- Major depressive disorder:
- PO 40-60mg/day initially OD or divided BD *1/52 if patient needs to adjust to therapy
- Consider starting at 30mg OD *1/52 to allow for therapy adjustment before increasing to 60mg OD
- Max 120mg/day but doses >60mg/day not proven to add any therapeutic benefit
- Diabetic peripheral neuropathy/neuropathic pain:
- PO 60mg/day OD or divided BD
- PO 60mg/day OD or divided BD
- Fibromyalgia:
- Adults & children>13 years: PO 30mg/day *1/52 to allow for therapy adjustment before increasing to 60mg/day
- Adults & children>13 years: PO 30mg/day *1/52 to allow for therapy adjustment before increasing to 60mg/day
- Chronic musculoskeletal pain:
- PO 30mg/day *1/52 to allow for therapy adjustment before increasing to 60mg/day
- PO 30mg/day *1/52 to allow for therapy adjustment before increasing to 60mg/day
- Generalized anxiety disorder:
- Age <65 years and >7 years: Initially PO 30mg OD *2/52 allow for therapy adjustment before increasing to 60mg/day
- Age <65 years and >7 years: Initially PO 30mg OD *2/52 allow for therapy adjustment before increasing to 60mg/day
- Stress urinary incontinence (Off-label):
- Initially PO 20mg BD *1/52
- Tablet/Capsule:
- 20mg
- 30mg
- 60mg
- Wait ≥14 days after discontinuing MAOI to initiate duloxetine therapy
- Wait ≥5 days after discontinuing duloxetine therapy to initiate MAOI therapy
- Taper to discontinue
- Administered without regard to meals
Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)
Exact mechanism unknown
- Nausea
- Headache
- Xerostomia
- Weight loss
- Abdominal pain
- Somnolence
- Fatigue
- Constipation
- Anorexia
- Insomnia
- Vomiting
- Dizziness
- Diarrhea
- Diaphoresis
- Erectile dysfunction
- Agitation
- Oropharyngeal pain
- Decreased libido
- Blurred vision
- Tremor
- Anxiety
- Anorgasmia
- Yawning
- Dyspepsia
- Ejaculatory dysfunction
- Elevated BP
- Palpitations
- Urinary hesitancy
- Elevated ALT/AST
- Sexual dysfunction
- Hypersensitivity to class/components
- MAO inhibitor use within 14 days
- Patients being treated with linezolid or IV methylene blue
- CrCl <30
- Chronic hepatic disease
- Cirrhosis
- Alcohol abuse
- Abrupt withdrawal
WARNING:
Increased the risk of suicidal thoughts and behavior in children, adolescents and young adults
- Eliglustat
- Isocarboxazid
- Linezolid
- Methylene blue injection
- Phenelzine
- Procarbazine
- Safinamide
- Selegiline
- Thioridazine
- Tranylcypromine
- Viloxazine
Drug Status
| Availability | Prescription only |
| Pregnancy | Category C |
| Breastfeeding | Use with caution |
| Schedule | Controlled |
| BRAND NAME | STRENGTH | FORMULATION | PACK SIZE | MANUFACTURER | DISTRIBUTOR |
|---|---|---|---|---|---|
| Cymbalta | 30mg | Capsule | 28’s | Eli Lilly | Statim Pharma |
| Cymbalta | 60mg | Capsule | 28’s | Eli Lilly | Statim Pharma |
| Duzela | 20mg | Capsule | 30’s | Sun Pharma | Sun Pharma |
| Duzela | 30mg | Capsule | 30’s | Sun Pharma | Sun Pharma |
| Duzela | 60mg | Capsule | 30’s | Sun Pharma | Sun Pharma |