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Duloxetine (SNRI)

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What is Duloxetine?

Duloxetine is an antidepressant. It is used mainly to treat depression and anxiety. Depression is a mental condition whereby a person feels upset or sad for an extended period of time, often for no apparent reason. Duloxetine can help ease these symptoms.

Duloxetine is a delayed release medication, and can also be used to treat generalised anxiety disorder and for chronic pain relief of some types of neuropathic pain caused by diabetes.

It’s necessary to have been given a prescription before you can buy Duloxetine. However, you are able to buy Duloxetine online after a brief assessment. Duloxetine is available as hard capsules in 20 mg, 30 mg, 40 mg and 60 mg strengths. Duloxetine is also available under the brand name Cymbalta. Cymbalta Duloxetine works in the same way as generic Duloxetine - they have the same active ingredient.

For further information on Duloxetine, please see the Patient Information Leaflet here.

How it works

Duloxetine is one of a group of antidepressants, called serotonin norepinephrine reuptake inhibitors, or SNRIs. These work in a similar way to SSRIs by increasing levels of serotonin in the brain. Serotonin is responsible for mood and social behaviour. However, unlike SSRIs, SNRIs also affects the way that norepinephrine works in the brain. Norepinephrine is a neurotransmitter responsible for feelings of anxiety. By affecting how serotonin and norepinephrine work, SNRIs reduce the effects of depression.

SNRIs sometimes take a while to begin working properly, so you won’t feel an improvement in your symptoms straight away. Duloxetine starts to work within two weeks of starting treatment, although it can take up to four weeks to work properly.

Before you take it

Duloxetine has the potential to increase blood pressure and heart rate. If you have a history of high blood pressure, or any heart-related problem such as heart disease or heart failure, you should speak with your doctor or health professional before using Duloxetine. They will be able to tell you whether it is suitable for you or not.

Duloxetine may cause drowsiness or sleepiness. You should avoid driving, operating heavy machinery or doing anything that requires a high level of concentration before you are fully aware of how Duloxetine affects you.

Duloxetine may harm a developing baby. It is not recommended during pregnancy, unless specifically prescribed by your doctor. If it is prescribed by your doctor during pregnancy, it is because they feel the benefits of taking the medicine outweigh the risks. You must tell your doctor if you are pregnant before taking Duloxetine.

Duloxetine should not be used if you are breastfeeding, as it has been known to pass into breast milk.

You should not stop taking Duloxetine unless your doctor instructs you to, even if you feel better. If you stop taking Duloxetine suddenly you may experience withdrawal symptoms. If you need to stop taking Duloxetine, this should be done gradually over a period of 7-14 days.

Duloxetine has been associated with fluctuations in weight, especially when you first begin taking it. Patients have reported minor weight gain or weight loss while taking Duloxetine. If you are concerned by this, you should speak with your doctor.

Do not drink alcohol while taking Duloxetine - this can cause a significant worsening of any potential side effects you may experience.

If you have glaucoma, Duloxetine may increase the pressure in your eyes. Consult your doctor before taking Duloxetine if you have glaucoma.

Duloxetine can make you feel worse before you feel better. If you are experiencing changes in mood, suicidal thoughts or thoughts of harming yourself, then you should immediately consult your doctor. Clinical trials have shown an increased risk of suicidal thoughts in patients under 25.

Duloxetine has been known to react with certain other non prescription or prescription drugs, and can have adverse effects in some patients. If any of the following apply to you, you must speak with your doctor before taking Duloxetine:

  • If you are taking herbal remedies for depression, such as St John’s Wort, as taking this with Duloxetine can cause serotonin syndrome
  • If you have kidney or liver problems
  • If you are taking any other antidepressants, such as monoamine oxidase inhibitors
  • If you are allergic to any of the ingredients in Duloxetine capsules
  • If you are also taking ciprofloxacin or enoxacin to treat some types of infection
  • If you are taking any other medications that contain Duloxetine, as it can be prescribed for a multitude of conditions

This list is not exhaustive, and for a complete list of drug interactions and warnings, you should consult the patient information leaflet.

Dosage Instructions

You must take Duloxetine exactly as your doctor or pharmacist has prescribed. Do not exceed the stated dose, and check with your relevant health care professional if you are unsure.

The usual dosage of Duloxetine in adults is 30mg - 60mg per day. However, your doctor may change this depending on the severity of your condition. Always follow your doctor’s advice. For other conditions, such as diabetic neuropathy, you should speak with your doctor to check the correct dose.

Duloxetine is for oral use, and you must swallow your tablets with plenty of water. Do not crush, suck or chew them. Duloxetine can be taken with or without food.

You don’t need to take Duloxetine at a specific time every day, as long as you take it at the same time every day. If it makes you drowsy, it may be best to take it before you go to bed.

You should store Duloxetine at room temperature, out of the reach of children and pets

Common Side Effects of Duloxetine

It’s possible that Duloxetine may cause side effects. These are typically mild to moderate in nature and will generally go away on their own. However, if they concern you, or you are experiencing them constantly, you may wish to consult your doctor for advice. Side effects may include:

  • Loss of appetite
  • Trouble sleeping
  • Weight gain
  • Dry mouth
  • Nausea or headache
  • Increased blood pressure
  • Blurred vision or dizziness
  • Constipation or diarrhoea
  • Problems urinating
  • Change in sexual function - erectile dysfunction or reduced sex drive

Duloxetine may also cause serious side effects in some patients. This is still rare, but dangerous to your health, so you must consult a doctor if you experience any of the following possible side effects:

  • Thoughts of suicide or harming yourself
  • Difficulty controlling movement, jerkiness or lack of coordination
  • Fast or irregular heart rate
  • Hair loss
  • Acid reflux
  • Bleeding that is very bad or that you cannot stop
  • Vomiting blood
  • Black, tarry stools
  • Yellowing of the skin or the whites of the eyes
  • Increased sweating

Duloxetine has the potential to cause a serious allergic reaction in some patients. This is very rare, but an allergic reaction is always an emergency that requires immediate medical attention. If you believe you are having an severe allergic reaction to Duloxetine, go to your local hospital immediately. Symptoms include:

  • Wheezing or difficulty breathing
  • Tightness in the chest or throat
  • Skin rash, which may include blistering, redness, peeling or itching
  • Swelling of the face, including the tongue, nose, throat, mouth or lips

This is not a complete list of side effects, and for a full list of potential or common side effects of Duloxetine, you should contact your doctor or read the patient information leaflet.

Frequently Asked Questions (FAQs)

Is Duloxetine safe for children?

No. Duloxetine should only be taken by people over the age of 18. We do not prescribe any medication to under 18s.

I’m pregnant. Can I take Duloxetine?

You should not take Duloxetine while pregnant or breastfeeding, as it can affect an unborn baby and can also pass into breast milk. You should only take Duloxetine while pregnant if you have been specifically advised to by your doctor.

What’s the difference between Cymbalta and Duloxetine?

Duloxetine is generic Cymbalta. It’s possible to have Cymbalta 60 mg or 30 mg pills prescribed to you, or to buy Cymbalta online. They have exactly the same active ingredient and work in the same way - for example, a Duloxetine 30mg capsule is the same as a Cymbalta 30mg capsule. You should take Cymbalta Duloxetine in exactly the same way as generic Duloxetine.

What happens if I miss a dose?

If you miss a dose of Duloxetine, take it as soon as you remember unless it is nearly time for your next dose. If this is the case, skip the missed dose and continue your dosing schedule as normal. Never take two doses at once and never double up to make up for a missed dose.

What happens if I take too much?

Taking an overdose of Duloxetine can cause serious side effects. Side effects include sleepiness, serotonin syndrome, seizures, feelings of intoxication and can even send you into a coma. If you believe you have overdosed on Duloxetine, you must immediately go to your local hospital or A&E department.

More Information
Dosage No
Dosage Instructions Take ONE as directed by your doctor.