DuloxetineReturn to Duloxetine overview
If you have any thoughts of suicide, or of other ways of hurting yourself, go straight to a hospital with your medicine. You need urgent help.
Duloxetine can make some people think about hurting themselves or have suicidal thoughts. This can happen to anyone, especially people who are under 18.
You must go straight to hospital with your medicine if you have any of these thoughts. You must tell the doctor that you are taking duloxetine. There are other things you can take instead.
This can happen just after you stop taking duloxetine as well, so please tell the doctor about duloxetine - even if you have just stopped taking it.
Duloxetine has some side effects, and if they happen they can be serious
Stop taking duloxetine and go to a doctor or hospital straight away if you get any of the following symptoms:
- Difficulty breathing, any rash and itching, or swelling of your face, lips, tongue or throat so that you cannot swallow or breathe.
- This might be an allergic reaction.
Go to a doctor or hospital straight away, but do not stop your duloxetine, if you get any of the following symptoms:
- You get a high temperature/fever, agitation, confusion, trembling or weird muscle movements. These may be signs of a rare condition called ‘serotonin syndrome’.
- Tiredness, confusion and muscle twitching. You may have a low blood level of sodium.
- Your skin starts going red and blistering or peeling.
Unexplained vaginal bleeding (like an unusual period for girls).
The capsules contain gelatine, sugar and some additives that can cause allergic reactions in some people
- The capsules contain gelatine, which some people do not like to eat because of religious or cultural beliefs.
- The capsules contain a small amount of sugar (sucrose and sugar spheres).
Tell your doctor or pharmacist before you take duloxetine if you have, or have ever had, any of these conditions
You need to talk to your doctor or pharmacist before you take duloxetine if you have, or have ever had:
- eye problems, such as certain kinds of glaucoma (increased pressure in the eye)
- low sodium levels in your blood, seen in tests (hyponatraemia)
- a tendency to develop bruises or to bleed easily (bleeding disorders)
- mania (feeling over-excited or unusually happy)
- bipolar disorder (feeling over-excited or extremely happy, and then sometimes feeling very low)
- kidney or liver problems
- heart problems
- fits (seizures, epilepsy)
- thoughts of harming or killing yourself
- an allergy to duloxetine or other ingredients in tablets and capsules
Some side-effects that do appear should get better after a few days. If they do not, you should go back to your doctor. If you get any side effects not listed here please look at the patient leaflet in the medicine pack
Some side-effects of duloxetine may - strangely - seem like other mental health symptoms. Some side-effects here are also the opposites of each other. The balance of chemicals in the brain is very fragile, and hard to control! If they do not get better after a few days on the tablets, go back to the doctor.
Do not stop taking the capsules until you talk to your doctor, or you may get withdrawal symptoms as well.
Very common side effects (could affect more than 1 in 10 people)
- Feeling sleepy
- Feeling sick (nausea)
- Dry mouth
Common side effects (could affect up to 1 in 10 people)
- not feeling hungry
- weight loss - Some children and young people aged under 18 who took duloxetine had some weight loss at first, but after 6 months of treatment they went back to normal compared with other people of the same age
- feeling nervous, anxious, restless, agitated or tense
- lower sex drive, or other sexual problems including difficulty staying hard (keeping your erection) and difficulty having an orgasm (coming)
- sleep problems, unusual dreams, tiredness or sleepiness
- feeling dizzy
- feeling sluggish - having low energy
- uncontrollable shaking movements, or feeling numb
- blurred eyesight
- feeling your pumping heartbeat in your chest, higher blood pressure
- flushing red skin, sweating more
- yawning a lot
- ringing in the ears (tinnitus)
- indigestion, being sick, constipation or diarrhoea, stomach pain, or passing wind
- itchy skin rash, or skin prickling/tingling/numbness
- muscle pain or spasm
- going to wee more often, which may be painful
- falling (this happens mainly in older people)
- There are other side-effects that you can get when taking this medicine - we have only included the most common ones here.
- Please look at the leaflet inside your medicine box, or ask a doctor or pharmacist, if you want to know if you are getting a side-effect from your medicine.
- If you do get a side-effect, please think about reporting it via the Yellow Card Scheme.
Duloxetine does not mix well with some other medicines and drugs
Do not take duloxetine if you take:
- An antidepressant medicine called a monoamine oxidase inhibitor (MAOI), or if you have taken one in the last two weeks
Talk to your doctor or pharmacist if you are taking any other medicines
Always talk to the doctor if you are taking other medicines. Tell the pharmacist you are taking duloxetine if you buy medicines (including things you put on your skin) for common illnesses.
Be careful if you are also using street drugs
- Cannabis can make drowsiness, dizziness and confusion worse when taken with duloxetine.
- Methadone can make sleepiness worse with duloxetine. The duloxetine could increase the concentration of methadone in your body.
- Duloxetine is likely to raise the effect of cocaine in your body, giving you a bigger reaction.
- Taking duloxetine with cocaine or ecstasy or amphetamines could bring on serotonin syndrome. You could get a high temperature/fever, agitation, confusion, trembling or weird muscle movements. You need to go to hospital if this happens. Tell the doctor everything that you have taken.
Stopping this medicine quickly, or reducing the dose too much at once, may cause uncomfortable symptoms. You can stop taking it safely with your doctor’s help
Once you start taking a medicine like duloxetine, the brain adjusts to having a new levels of serotonin and noradrenaline around. If you stop taking duloxetine all at once, the balance starts to change again. You could get some symptoms from the change.
You may get uncomfortable withdrawal symptoms if you stop duloxetine suddenly. It is better to agree stopping with a doctor who will reduce your dose gradually over at least 4 weeks.
Some of the symptoms you might get include
- tingling feelings like pins and needles, or electric shocks (particularly in the head)
- sleep disturbances (vivid dreams, nightmares, not being able to sleep)
- feeling anxious, restless, agitated or irritable
- feeling sick or being sick
- feeling unusually tired or weary
- muscle pain
- diarrhoea (loose poo)
- sweating a lot
- vertigo (losing your balance)
- These symptoms should stop after 2 weeks for most people, but some people can get them for 2-3 months or more.
- Most people get mild symptoms, but for some people they can be very intense.
- Go and speak to your doctor if you have missed a few doses, or have decided to stop taking your medication.
- When you agree with your doctor to stop the medicine, you will carry on with a lower dose for at least 2 weeks. This will lower your risk of getting withdrawal symptoms.
Search www.medicines.org.uk to find patient information leaflets and prescribing information on duloxetine. The 20mg and 40mg capsule strengths (including Yentreve) are for stress incontinence in women. The 30mg and 60mg capsule strengths (including Cymbalta) are the ones to search. The SmPC lists all the inactive ingredients in the product so you can check against any allergies. If you are still unsure about this then speak to your pharmacist.
British National Formulary (BNF) and British National Formulary for children. Download the BNF/BNFC app (blue background) on to your mobile device. No longer available for public access via the web
Taylor D, Barnes T, Young A. Maudsley Prescribing Guidelines in Psychiatry, 13th edition. Oxford: John Wiley & Sons, May 2018. ISBN: 978-1-119-44260-8
Royal Pharmaceutical Society. Medicines Ethics and Practice (42nd edition). London: RPS, 2018. Standards for pharmacists to work to. It is not a free publication
World Anti Doping Agency WADA Prohibited List https://www.wada-ama.org/en/resources/science-medicine/prohibited-list-documents
Choiceandmedication; an independent source of information on many mental health conditions and their medicines with easy to read fact sheets www.choiceandmedication.org Personal subscriptions to download the app available for £1 per month (with proportionate discounts for longer periods) but your local mental health Trust may subscribe and provide information sheets for free.
Best Use of Medicines in Pregnancy (BUMPS). Information sheets on drugs in pregnancy http://www.medicinesinpregnancy.org/
Drugs and Lactation Database (LactMed). Information on drugs in breastfeeding https://toxnet.nlm.nih.gov/newtoxnet/lactmed.htm