (e.g., oral contraceptives and other steroid agents)

The drug is highly dependent on the protein of the plasma

Since duloxetine is highly dependent on the plasma protein, CYMBALTA injections to the patient use a drug that is highly bound to the protein increases the free drug concentration and potentially leads to side reactions. However, concomitant intake of the drug (60 or 120 mg) with warfarin (2 to 9 mg), a highly restrictive protein, significant changes in the INR and in the pharmacokinetics of S or total R-warfarin (a protein-mediated protein) Free) [See drug interactions].

Substance abuse and dependence

abuse

In animal studies, doxorubicin does not show abusive use (like depression).

While CYMBALTA has not been systematically exposed to potential risk of maladministration, there are no indications of drug search behavior in clinical trials. However, based on pre-sale experience, it cannot be anticipated that the use of active CNS drugs when it is marketed can be misused, disposed of, and / or abused. As a result, doctors should evaluate and follow such patients as a history of drug abuse because of signs of abuse or abuse of CYMBALTA (eg, tolerance development, dose increase, drug use behavior) Observe.

Affiliation

In drug dependence studies, dooletxitol did not show the potential for production of dependence in rats.

For whom Duloxetine might not be safe

Elderly adults may most likely cause a type of salt imbalance (hyponatremia), especially if they are taking water tablets (diuretics). Coldness, dizziness or loss of coordination can increase the risk of falling. They may be more susceptible to side effects, especially bleeding, dizziness, dizziness, or lack of coordination

Children may be more susceptible to side effects, especially loss of appetite and weight loss. Monitor weight and height in children taking this drug.

Can you use Diazepam while pregnancy?

During pregnancy, this medication should only be used when needed. It may be harmeul to a baby. Also, babies born to mothers who have taken the drug for the last 3 months of pregnancy can rarely develop symptoms such as nourishment / respiration, seizure, muscle stiffness or permanent crying. If you notice any of these symptoms in your baby, tell your doctor quickly.

Warnings of Duloxetine

This medicine may cause dizziness or drowsiness. Alcohol or marijuana can cause your dizziness or sleepiness. Do not drive, use machines, or do anything that you need to be alert to as long as you can safely do it. Avoid alcoholic beverages. Talk to your doctor if you use marijuana.

Before taking this medicine, your doctor or pharmacist should have your medical history, in particular a personal or family history of psychiatric disorders (such as bipolar disorder or manic disorder), personal or family history of suicide attempts, bleeding problems, family history of glaucoma (type Angular closure), high blood pressure, kidney disease, liver disease, seizure disorder, stomach problems (such as low calorie stomach emptying), alcohol and alcohol consumption.

This medicine has a black box warning. This is the FDA's most recent alert. The black alert gives the doctor and patient box a potentially dangerous effect.

This drug can cause depression in the early stages of treatment. Tell your doctor if your depression is getting worse or if you have a suicidal ideation. It may increase the risk of suicidal thoughts and suicidal behavior in people over the age of 24 and younger.

Drowsiness Warning: This medication can cause drowsiness or responds to your ability to make decisions, to think clearly or quickly. You should not drive, use heavy machinery, or do other dangerous activities to find out what effect your medicine has on you.

Serotonin Syndrome Warning: This drug affects a chemical in your brain called serotonin. The use of this drug with other drugs that affect serotonin may increase the risk of serious complications from serotonin syndrome. Signs may include:

Stimulation

Confusion

Increased blood pressure or heart rate

Sweating

Losing coordination

Dizziness and a falling warning: This medicine can cause a sudden drop in your blood pressure. This will increase your dizziness and danger of falling.

Duloxetine

Please if you have any questions about Duloxetine, you can ask us by commenting below this text, we'll answer you as soon as possible.

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