Duloxetine
Administration
- Type: SNRI
- Dosage Forms:
- Routes of Administration:
- Common Trade Names: Cymbalta
Adult Dosing
- 20-120mg PO daily
Pediatric Dosing
- > 7 years old: 20-120mg PO daily
Special Populations
- Pregnancy Rating: C
- Lactation risk: infant risk cannot be ruled out
- Renal dosing: avoid use if CrCl <30 mL/min
- Hepatic dosing: Avoid use in hepatic impairment
Contraindications
- Allergy to class/drug
- MAOI use concomitantly or within past 14 days
Adverse Reactions
Serious
- Hypertensive crisis
- Orthostatic hypotension
- Myocardial infarction
- Serotonin syndrome
- Withdrawal syndrome
- GI bleed
- SJS
- Suicidal thoughts
- Liver failure
Common
- Nausea, anorexia, constipation, diarrhea, xerostomia
- Dizziness, fatigue/somnolence, insomnia
- Headache
- Hypertension
Pharmacology
- Half-life: 8-17h
- Metabolism: Hepatic, CYP1A2 and CYP2D6
- Excretion: Mostly renal
Mechanism of Action
- Selectively inhibits reuptake of serotonin and norepinephrine