Duloxetine: Price, Dosage & Where to Buy

Duloxetine is an antidepressant in the serotonin and noradrenaline reuptake inhibitor (SNRI) class, used to treat major depressive disorder in adults. It is available as oral delayed-release capsules and requires a prescription in the United Kingdom, with treatment monitored for changes in mood, behaviour and the emergence of suicidal thoughts.

Duloxetine belongs to the serotonin and noradrenaline reuptake inhibitor class. Serotonin and noradrenaline are chemical messengers that allow nerve cells to communicate. After a messenger is released, nerve cells normally reabsorb some of it through a process called reuptake.

By reducing this reuptake, SNRIs increase the availability of these messengers between nerve cells. This affects signalling involved in mood and anxiety, as well as pathways in the nervous system that regulate pain.

Duloxetine is indicated for major depressive disorder in adults and generalised anxiety disorder in adults and children aged 7 years and older. Its pain-related indications include diabetic peripheral neuropathic pain in adults, meaning pain associated with diabetes-related damage to peripheral nerves.

It is also indicated for fibromyalgia in adults and children aged 13 years and older, and for chronic musculoskeletal pain in adults. These indications cover both mental health conditions and persistent pain conditions; the prescribed treatment depends on the condition being managed.

The label lists oral delayed-release capsules in strengths of 20 mg, 30 mg, 40 mg, 60 mg, 80 mg, 90 mg and 120 mg, and delayed-release pellet capsules in strengths of 20 mg, 30 mg, 40 mg and 60 mg. The label lists adult depression starting dosages of 40 mg/day to 60 mg/day, a maintenance dosage of 60 mg/day and a maximum of 120 mg/day. The label lists 60 mg/day as the adult generalised anxiety starting and target dosage, with a maximum of 120 mg/day.

The label lists 30 mg/day as the starting dosage for older patients with generalised anxiety. The label lists 60 mg once daily for adult diabetic peripheral neuropathic pain. The label lists 30 mg once daily initially for adult fibromyalgia and chronic musculoskeletal pain, increasing to 60 mg once daily.

The capsules are intended to remain whole, as crushing, chewing or opening can affect the enteric coating. Gradual dosage reduction is described to avoid discontinuation symptoms.

The label specifies storage at 25°C (77°F), with excursions permitted to 15-30°C (59-86°F). Keep the medicine out of the sight and reach of children and follow the pack's storage directions to maintain quality.

A missed dose is generally resumed when remembered, unless it is almost time for the next scheduled dose. In that situation, the missed dose is omitted and the regular schedule continues.

Doses should not be doubled or combined to compensate for a missed dose. A pharmacist can clarify uncertainty about the schedule.

Published and observational data have not identified a clear drug-associated risk of major birth defects or other adverse developmental outcomes. Use in the month before delivery may be associated with increased bleeding after childbirth. Exposure late in pregnancy has been associated with newborn breathing, feeding and adaptation difficulties, sometimes requiring hospital care.

Untreated depression and fibromyalgia also carry pregnancy risks, and stopping antidepressants can increase the likelihood of depression returning. Discuss treatment with a doctor during pregnancy. The label does not specify human breastfeeding data.