Adapted from The Faculty of Pain Medicine, Royal College of Anaesthetists, patient information booklet. Original can be accessed at: https://fpm.ac.uk/sites/fpm/files/documents/2019-08/Duloxetine2017.pdf
Why have I been prescribed duloxetine?
• Duloxetine is used to treat some types of persistent pain.
• It is especially good for nerve pain, such as burning, shooting or
stabbing pain, and for pain that keeps you awake at night.
• Duloxetine belongs to the group of medicines called Serotonin
Noradrenergic Reuptake Inhibitors (SNRI) that are also used to treat
depression.
• You may notice that information from the manufacturer may not
mention your type of pain.
How does duloxetine work?
• Duloxetine works by changing the amount of specific nerve
transmitters in the nervous system, reducing pain messages arriving
in the brain.
When should I take it?
• It is best to take duloxetine at the same time each day. Most people
take it in the morning. If you find that you feel drowsy after taking it
in the morning, try taking it in the evening.
How is duloxetine taken?
• The capsules should be swallowed whole, with a glass of water.
• Duloxetine may be taken on an empty or full stomach.
• You will be told how much to start taking and when to increase the
dose.
• Do not take more than prescribed.
How long will it take to work?
• Every patient is different. You may notice some initial benefit within 1
week, however it may take up to 1 month for a full effect. Your doctor
may need to increase the dose to get the maximum effect.
• Duloxetine does not work for everyone. If you do not feel any improvement in
your pain, do not suddenly stop taking the tablets but speak to your doctor.
What are the possible side effects?
• Most side effects are mild and can be expected to reduce after a few
doses.
• Common side effects include; headache, drowsiness, sickness
(nausea), dizziness, blurred vision and dry mouth. If you have these
side effects and they are severe contact your doctor or pharmacist for
advice.
• Less common side effects include loss of appetite, flushes, raised
blood pressure, difficulty sleeping, feeling anxious, shaky and
increased sweating. If any of these side effects occur contact your
doctor or pharmacist for advice.
Can I take this medication long-term?
• Yes, if it helps. You may wish to reduce treatment every so often,
to check if your pain is still a problem. This should be done with
the advice of your GP or pain specialist, gradually reducing your
medication over a period of time.
Can I drink alcohol?
• Alcohol increases the sedative effects of duloxetine, it is best not
to drink alcohol when you start taking it. Once settled on a steady
dose, you may drink alcohol in moderation but it may make you more
drowsy than normal.
Can I drive?
• Duloxetine may cause drowsiness. If this happens, do not drive.
What should I tell the doctor?
• If you are allergic to any drugs
• If you are taking any other medicines or herbal medicines
• If you have epilepsy or a glaucoma
• If you are taking any medicine that causes sleepiness (e.g. strong
painkillers such as morphine) or increases the level of serotonin (e.g.
tramadol, SSRIs and SNRIs taken for depression)
• If you are pregnant or breastfeeding, or if you are planning to
become pregnant in the future
• If you take any anticoagulants, antiplatelet agents or other drugs to
thin the blood.
• If you have or have had a mental health problem
• If you have kidney or liver problems
• If you are taking any antidepressant
• If you are taking ciprofloxacin, an antibiotic used to treat infections
What if I forget or miss a dose?
• If you forget a dose then you can consider taking it when you
remember that night but this may result in sleepiness the following
day and affect your concentration, work or driving ability. The
alternative is to wait until the next dose is scheduled.
• If you only take one dose in the morning and you miss the dose, do
not take the medicine in the evening. Wait until the next morning
and skip the missed dose.
• Do not take two doses together.
What if I want to stop taking duloxetine?
• If you stop taking duloxetine suddenly, you might experience
withdrawal symptoms. Speak to your healthcare professional (doctor,
nurse, pharmacist) who will be able to supervise a gradual reduction.