Duloxetine
Pronunciation: (doo-LOX-e-teen).
- Generic name
- Duloxetine
- Brand names
- Andepra, Dulane, Cymbalta, Apo-Duloxetine, Dulot, Yentreve
- Drug class
- Serotonin-Norepinephrine Reuptake Inhibitor (SNRI)
Availability and supply rules vary by country
Trade names by country: United States · Canada
Australia: · Full directory
What Duloxetine is and how it works
Uses, formulations, monitoring, and supply rules can differ by patient, product, and country. Follow the exact local product information and professional advice.
Mechanism of action: how Duloxetine works
Duloxetine is a selective serotonin and norepinephrine reuptake inhibitor (SNRI). It inhibits the reuptake of serotonin and norepinephrine in the central nervous system, increasing their synaptic concentrations. This dual action is thought to contribute to its antidepressant, anxiolytic, and analgesic effects. (1)
What Duloxetine is used for
Major Depressive Disorder
Major Depressive Disorder
Generalized Anxiety Disorder
Generalized Anxiety Disorder
Chronic Pain
Chronic Pain
Before taking Duloxetine
Do not take / not appropriate for
- Uncontrolled narrow-angle glaucoma, concomitant use with MAOIs or within 14 days of stopping an MAOI, severe hepatic impairment, and known hypersensitivity to duloxetine. (Contraindication)
Tell your clinician about
How to take Duloxetine
- General Instructions: Take duloxetine exactly as prescribed, usually once or twice daily. Swallow the capsule whole; do not crush, chew, or open it.. Adult Dosing: Typical starting dose for depression or anxiety is 30–60 mg once daily, which may be increased up to 120 mg per day based on response and tolerability. For pain conditions, dosing may start at 30 mg daily and increase as needed.. Pediatric Dosing: Duloxetine is approved for use in children 7 years and older for generalized anxiety disorder and in adolescents for fibromyalgia. Dosing is weight-based and should be determined by a pediatric specialist.. Administration: Take with or without food, but taking with food may help reduce stomach upset. Try to take it at the same time each day.. When To Stop: Do not stop duloxetine suddenly. Your doctor will guide you on how to taper the dose to avoid withdrawal symptoms.. Storage: Store at room temperature (20–25°C/68–77°F), away from moisture and heat. Keep out of reach of children.
- This page does not provide a dose calculator. Dosing must follow the prescriber, pharmacist, or product label.
Procedures and treatment changes
Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician.
Missed dose
If you forget a dose, contact your healthcare provider or pharmacist for advice on what to do next. Do not take an extra dose to make up for the missed one.
Overdose
In case of overdose, seek emergency medical attention or call your local poison control center immediately. Symptoms may include drowsiness, vomiting, seizures, rapid heartbeat, or loss of consciousness. Supportive care and monitoring are essential.
Side effects
Side effects and their urgency vary; report severe, persistent, or concerning symptoms to a healthcare professional.
Nausea
Incidence: Up to 30% (most common)
Somnolence (drowsiness)
Incidence: Up to 21%
Headache
Incidence: Up to 18%
Dizziness
Incidence: Up to 17%
Dry mouth
Incidence: Up to 15%
Constipation
Incidence: Up to 15%
Decreased appetite
Incidence: Up to 16%
Fatigue
Incidence: Up to 12%
Signs of liver problems (yellowing of skin/eyes, dark urine, severe stomach pain)
Incidence: Uncommon but serious
Signs of serotonin syndrome (agitation, rapid heartbeat, fever, muscle stiffness) or worsening mood/suicidal thoughts
Incidence: Rare but serious
Serious warnings
BOXED WARNING — serious
Symptoms: BOXED WARNING: Antidepressants, including duloxetine, increase the risk of suicidal thinking and behavior in children, adolescents, and young adults in short-term studies (no increased risk was seen over age 24, and a reduced risk was seen at 65+). Patients of all ages starting therapy must be monitored closely for clinical worsening and the emergence of suicidal thoughts or behavior; families and caregivers should be advised of the need for close observation and communication with the prescriber.
Action: Follow the urgency stated and seek prompt or emergency care when indicated.
May cause liver injury — serious
Symptoms: May cause liver injury; monitor for signs of liver dysfunction. Can increase blood pressure and heart rate; monitor regularly. Risk of serotonin syndrome, especially with other serotonergic drugs. May cause withdrawal symptoms if stopped abruptly.
Action: Follow the urgency stated and seek prompt or emergency care when indicated.
Contraindications recorded in the clinician database — serious
Symptoms: Contraindications recorded in the clinician database: Contraindications: Uncontrolled narrow-angle glaucoma, concomitant use with MAOIs or within 14 days of stopping an MAOI, severe hepatic impairment, and known hypersensitivity to duloxetine. Precautions: Use with caution in patients with a history of mania, seizures, hypertension, bleeding disorders, or those at risk for hyponatremia. Monitor for worsening depression or suicidal ideation.
Action: Follow the urgency stated and seek prompt or emergency care when indicated.
Interactions
| Medicine or test | Effect | Action |
|---|---|---|
| MAOIs (including linezolid, IV methylene blue) | Do not combine with an MAOI intended for psychiatric disorders (allow a 14-day washout after stopping duloxetine before starting an MAOI, and a 5-day washout after stopping an MAOI before starting duloxetine); do not start duloxetine in a patient being treated with linezolid or intravenous methylene blue. This combination carries a risk of serious, potentially fatal reactions. | (2) |
| Other serotonergic agents (triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, tryptophan, buspirone, St John's Wort) | Combining duloxetine with other serotonergic drugs increases the risk of serotonin syndrome, a potentially life-threatening condition. Always inform your healthcare provider about all medicines and supplements you are taking. | (2) |
| CYP1A2 inhibitors (e.g., fluvoxamine, cimetidine, ciprofloxacin) and CYP2D6 inhibitors (e.g., paroxetine, fluoxetine, quinidine) | CYP1A2 inhibitors can markedly raise duloxetine levels (reported up to roughly 6-fold) and CYP2D6 inhibitors can raise levels by roughly 60%, increasing the risk of side effects; these combinations should generally be avoided or require closer monitoring. | (2) |
| Blood thinners, NSAIDs, and aspirin | Duloxetine can interact with blood thinners (such as warfarin) and increases bleeding risk when combined with NSAIDs or aspirin. Always inform your healthcare provider about all medicines and supplements you are taking. | (1) |
Pregnancy, breastfeeding, kidney/liver function, age
Pregnancy
Duloxetine should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus; adequate, well-controlled human studies are lacking. Discuss the risks and benefits with your healthcare provider before use in pregnancy.
Breastfeeding
Nursing while taking duloxetine is not recommended, as infant safety data are lacking. Discuss feeding options with your healthcare provider.
Children
GAD is FDA-approved for ages 7-17 (initial 30 mg/day for at least 2 weeks, maintenance 30-60 mg/day, maximum 120 mg/day); fibromyalgia is FDA-approved for ages 13 and older (initial 30 mg/day for at least 1 week, maintenance 30-60 mg/day). Safety and efficacy for chronic musculoskeletal pain, diabetic peripheral neuropathy, and major depressive disorder have NOT been established in children — dosing for those conditions must not be extrapolated to pediatric patients.
Renal Impairment
Hepatic impairment: duloxetine should ordinarily not be given to patients with any hepatic insufficiency or cirrhosis (also a contraindication in severe hepatic impairment per the clinician record). Renal impairment: not recommended for patients with severe renal impairment or end-stage renal disease (estimated creatinine clearance/GFR under 30 mL/min).
Hepatic Impairment
Hepatic impairment: duloxetine should ordinarily not be given to patients with any hepatic insufficiency or cirrhosis (also a contraindication in severe hepatic impairment per the clinician record). Renal impairment: not recommended for patients with severe renal impairment or end-stage renal disease (estimated creatinine clearance/GFR under 30 mL/min).
Monitoring
Storage
Store at room temperature (20-25°C/68-77°F), away from moisture and heat. Keep out of reach of children.
Study the drug class: SNRIs and other antidepressants
Professional information
Clinician-facing context only. This section does not replace current product labeling.
General (adult)
Indication: Major Depressive Disorder / Generalized Anxiety Disorder
Dose summary: MDD: 20-30 mg twice daily or 30-60 mg once daily initial, target/maintenance 60 mg/day, maximum 120 mg/day. GAD: 60 mg once daily initial and maintenance, maximum 120 mg/day.
Renal context: Not recommended for patients with severe renal impairment or end-stage renal disease (estimated creatinine clearance/GFR under 30 mL/min). (1) (2)
General (adult)
Indication: Fibromyalgia / Chronic musculoskeletal pain / Diabetic peripheral neuropathic pain
Dose summary: Initial 30 mg once daily for about 1 week, then increase to 60 mg once daily; maximum 60 mg/day for these indications (no added benefit demonstrated above 60 mg/day for diabetic peripheral neuropathic pain).
Renal context: Not recommended for patients with severe renal impairment or end-stage renal disease (estimated creatinine clearance/GFR under 30 mL/min). (1) (2)
General (pediatric)
Indication: Generalized Anxiety Disorder (ages 7-17) / Fibromyalgia (ages 13+)
Dose summary: GAD: initial 30 mg/day for at least 2 weeks, then 30-60 mg/day maintenance, maximum 120 mg/day. Fibromyalgia: initial 30 mg/day for at least 1 week, then 30-60 mg/day maintenance. Not established for chronic musculoskeletal pain, diabetic peripheral neuropathy, or MDD in children.
Renal context: No pediatric-specific renal-impairment dosing data were found; apply the same avoidance in severe renal impairment used for adults and involve a pediatric specialist. (1) (2)
Frequently asked questions
How long does it take for duloxetine to work?
You may start to feel some improvement in mood or pain within 1–2 weeks, but it can take up to 4–6 weeks to feel the full benefit. Continue taking the medication as prescribed and talk to your doctor if you have concerns.
Can duloxetine cause weight gain?
Weight changes are possible with duloxetine. Some people may experience weight loss, while others may gain weight. Discuss any significant changes with your healthcare provider.
Is duloxetine addictive?
Duloxetine is not considered addictive, but stopping it suddenly can cause withdrawal symptoms. Always follow your doctor's instructions when discontinuing.
Can I drink alcohol while taking duloxetine?
It is best to avoid alcohol while taking duloxetine, as it can increase the risk of liver damage and worsen side effects such as drowsiness.
What should I do if I experience side effects?
Mild side effects often improve over time. If you experience severe or persistent symptoms, or any warning signs such as jaundice or suicidal thoughts, contact your doctor immediately.
Is duloxetine safe during pregnancy or breastfeeding?
Duloxetine should only be used during pregnancy or breastfeeding if clearly needed and prescribed by your doctor. Discuss the risks and benefits with your healthcare provider.
Can duloxetine be used in children?
Duloxetine is approved for certain conditions in children and adolescents, such as generalized anxiety disorder and fibromyalgia. Dosing and safety should be determined by a pediatric specialist.
What happens if I take too much Duloxetine?
Taking too much Duloxetine can lead to serious symptoms such as drowsiness, seizures, increased heart rate, and serotonin syndrome, which can be life-threatening. If you suspect an overdose, it is crucial to seek immediate emergency medical attention. Do not attempt to self-treat or wait for symptoms to worsen.
Is Duloxetine safe during pregnancy?
The safety of Duloxetine during pregnancy is a complex matter. It is categorized as a Pregnancy Category C medication, meaning animal reproduction studies have shown an adverse effect on the fetus, but there are no adequate and well-controlled studies in humans. Therefore, it is essential to consult your doctor to weigh the potential benefits against the risks for both you and your baby.
What is the mechanism of action of Duloxetine?
Duloxetine is a selective serotonin and norepinephrine reuptake inhibitor (SNRI). It inhibits the reuptake of serotonin and norepinephrine in the central nervous system, increasing their synaptic concentrations. This dual action is thought to contribute to its antidepressant, anxiolytic, and analgesic effects. (1)
What is the generic name of Duloxetine?
The generic name is Duloxetine. It is sold under brand names including Andepra, Dulane, Cymbalta, Apo-Duloxetine, Dulot, Yentreve.
What class of drug is Duloxetine?
Duloxetine is classed as: Serotonin-Norepinephrine Reuptake Inhibitor (SNRI).
References
- Duloxetine - MedGuideGlobal clinician-authored medicine recordMedGuideGlobal · Global · accessed 2026-08-06 · source 1
- Duloxetine Dosage Guide and Side Effects - Drugs.comDrugs.com · United States · accessed 2026-08-06 · source 2
- DULOXETINE CAPSULE, DELAYED RELEASE [REMEDYREPACK INC.] — US prescribing information (DailyMed SPL)U.S. National Library of Medicine (DailyMed) · US · accessed 2026-08-14 · source 3
- Duloxetine Delayed-Release — FDA approval record (Drugs@FDA ANDA203088)U.S. Food and Drug Administration · US · accessed 2026-08-14 · source 4
- Duloxetine — RxNorm normalized drug concept (RXCUI 476250)U.S. National Library of Medicine (RxNorm) · US · accessed 2026-08-14 · source 5
Brand names by country
Single-ingredient Duloxetine names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.
Priority countries
United States
- Duloxetine D/R20 mg, 60 mg, 30 mg · direct_rx
- DRIZALMA SPRINKLE30 mg, 20 mg, 40 mg, 60 mg · sun pharmaceutical industries, inc.
- Cymbalta60 mg, 30 mg, 20 mg · eli lilly and company
Canada
- CYMBALTA
- DULOXETINE DR