Dexnova
Generic Name
Duloxetine
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| dexnova 60 mg capsule | ৳ 16.00 | ৳ 160.00 |
Description
Overview of the medicine
Dexnova 60 mg Capsule contains Duloxetine, a selective serotonin and norepinephrine reuptake inhibitor (SNRI) used to treat major depressive disorder, generalized anxiety disorder, diabetic peripheral neuropathic pain, fibromyalgia, and chronic musculoskeletal pain.
Uses & Indications
Dosage
Adults
For MDD and GAD: Initially 20 mg once or twice daily, or 30 mg once daily, then typically 60 mg once daily. Max 120 mg/day (rarely). For pain indications: Typically 60 mg once daily. Initiate with 30 mg once daily for 1 week to allow adjustment.
Elderly
No specific dose adjustment is recommended for elderly patients based solely on age; however, caution is advised, and lower starting doses may be considered, especially with renal impairment.
Renal_impairment
Severe renal impairment (CrCl <30 mL/min): Not recommended. Moderate renal impairment: Consider lower dose or less frequent dosing.
How to Take
Take orally, with or without food. Swallow the capsule whole; do not chew, crush, or open it.
Mechanism of Action
Duloxetine works by increasing the levels of serotonin and norepinephrine in the brain, which are neurotransmitters that help regulate mood and pain signals.
Pharmacokinetics
Onset
Antidepressant and anxiolytic effects may take 2-4 weeks. Pain relief may be observed earlier.
Excretion
Primarily excreted in urine (approximately 70%) as metabolites, with a smaller amount in feces (approximately 20%).
Half life
Approximately 12 hours (range: 8-17 hours).
Absorption
Well-absorbed orally, peak plasma concentration reached in about 6 hours. Food may delay time to peak concentration but does not affect the extent of absorption.
Metabolism
Extensively metabolized in the liver by CYP1A2 and CYP2D6 to inactive metabolites.
Side Effects
Contraindications
- Hypersensitivity to duloxetine or any component of the formulation
- Concomitant use with Monoamine Oxidase Inhibitors (MAOIs) or within 14 days of discontinuing an MAOI
- Uncontrolled narrow-angle glaucoma
- Severe renal impairment (CrCl <30 mL/min)
- Severe hepatic impairment or end-stage renal disease
Drug Interactions
MAOIs
Risk of serotonin syndrome, hypertensive crisis. Avoid concomitant use.
Warfarin
Potential for increased bleeding risk due to altered coagulation.
Other SNRIs/SSRIs/Tricyclic Antidepressants
Increased risk of serotonin syndrome.
CYP2D6 Inhibitors (e.g., paroxetine, quinidine)
May increase duloxetine plasma levels.
CNS Depressants (e.g., alcohol, benzodiazepines)
Enhanced CNS depressant effects.
CYP1A2 Inhibitors (e.g., fluvoxamine, ciprofloxacin)
May increase duloxetine plasma levels.
Storage
Store in a cool, dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include somnolence, coma, serotonin syndrome, seizures, vomiting, and tachycardia. Treatment is supportive and symptomatic; activated charcoal may be considered. There is no specific antidote.
Pregnancy & Lactation
Pregnancy Category C. Duloxetine should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is excreted in human breast milk; therefore, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24 to 36 months from manufacturing date
Availability
Pharmacies, Hospitals
Approval Status
Approved by relevant authorities (e.g., FDA, DGDA)
Patent Status
Generics available
Clinical Trials
Duloxetine has undergone numerous clinical trials demonstrating its efficacy and safety for approved indications, including studies comparing it to placebo and other antidepressants.
Lab Monitoring
- Liver function tests (especially in patients with pre-existing liver disease or those consuming substantial amounts of alcohol)
- Renal function tests (for patients with renal impairment)
- Blood pressure (periodically)
Doctor Notes
- Advise patients on the importance of adherence and not to discontinue abruptly.
- Monitor for signs of worsening depression, suicidality, and serotonin syndrome.
- Caution in patients with a history of seizures or controlled narrow-angle glaucoma.
Patient Guidelines
- Take the medicine exactly as prescribed by your doctor.
- Do not stop taking this medicine abruptly without consulting your doctor, as withdrawal symptoms may occur.
- Report any unusual changes in mood, behavior, or suicidal thoughts immediately to your doctor.
- Avoid alcohol while taking this medicine.
- Be cautious when driving or operating machinery until you know how this medicine affects you.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is close to the time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
This medicine may cause dizziness, drowsiness, or blurred vision. Avoid driving or operating heavy machinery until you know how it affects you.
Lifestyle Advice
- Engage in regular physical activity.
- Maintain a balanced diet.
- Practice stress-reduction techniques (e.g., yoga, meditation).
- Ensure adequate sleep.
Alternative Medicines in Bangladesh
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Global Brand Names
International brand names for this medicine
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