Duloxetine at a glance
Medicine class
Serotonin and noradrenaline reuptake inhibitor (SNRI).
Form
Gastro-resistant hard capsules that should be swallowed whole.
Food
May be taken with or without food.
Stopping treatment
Stopping suddenly can cause withdrawal symptoms.
What is Duloxetine used for?
The licensed indication depends on the individual duloxetine product.
Major depressive disorder in adults.
Generalised anxiety disorder in adults.
Diabetic peripheral neuropathic pain in adults.
Moderate-to-severe stress urinary incontinence in adult women for specifically licensed products.
Other forms of neuropathic pain and fibromyalgia may be treated outside the selected product licences.
How does Duloxetine work?
Duloxetine reduces the reuptake of serotonin and noradrenaline, increasing their signalling in the nervous system. This can improve mood and anxiety, alter pain processing and, in stress urinary incontinence, strengthen nerve signalling involved in urethral closure during bladder filling.
Duloxetine preparations and strengths
Capsule
Route: Oral
Strengths: 20 mg, 30 mg, 40 mg, 60 mg
Gastro-resistant capsule
Route: Oral
Strengths: 20 mg, 30 mg, 40 mg, 60 mg, 90 mg, 120 mg
How to take Duloxetine
Follow the label and the instructions supplied with the prescribed product.
Swallow gastro-resistant capsules whole with water; do not chew or crush them.
They may be taken with or without food.
Do not drive, cycle or operate machinery if duloxetine makes you dizzy or sleepy.
Duloxetine side effects
Common or expected effects
- Nausea or vomiting
- Headache
- Dry mouth
- Dizziness or sleepiness
- Diarrhoea or constipation
- Difficulty sleeping
- Increased sweating
- Reduced appetite or weight loss
- Sexual problems
Get urgent medical advice
- Suicidal thoughts or marked worsening of mood
- Serotonin syndrome symptoms, including agitation or confusion with fever, sweating, shaking, muscle twitching or a fast heartbeat
- Severe allergic reaction
- Seizure
- Mania or unusually elevated, overactive mood
- Signs of liver injury, such as jaundice or dark urine
- Severe eye pain or sudden visual disturbance
- Unusual or significant bleeding
- Severe weakness, confusion or seizures that may indicate low blood sodium
Duloxetine in pregnancy
Duloxetine can be used during pregnancy when a GP or specialist considers it appropriate. Current UK pregnancy information does not show increased risks of miscarriage, birth defects, stillbirth or premature birth, but exposure near delivery can cause temporary symptoms in the newborn; hospital delivery and postnatal observation may therefore be advised.
Duloxetine while breastfeeding
Duloxetine passes into breast milk in small amounts. It can be used cautiously when clinically appropriate, although medicines with more breastfeeding evidence may be preferred. For a full-term healthy infant, monitor feeding, alertness, irritability, gastrointestinal symptoms and weight gain; seek specialist advice for premature or unwell infants.
Duloxetine interactions
Check prescribed, non-prescription and herbal medicines before combining them with duloxetine.
Monoamine oxidase inhibitors, including linezolid
The combination can cause potentially life-threatening serotonin syndrome and must generally be avoided.
Fluvoxamine, ciprofloxacin or enoxacin
These strongly inhibit duloxetine metabolism and can markedly increase exposure; concomitant use is contraindicated by the selected product information.
Other serotonergic medicines, including SSRIs, SNRIs, tricyclic antidepressants, tramadol, triptans and St John's wort
Common questions about Duloxetine
Answers are fully visible for fast scanning and source review.
Is duloxetine an antidepressant?
Yes. Duloxetine is an SNRI antidepressant, although some products are also licensed for diabetic nerve pain or stress urinary incontinence.
Can duloxetine be used for nerve pain?
Yes. Selected products are licensed for diabetic peripheral neuropathic pain, and clinicians sometimes prescribe it outside the licence for other neuropathic pain conditions.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.