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Outcome and Management The serum aminotransferase elevations that occur on duloxetine therapy are usually self-limited and do not require dose modification or
End-stage renal disease (requiring dialysis), severe renal impairment (estimated CrCl < 30 ml/min) Any hepatic impairment
The an-tidepressants associated with greater risks of hepatotoxicity are iproniazid, nefazodone, phenelzine, imipramine, amitriptyline, duloxetine, bupropion, trazodone
Pharmacists have a responsibility to ensure safe medication use in patients with cirrhosis
In addition to these indications, duloxetine is approved by the FDA for treatment of major depression, anxiety, and stress urinary incontinence
Abstract
Continuing Education Activity Duloxetine is a medication used to manage major depressive disorder (MDD), generalized anxiety disorder (GAD), fibromyalgia
Venlafaxine and duloxetine have been associated with severe DILI in uncontrolled observations
Common side effects include feeling sick, a dry mouth, headache, constipation and feeling sleepy
The recommended dose of Cymbalta for treating depression is 20 or 30 mg twice daily or 60 mg once daily
Do not use duloxetine with buspirone (Buspar®), fentanyl (Abstral Cymbalta is the brand name of the medicine duloxetine, which is used to treat major depressive disorder in adults and generalized anxiety disorder in adults and kids who are at least 7 years old
anxiety – the starting dose is 30mg, taken once a Duloxetine (Cymbalta) is a selective serotonin and norepinephrine reuptake inhibitor (SNRI) antidepressant used for treating depression, anxiety disorder, and pain
Liver disease (including cirrhosis)—Should not be used in patients with these conditions
Although not all of these side effects may occur, if they do occur they may need medical attention
These include depression, some anxiety disorders and also a certain type of pain caused by nerve damage in people with diabetes, called diabetic neuropathy
Duloxetine is an SNRI antidepressant
Of these drugs, Valproate is associated with the greatest risk of potential liver toxicity
The maximum dosage for this drug is 120 mg daily
and alkaline phosphatase concentrations have occurred in duloxetine-treated patients with chronic hepatic disease or cirrhosis
A pooled analysis of six different placebo-controlled research studies found that 44
If you are taking thioridazine
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At this dose, there was moderate quality evidence that duloxetine reduced pain in both painful diabetic peripheral neuropathy and fibromyalgia