Duloxen 20

Indications

Duloxen is a serotonin and norepinephrine reuptake inhibitor (SNRI) indicated for the management of:

• Major Depressive Disorder (MDD)
• Generalized Anxiety Disorder (GAD)
• Diabetic Peripheral Neuropathic Pain (DPNP)
• Fibromyalgia
• Chronic Musculoskeletal Pain

Always consult a registered healthcare professional before use.

Pharmacology

Duloxetine Hydrochloride is an oral selective serotonin and norepinephrine reuptake inhibitor (SSNRI). It has a minor inhibitory effect on dopamine reuptake and shows minimal affinity for various receptors, including adrenergic, cholinergic, and GABA receptors. Duloxetine does not inhibit monoamine oxidase (MAO) and is primarily metabolized in the liver.

Dosage & Administration

• Major Depressive Disorder (MDD):
  • Starting Dose: 40-60 mg/day
  • Target Dose: 40 mg/day (20 mg twice daily) to 60 mg/day (once daily)
  • Maximum Dose: 120 mg/day
• Generalized Anxiety Disorder (GAD):
  • Starting Dose: 60 mg/day
  • Maximum Dose: 120 mg/day
• Diabetic Peripheral Neuropathic Pain (DPNP):
  • Starting Dose: 60 mg/day
  • Maximum Dose: 60 mg/day
• Fibromyalgia & Chronic Musculoskeletal Pain:
  • Starting Dose: 30 mg/day
  • Maximum Dose: 60 mg/day

Consult a registered healthcare professional for dosing advice.

Interactions

Duloxen’s metabolism involves CYP1A2 and CYP2D6 isozymes. Co-administration with potent CYP1A2 inhibitors like fluvoxamine can increase Duloxen levels. Avoid combinations with other drugs affecting these enzymes, as they may alter plasma concentrations.

Contraindications

Duloxetine is contraindicated for individuals with known hypersensitivity to the drug, bipolar depression, significant alcohol use, or chronic liver disease. Caution is advised for those with narrow-angle glaucoma.

Side Effects

Common side effects include nausea, dizziness, dry mouth, and constipation. Rare effects may involve increased blood pressure and seizures. Severe overdose can lead to life-threatening cardiac arrhythmias.

Pregnancy & Lactation

Duloxetine is categorized as Pregnancy Category C. Its use during pregnancy should be based on a careful risk-benefit analysis. The effects on lactation are unknown, and nursing while on Duloxetine is not recommended.

Precautions & Warnings

Patients should be monitored for clinical worsening, suicidality, and unusual behavior changes, particularly during the initial treatment phase. Blood pressure should be monitored regularly, especially if combined with NSAIDs or anticoagulants.

Use in Special Populations

Safety and efficacy in pediatric patients have not been established.

Overdose Effects

In the event of an overdose, general supportive measures should be employed. There is no specific antidote for Duloxen, and gastric lavage may be indicated if performed shortly after ingestion.

Therapeutic Class

Serotonin-norepinephrine reuptake inhibitor (SNRI)

Storage Conditions

Store below 30°C, away from light and out of reach of children.