Dulox 30 mg

Description

Indications
Dulox is a serotonin and norepinephrine reuptake inhibitor (SNRI) prescribed for the following conditions:

• Major Depressive Disorder (MDD)
• Generalized Anxiety Disorder (GAD)
• Diabetic Peripheral Neuropathic Pain (DPNP)
• Fibromyalgia
• Chronic Musculoskeletal Pain

Follow the advice of a registered healthcare professional when using this medication.

Pharmacology
Duloxetine Hydrochloride is a selective serotonin and norepinephrine reuptake inhibitor (SSNRI) intended for oral use. It is a less potent inhibitor of dopamine reuptake and does not significantly bind to receptors for dopamine, adrenergic, cholinergic, histaminergic, opioid, glutamate, or GABA in laboratory tests. Duloxetine does not inhibit monoamine oxidase (MAO). After oral administration, Duloxetine is well absorbed, and its elimination primarily occurs through liver metabolism.

Dosage & Administration

• Major Depressive Disorder (MDD)
  Starting Dose: 40 mg/day to 60 mg/day
  Target Dose:

  • Acute: 40 mg/day (20 mg twice daily) to 60 mg/day (once daily or as 30 mg twice daily)
  • Maintenance: 60 mg/day
    Maximum Dose: 120 mg/day

• Generalized Anxiety Disorder (GAD)
  Starting Dose: 60 mg/day
  Target Dose: 60 mg/day (once daily)
  Maximum Dose: 120 mg/day

• Diabetic Peripheral Neuropathic Pain (DPNP)
  Starting Dose: 60 mg/day
  Target Dose: 60 mg/day (once daily)
  Maximum Dose: 60 mg/day

• Fibromyalgia
  Starting Dose: 30 mg/day
  Target Dose: 60 mg/day (once daily)
  Maximum Dose: 60 mg/day

• Chronic Musculoskeletal Pain
  Starting Dose: 30 mg/day
  Target Dose: 60 mg/day (once daily)
  Maximum Dose: 60 mg/day

For some patients, starting with 30 mg once daily may be beneficial. There is no evidence to support additional benefits with doses greater than 60 mg/day, and higher doses may increase adverse reactions. A gradual reduction in dosage is recommended to prevent withdrawal symptoms.

Follow the advice of a registered healthcare professional when using this medication.

Interactions
Dulox metabolism is influenced by both CYP1A2 and CYP2D6 enzymes. Co-administration of Dulox with fluvoxamine, a potent CYP1A2 inhibitor, increases Dulox levels (AUC, Cmax, and t1/2). Other drugs that inhibit CYP1A2, such as cimetidine and quinolone antibiotics (e.g., ciprofloxacin and enoxacin), are expected to have similar effects and should be avoided. The concurrent use of Dulox with potent CYP2D6 inhibitors may lead to higher Dulox concentrations.

Contraindications
Dulox is contraindicated in patients who have a known hypersensitivity to the drug or any of its components. It is also not approved for treating bipolar depression. Dulox should not be prescribed to individuals with significant alcohol use or chronic liver disease. Due to an increased risk of mydriasis, caution is recommended in patients with controlled narrow-angle glaucoma.

Side Effects
Common adverse effects reported by Dulox users include nausea, dizziness, dry mouth, constipation, decreased appetite, fatigue, drowsiness, excessive sweating, hyperhidrosis, and weakness. Blood pressure may be slightly elevated. No clinically significant differences in QT, PR, and QRS intervals were found between Dulox-treated and placebo-treated patients.

Pregnancy & Lactation

• Pregnancy: Category C. There are no adequate studies in pregnant women, so Duloxetine should be used during pregnancy only when the potential benefit outweighs the risks to the fetus.
• Labor and Delivery: The effect of Duloxetine during labor is unknown. It should be used only if the potential benefit justifies the potential risk.
• Lactation: It is not known whether Duloxetine is excreted in human milk. Nursing while on Duloxetine is not recommended.

Precautions & Warnings
Patients using antidepressants for any condition should be closely monitored, especially during the initial months of treatment or when doses are changed. Blood pressure should be measured before and during treatment. Caution is advised with concurrent use of Dulox and NSAIDs, aspirin, or other anticoagulant medications due to an increased bleeding risk. Dulox should be used with caution in patients with a history of mania or seizure disorders.

Use in Special Populations

• Pediatric Use: The safety and effectiveness of Dulox in pediatric patients have not been established.

Overdose Effects
There is limited clinical experience with Dulox overdose. In case of overdose, general treatment measures should be followed, such as ensuring adequate airway management, oxygenation, and monitoring vital signs. Inducing vomiting is not recommended. Gastric lavage and activated charcoal may be considered if the overdose is recent or symptoms are severe.

Therapeutic Class
Serotonin-Norepinephrine Reuptake Inhibitor (SNRI)

Storage Conditions
Store below 30°C, away from light, and keep out of the reach of children.

Pack Image of Dulox 30 mg Tablet