Duloxetine Hydrochloride(do locks’ ah teen)
CymbaltaDNC
PREGNANCY CATEGORY C
Drug Classes
Antidepressant
Serotonin and norepinephrine reuptake inhibitor
Therapeutic Actions
Inhibits neuronal serotonin and norepinephrine reuptake in the CNS resulting in a potentiation of serotonin and norepinephrine effects with resultant antidepressive effects.
Indications
Treatment of major depressive disorder
Management of neuropathic pain associated with diabetic peripheral neuropathy
Treatment and maintenance therapy of generalized anxiety disorder
Treatment of fibromyalgia
Management of chronic musculoskeletal pain; including low back pain and chronic pain due to osteoarthritis
Unlabeled use: Stress incontinence
Contraindications and Cautions
Contraindicated with allergy to any component of drug, concurrent use of MAOIs, uncontrolled narrow-angle glaucoma, lactation, concurrent substantial alcohol use, end-stage renal disease, hepatic impairment.
Use cautiously with pregnancy, history of mania, history of seizures, controlled narrow-angle glaucoma.
Available Forms
DR capsulesDNC—20, 30, 60 mg
Dosages
Adults
Major depressive disorder: 20 mg PO bid; up to 60 mg/day given once a day or 30 mg bid has been used; may be increased in 30-mg increments to a maximum of 120 mg/day.
Switching from an MAOI: Allow at least 14 days to elapse between discontinuing the MAOI and beginning duloxetine.
Switching to an MAOI: Allow at least 5 days to elapse between discontinuing duloxetine and starting an MAOI.
Diabetic neuropathic pain: 60 mg/day PO taken as a single dose, without regard to food.
Generalized anxiety disorder: 60 mg/day PO; may be increased in 30-mg increments to maximum of 120 mg/day.
Fibromyalgia: 30 mg/day PO for 1 wk; then increase to 60 mg/day.
Chronic musculoskeletal pain: Initially, 30 mg/day PO for 1 wk, then increase to maintenance dose of 60 mg/day PO.
Pharmacokinetics
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