Duloxetine
Antidepressant — SNRI
Indications
DepressionGADDiabetic peripheral neuropathic painStress urinary incontinence
Adult dose
Depression/GAD: 60 mg OD (start 30 mg OD if tolerability concern), max 120 mg.
Common side effects
NauseaDry mouthConstipationInsomniaSweating
Serious side effects
HepatotoxicityHyponatraemiaSerotonin syndromeHypertension
Contraindications
Hepatic impairmentSevere renal impairment (CrCl <30)Uncontrolled hypertensionMAOI within 14 days
Monitoring
- LFTs if symptoms or risk factors
- BP
Notable interactions
- CYP1A2 inhibitors (fluvoxamine, ciprofloxacin) — avoid
- MAOIs
- Other serotonergic
Curated reference based on BNF, Maudsley Prescribing Guidelines and NICE. Verify against current BNF and local guidelines before prescribing.