Medicine Information

Dulox

Name: Dulox
Brand: Dulox
Rating: 4.5 (117 reviews)

Tablet30 mgAntidepressantsATC: N06AX21

Generic Name

Duloxetine

Manufacturer

Square Pharmaceuticals Ltd.

Country

Bangladesh

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Price Details

Current market pricing information

Variant	Unit Price	Strip Price
dulox 30 mg tablet	৳ 12.00	৳ 120.00

Description

Overview of the medicine

Duloxetine is a selective serotonin and norepinephrine reuptake inhibitor (SNRI) used to treat major depressive disorder, generalized anxiety disorder, diabetic peripheral neuropathic pain, chronic musculoskeletal pain, and fibromyalgia.

Uses & Indications

Major Depressive Disorder (MDD)

Generalized Anxiety Disorder (GAD)

Diabetic Peripheral Neuropathic Pain (DPNP)

Chronic Musculoskeletal Pain

Fibromyalgia

Dosage

Adults

Major Depressive Disorder/Generalized Anxiety Disorder: Initial dose 30 mg once daily for 1 week, then 60 mg once daily. Max 120 mg/day. Diabetic Peripheral Neuropathic Pain/Chronic Musculoskeletal Pain/Fibromyalgia: 60 mg once daily.

Elderly

No specific dose adjustment for elderly, but caution advised. Initiate at lower dose and monitor closely.

Renal_impairment

Avoid in severe renal impairment (creatinine clearance <30 mL/min). For moderate impairment, dose adjustment may be necessary. Consult physician.

How to Take

Take orally once daily, with or without food. Swallow the tablet whole; do not crush, chew, or open. Consistency in taking at the same time each day is recommended.

Mechanism of Action

Duloxetine works by increasing the levels of serotonin and norepinephrine, two natural substances in the brain that help maintain mental balance and stop the movement of pain signals in the body.

Pharmacokinetics

Onset

Antidepressant effects typically begin within 2-4 weeks. Pain relief may be observed sooner.

Excretion

Primarily excreted in urine (about 70%) and feces (about 20%) as metabolites.

Half life

Approximately 12 hours (range 8-17 hours).

Absorption

Well absorbed after oral administration, though food can decrease Cmax and delay Tmax. Bioavailability is about 50%.

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 MAOIs (Monoamine Oxidase Inhibitors) 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

Concomitant use is contraindicated due to increased risk of serotonin syndrome.

SSRIs and other SNRIs

Increased risk of serotonin syndrome.

Warfarin and other anticoagulants

Increased risk of bleeding due to duloxetine's effect on platelet aggregation.

CYP1A2 Inhibitors (e.g., fluvoxamine, ciprofloxacin)

May significantly increase duloxetine levels.

CYP2D6 Substrates (e.g., tricyclic antidepressants, risperidone, thioridazine)

Duloxetine is a moderate inhibitor of CYP2D6, potentially increasing concentrations of co-administered drugs metabolized by CYP2D6.

Storage

Store at room temperature (below 30°C), in a dry place, protected from light and moisture. Keep out of reach of children.

Overdose

Symptoms of overdose include somnolence, coma, serotonin syndrome, seizures, vomiting, and tachycardia. Management is primarily supportive; maintain an open airway, monitor cardiac and vital signs, and provide symptomatic and supportive care. Activated charcoal may be considered.

Pregnancy & Lactation

Pregnancy Category C. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is excreted in human milk; caution should be exercised when administered to a nursing woman. Consult your doctor.

Frequently Asked Questions

Common questions about this medicine

Pack Sizes

10 tablets per pack30 tablets per pack

Shelf Life

Typically 24-36 months from the date of manufacture, depending on the manufacturer.

Availability

Pharmacies and hospitals

Approval Status

Approved by FDA and DGDA

Patent Status

Generic available

Clinical Trials

Numerous clinical trials have established duloxetine's efficacy and safety across its approved indications, including major depressive disorder, generalized anxiety disorder, and various neuropathic and chronic pain conditions.

Lab Monitoring

Liver function tests (baseline and periodically)
Blood pressure (regularly)
Renal function (for patients with renal impairment)

Doctor Notes

Regularly monitor blood pressure, especially in patients with pre-existing hypertension.
Assess for suicidal ideation, particularly in pediatric, adolescent, and young adult patients at treatment initiation or dose changes.
Caution is advised in patients with a history of seizures, bipolar disorder (mania/hypomania), or severe gastrointestinal motility disorders.
Liver function tests should be monitored periodically.

Patient Guidelines

Do not stop duloxetine abruptly to avoid withdrawal symptoms; dosage should be gradually reduced under medical supervision.
Report any worsening of depression, suicidal thoughts, or unusual changes in behavior to your doctor immediately.
Avoid alcohol consumption while taking this medicine.
Be aware of symptoms of serotonin syndrome (e.g., agitation, hallucinations, rapid heart rate, fever).

Missed Dose Advice

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not double dose to catch up.

Driving Precautions

Duloxetine may cause dizziness, drowsiness, or blurred vision. Patients should be cautious when driving or operating hazardous machinery until they know how the medicine affects them.