Duloxetine

Duloxetine is an antidepressant medicine.

It's also known in Ireland by the brand names Cymbalta, Loxentia and Yentreve.

Duloxetine comes as capsules and is only available on prescription.

Uses of duloxetine

Duloxetine is used to treat depression and anxiety.

It's also used to treat nerve pain and can be used to treat stress urinary incontinence in women.

Get emergency help

You might have to get emergency help if you have a serious allergic reaction, have serious side effects or take too much.

Serious allergic reaction

Serious allergic reaction to duloxetine is rare.

Immediate action required: Call 999 or 112 or go to an emergency department (ED) if:

  • you get a skin rash that may include itchy, red, swollen, blistered or peeling skin
  • you're wheezing
  • you get tightness in the chest or throat
  • you have trouble breathing or talking
  • your mouth, face, lips, tongue or throat start swelling

These are warning signs of a serious allergic reaction (anaphylaxis) and you might need to go to hospital.

Serious side effects

Serious side effects are rare.

Immediate action required: Call 999 or 112 or go to an emergency department (ED) immediately if you get:

  • tightness in your chest or shortness of breath
  • any bleeding that's very bad or that you cannot stop, such as cuts or nosebleeds that do not stop within 10 to 15 minutes
  • painful erections that last longer than 4 hours - this may happen even when you're not having sex

Urgent advice: Speak to your GP straight away if you experience:

  • thoughts about harming yourself or ending your life
  • hallucinations or become aggressive and angry
  • feelings of euphoria, excessive enthusiasm or excitement, or feeling restless
  • a general feeling of being very unwell
  • constant headaches, long-lasting confusion or weakness, or frequent muscle cramps
  • yellowing of the skin, or the whites of your eyes go yellow - these can be signs of a liver problem
  • eye pain
  • vomiting blood or dark vomit, coughing up blood, blood in your wee, black or red poo
  • bleeding from the gums, or bruises that appear without a reason or get bigger

You should also speak to your GP if you experience changes in your periods, such as heavy bleeding, spotting or bleeding between periods.

If you take too much

Urgent advice: Call your GP or pharmacist straight away if:

you take more than your recommended dose of duloxetine.

Symptoms of an overdose include you:

  • feel sleepy
  • are being sick (vomiting)
  • have tremors
  • feel dizzy
  • have a fast heart rate
  • have a fit (seizure)
  • are sweating
  • feel restless

If you need to go to an emergency department do not drive yourself  - get someone else to drive you or call 999 for an ambulance.

Take the duloxetine packet, or the leaflet inside it, plus any remaining medicine with you.

When you start taking duloxetine

Duloxetine normally takes 2 to 4 weeks to work. It may take longer if you're taking it for nerve pain.

You may experience these common side effects:

  • feeling sick
  • having a dry mouth
  • having a headache
  • being constipated
  • feeling sleepy

Do not stop taking duloxetine after a week or 2 if you think it's not helping your symptoms. Give the medicine at least 6 weeks to work.

You can drink alcohol while you’re taking duloxetine, but it may make you feel sleepy or tired.

Check if you can take duloxetine

You can only take duloxetine if you’re aged 18 and over.

You can only use it for stress urinary incontinence if you’re a woman.

Check with your GP before starting to take duloxetine if you:

  • already have a medical condition
  • are taking any other medication or supplements
  • have had an allergic reaction to medicine in the past
  • have thoughts about harming yourself or ending your life
  • are trying to get pregnant, already pregnant or breastfeeding

Pregnancy and duloxetine

Talk to your GP or pharmacist before taking duloxetine if you are pregnant, think you may be pregnant or are planning to have a baby.

You should only take duloxetine during pregnancy if the benefits of the medicine outweigh the potential risks.

Do not stop taking your medicine unless your GP tells you to.

Breastfeeding and duloxetine

You can take duloxetine when you’re breastfeeding.

It does pass into breastmilk in very small amounts, but it's not known if it's harmful to the baby.

Speak to your GP about which treatment is best for you if you are breastfeeding.

How and when to take it

Take duloxetine once a day for depression, anxiety and nerve pain.

Take it twice a day for urinary incontinence

You can take duloxetine with or without food, but it's best to take it at the same time each day.

Important

Do not stop taking duloxetine suddenly without talking to your GP first.

Taking duloxetine for depression or anxiety

Once you're feeling better, it's likely that you'll continue to take duloxetine for several more months. This is recommended even if you no longer feel depressed or anxious. It is to avoid relapse.

Your GP can tell you to how best to come off duloxetine. Stopping your medicine too soon can make depression and anxiety return.

Taking duloxetine for nerve pain or urinary incontinence

You can take duloxetine long term if it’s helping your symptoms. Your GP may check that you're still getting relief from the pain or urinary incontinence every few months.

If you forget to take it

If you usually take duloxetine:

  • once a day - take the missed dose as soon as you remember, unless it's less than 12 hours until your next dose, in which case skip the missed dose
  • twice a day - take the missed dose as soon as you remember, unless it's less than 4 hours until your next dose, in which case skip the missed dose

Important

Never take 2 doses at the same time to make up for a forgotten one.

Side effects

Some of the common side effects of duloxetine will gradually improve as your body gets used to it. Keep taking the medicine.

Non-urgent advice: Tell your GP, a pharmacist or nurse if these side effects bother you or do not go away:

  • difficulty sleeping
  • headaches
  • feeling dizzy
  • blurred vision
  • constipation or diarrhoea
  • feeling or being sick (nausea or vomiting)
  • dry mouth
  • sweating
  • tiredness
  • less appetite than usual and weight loss
  • feeling less interested in sex, or having problems keeping an erection or reaching orgasm

This is not a full list of side effects of duloxetine.

Taking duloxetine with other medicines

Some medicines interfere with the way duloxetine works. Before you start taking duloxetine, check with your GP, a pharmacist or nurse if you’re on any other medicines or supplements. 

Recreational drugs

Cannabis can affect the levels of duloxetine and make you more likely to get side effects.

It may be dangerous to take duloxetine with:

  • stimulants like MDMA (ecstasy) or cocaine
  • hallucinogens like LSD
  • novel psychoactive substances (which used to be known as legal highs) like mephedrone

Finding your patient information leaflet online

Your patient information leaflet (PIL) is the leaflet that comes in the package of your medicine. 

Information:

To find your PIL online, visit the Health Products Regulatory Authority (HPRA) website

  1. In the ‘Find a medicine’ search box, enter the brand name of your medicine. A list of matching medicines appears.
  2. To the right of your medicine, select ‘PIL’. A PDF of the PIL opens in a new window. 

You can also:

  1. Select the brand name of your medicine.
  2. Scroll down to the Documents section.
  3. From the Package Leaflet line, select PDF version. A PDF of the PIL opens in a new window. 

If your PIL is not on the HPRA website, the European Medicines Agency (EMA) website opens in a new window when you select ‘PIL’.

You can find your PIL on the EMA website.

Finding your PIL on the EMA website

If your PIL is not on the HPRA website, you will be sent to the European Medicines Agency (EMA) website.

To find your PIL on the EMA website:

  1. In the Medicines search box, enter the brand name of your medicine and the word ‘epar’. For example: ‘Zoely epar’. A list of matching medicines appears.
  2. Select the ‘Human medicine European public assessment report (EPAR)’ for your medicine
  3. From the table of contents, select Product information.
  4. Select the EPAR – Product Information link for your medicine. A PDF opens in a new window. The PIL information is in Annex III of the PDF under ‘labelling and package leaflet’

This content was fact checked by a pharmacist, a GP, the National Medication Safety Programme (Safermeds) and the Health Products Regulatory Authority (HPRA).

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This project has received funding from the Government of Ireland’s Sláintecare Integration Fund 2019 under Grant Agreement Number 123.

Page last reviewed: 24 September 2021
Next review due: 24 September 2024

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