Duloxetine

What duloxetine is for

Duloxetine can be used to treat mental health conditions such as depression and anxiety.

It's also used to treat nerve pain, such as fibromyalgia, and stress urinary incontinence in women.

It's a type of antidepressant called a serotonin noradrenaline reuptake inhibitor (SNRI).

It's thought to work by increasing the levels of serotonin and noradrenaline (chemicals in the brain linked to mood). When these levels are normal this may reduce stress levels and negative thoughts.

For nerve pain, duloxetine reduces the pain messages nerves send to your brain.

How to take duloxetine

Duloxetine comes as capsules you swallow whole with water. How much you need to take depends on why you're taking it.

Your doctor may prescribe a low dose to start with and increase it after a week or more.

You can take duloxetine capsules once or twice day, with or without food.

Always check the packet or leaflet that comes with your medicine. Ask a pharmacist or doctor for advice if you're not sure how to take it or have any problems taking it.

If you miss a dose of duloxetine

If you forget to take duloxetine, take it as soon as you remember, unless it's nearly time for your next dose.

If it's nearly time for your next dose, skip the dose you missed and take your next dose at the usual time.

Do not take 2 doses to make up for a missed dose.

If you take too much duloxetine

Taking an extra dose of duloxetine can be dangerous.

How to stop taking duloxetine

Your doctor may suggest you stop taking duloxetine if you've been feeling better for some time.

But do not suddenly stop taking it because it may cause withdrawal symptoms.

Your doctor will gradually reduce your dose over several weeks or months. Always follow your doctor's advice.

Side effects of duloxetine

Like all medicines, duloxetine can cause side effects, although not everyone gets them.

Most side effects should ease after a couple of weeks as your body gets used to the medicine, but some can last longer.

Common side effects

Common side effects of duloxetine include:

• headaches
• feeling sick (nausea) and being sick (vomiting)
• feeling dizzy or drowsy (sleepy)
• dry mouth
• diarrhoea or constipation
• problems sleeping (insomnia)
• sexual problems, such as low sex drive (loss of libido)
• losing weight

If you feel dizzy or drowsy after taking duloxetine, do not drive, ride a bike or use machinery until these symptoms have gone away.

Serious side effects

Duloxetine can sometimes cause more serious side effects, although most of them are rare.

Possible serious side effects of duloxetine include:

• an allergic reaction (anaphylaxis) – causing symptoms such as a swollen throat or tongue, a raised, itchy rash and difficulty breathing
• serotonin syndrome – a condition that causes a fast heartbeat, sweating, shaking, twitching muscles and feeling confused or agitated
• unexplained muscle pain or weakness
• high moods (mania or hypomania) – for example feeling very happy, excited or energetic
• very low mood and having suicidal thoughts

Who can and cannot take duloxetine

Most adults can take duloxetine.

Duloxetine is not suitable for everyone. For example, it may not be suitable if you have:

• epilepsy
• heart disease
• glaucoma
• ever had mania (high moods caused by a mental health condition)

Before taking duloxetine, tell your doctor if you have any other medical conditions.

Breastfeeding and duloxetine

Tell your doctor if you're breastfeeding.

Duloxetine is sometimes used while breastfeeding, but it's best to check because the medicine can pass into your breast milk.

You may be able to take it, if the benefits outweigh the risks. Sometimes your doctor might want to switch you to a different type of antidepressant.

It's rare for breastfed babies to get side effects from duloxetine. Speak to a healthcare professional or call NHS 111 if you have any concerns about your baby.

Pregnancy and duloxetine

Tell your doctor if you're pregnant or you get pregnant while taking duloxetine.

Duloxetine can be used during pregnancy if needed. Your doctor will talk to you about the risks and benefits of taking it while you're pregnant.

If you need to take duloxetine while you're pregnant, your doctor will prescribe the lowest possible effective dose.

You may be advised to give birth in hospital so you and your baby can be closely monitored after you've given birth.

Find out more about taking duloxetine during pregnancy on the Bumps (Best Use of Medicines in Pregnancy) website

Taking duloxetine with other medicines, food and drink

There are some medicines, remedies and supplements that may not mix well with duloxetine.

This includes some types of:

• anticoagulants and antiplatelet medicines, such as warfarin, apixaban and clopidogrel
• non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen
• other antidepressants called monoamine oxidase inhibitors (MAOIs), such as moclobemide and selegiline

Do not use the herbal supplement St John's wort when taking duloxetine.

Before taking duloxetine, tell your doctor if you're taking any other medicines, herbal remedies, vitamins or supplements.

Food, drink and alcohol with duloxetine

You can eat normally while taking duloxetine.

It's best not to drink alcohol while taking duloxetine as it can increase the risk of side effects.