DULOXETINE

Antidepressant medications are used to treat a variety of conditions, including depression and other mental/mood disorders. These medications can help prevent suicidal thoughts/attempts and provide other important benefits

Tell the doctor immediately if you notice worsening depression/other psychiatric conditions, unusual behavior changes (including possible suicidal thoughts/attempts), or other mental/mood changes (including new/worsening anxiety, panic attacks, trouble sleeping, irritability, hostile/angry feelings, impulsive actions, severe restlessness, very rapid speech). Be especially watchful for these symptoms when a new antidepressant is started or when the dose is changed.

Side effects may range from mild to serious complications.  Consult your doctor immediately when you feel the following symptoms: Nausea, dry mouth, constipation, loss of appetite, tiredness, drowsiness, or increased sweating, dizziness or lightheadedness may occur, especially when you first start or increase your dose of this drug. To reduce the risk of dizziness, lightheadedness, or falling, get up slowly when rising from a sitting or lying position. This medication may raise your blood pressure. Check your blood pressure regularly and tell your doctor if the results are high. It may also cause: confusion, easy bruising/bleeding, decreased interest in sex, changes in sexual ability, muscle cramps/weakness, shaking (tremor), difficulty urinating, unusual decrease in the amount of urine, signs of liver problems (such as stomach/abdominal pain, persistent nausea, vomiting, yellowing eyes/skin, dark urine), black/bloody stools, vomit that looks like coffee grounds, seizure, eye pain/swelling/redness, vision changes (such as seeing rainbows around lights at night, blurred vision).

This medication may increase serotonin and rarely cause a very serious condition called serotonin syndrome/toxicity with the following symptoms: fast heartbeat, hallucinations, loss of coordination, severe dizziness, severe nausea/vomiting/diarrhea, twitching muscles, unexplained fever, unusual agitation/restlessness.

Seek emergency medical help if you experience allergies (rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing) or the symptoms mentioned above while taking this drug.

Precautions

Inform your doctor of your allergies (food or drugs), medical conditions and  medical history before taking this drug, especially of: personal or family history of psychiatric disorders (such as bipolar/manic-depressive disorder), personal or family history of suicide attempts, bleeding problems, personal or family history of glaucoma (angle-closure type), high blood pressure, kidney disease, liver disease, seizure disorder, stomach problems (such as slow emptying of the stomach), use/abuse of alcohol, increase blood sugar.

Do not perform activities that require alertness such as driving and using machinery because this drug can make you dizzy.

Older adults and children may have increased risk to experiencing side effects.

For pregnant and nursing (breastfeeding) women, consult your doctor before using this medication. For pregnant and nursing (breastfeeding) women, consult your doctor before using this medication.

Interactions

Before using this drug, tell your doctor of the current medications, products (herbal/nonprescription) that you are taking especially of: other drugs that can cause bleeding/bruising (including antiplatelet drugs such as clopidogrel, NSAIDs such as ibuprofen, “blood thinners” such as warfarin), cimetidine, certain quinolone antibiotics (such as ciprofloxacin, enoxacin), antiarrhythmic drugs (such as propafenone, flecainide, quinidine), antipsychotics (such as thioridazine), tricyclic antidepressants (such as desipramine, imipramine), MAO inhibitors (isocarboxazid, linezolid, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, selegiline, tranylcypromine), MDMA/”ecstasy,” St. John’s wort, certain antidepressants (including SSRIs such as fluoxetine/paroxetine, other SNRIs such as desvenlafaxine/venlafaxine), tryptophan, alcohol, antihistamines (such as cetirizine, diphenhydramine), drugs for sleep or anxiety (such as alprazolam, diazepam, zolpidem), muscle relaxants, and narcotic pain relievers (such as codeine). Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness.

Overdose

Get medical emergency help immediately when you experience symptoms of overdose.

Missed Dose

If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

Storage

Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets. Discard the drug properly- do not throw in toilet or sink.

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