Has your doctor prescribed you a medication called Duloxetine? Maybe it's for your depression, anxiety, or a long-standing physical ache or nerve pain. Before you start taking this medication, you probably have a lot of questions in your mind. "What will happen with this?", "Are there any side effects?", "What should I be concerned about?" Don't worry, we'll talk about all of this in a simple way today, like with a friend.
What kind of medicine is Duloxetine?
Simply put, this is a drug that helps control your mood and pain. Our brains have a number of chemicals that carry messages. Serotonin and Norepinephrine are the two that mainly help control our happiness, mood, and how we feel about pain.
Sometimes, for various reasons, the levels of these chemicals in the brain can decrease. This is when we experience conditions like:
- Depression
- Generalized Anxiety Disorder
- Fibromyalgia - pain and fatigue throughout the body
- Nerve pain caused by diabetes
- Long-lasting bone or joint pain
Duloxetine works by increasing the levels of serotonin and norepinephrine in the brain, improving your mood and relieving pain. This class of drugs is medically known as SNRI (Serotonin-Norepinephrine Reuptake Inhibitor) .
Things you need to tell your doctor before starting medication
This is very important. Before you are prescribed Duloxetine, you should tell your doctor your complete medical history. Because we need to be very careful when using this medicine with certain medical conditions. If you have any of the following, be sure to inform your doctor .
| Illness or other condition | Why is it important to tell the doctor ? |
|---|---|
| Liver or kidney disease | These organs are responsible for removing drugs from the body. If their function is impaired, the dosage of the drug may need to be adjusted. |
| High blood pressure | Duloxetine can further increase blood pressure. |
| Glaucoma condition | There is a risk of increased eye pressure. |
| Bipolar disorder or mania | This medication can cause a manic state. |
| If you have had previous suicidal thoughts or attempts | You should be especially careful about these thoughts when you first start taking the medication. |
| If you are taking blood-thinning medications (e.g. Warfarin, Aspirin) | The risk of bleeding may increase. |
| If you have taken MAOI medication within the past 14 days | These two medications are not used together as a serious reaction may occur. |
| If you are pregnant, trying to get pregnant, or breastfeeding | You need to talk to your doctor about the possible effects on the baby. |
| If you have allergies to other medicines, foods, or dyes | Be aware of the possibility of an allergic reaction to Duloxetine. |
How should I use the medicine?
Take your medicine exactly as your doctor has prescribed, at the time prescribed. You can usually take it with a glass of water. It doesn't matter whether you take it before or after a meal.
Very important: Do not break, crush, or chew the capsules of this medicine. Doing so may cause the medicine to be absorbed into the body too quickly and increase side effects. Some types of capsules can be opened and mixed with something like applesauce. But check with your doctor before taking this.
What if I miss a dose of medicine?
Take the missed dose as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take the next dose at the scheduled time. Never take two doses at the same time.
Do not stop taking the medicine suddenly!
This is the most important thing to remember. Do not stop taking this medication suddenly without your doctor's advice. Doing so may cause withdrawal symptoms such as dizziness, nausea, headaches, and insomnia. If you do stop, you should gradually reduce the dose as directed by your doctor.
What if I take too much medicine?
If you think you have accidentally taken too much medicine, go to the nearest Emergency Department (ETU) immediately. Or call the National Poisons Information Centre at the Colombo National Hospital .
Things to consider when taking medication
It's important to pay some attention to your body while taking Duloxetine.
- Changes in symptoms: You may not notice much difference for a few weeks after starting the medication. But don't worry. It can take 4-6 weeks for the medication to take full effect. So continue taking the medication as directed by your doctor. If your symptoms do not improve or get worse, tell your doctor.
- Suicidal thoughts: Especially in young people and when first starting the medication, sudden changes in mood, agitation, irritability, or suicidal thoughts may occur. If you notice any of these changes, tell your doctor or a family member right away. This is very important.
- Skin reactions: Although rare, some people may experience a serious skin reaction. If you experience fever, body aches, red, scaly skin, blistering, or peeling skin, seek medical attention immediately.
- Drowsiness and dizziness: This medicine may make you feel drowsy and dizzy. Therefore , avoid driving or operating machinery until you know how this medicine affects you. Stand up slowly when you get up from a sitting position or when you get out of bed.
- Alcohol: Avoid drinking alcohol while taking Duloxetine. Alcohol can increase the side effects of the drug (especially liver damage).
- Blood pressure and sugar: This medicine may increase blood pressure. If you have diabetes, be careful about your blood sugar levels. Your doctor will tell you to check these regularly.
Possible side effects of the medicine
Like any medicine, Duloxetine can have side effects. Not everyone gets them. The table below shows what they are and what to do if they happen.
| Side effect | Description |
|---|---|
| Serious side effects that should be reported to your doctor immediately | |
| Serious allergies | Skin rash, itching, swelling of the face, lips, tongue, difficulty breathing. |
| Serotonin Syndrome | Anxiety, rapid heartbeat, tremors, excessive sweating, fever, vomiting, diarrhea. |
| Liver damage | Pain in the upper right side of the abdomen, loss of appetite, yellowing of the eyes/skin, dark urine. |
| Abnormal bleeding | Black stools, vomiting blood, red/purple spots on the skin, and unexplained bruising. |
| Eye pain/vision changes | Sudden eye pain, blurred vision, seeing rings around lights. |
| Side effects that are usually not serious, but should be reported to the doctor if they persist | |
| Nausea/vomiting | It can occur frequently in the early stages. |
| Dry mouth | Chewing sugar-free gum and drinking water can help. |
| Constipation/diarrhea | Ask your doctor about dietary changes. |
| Appetite | It can heal in a short time. |
| Excessive sweating | Wearing light clothing will help. |
| Changes in sexual desire/function | Don't be shy about this and talk to your doctor. |
Take-Home Message
- Duloxetine is an effective medication for depression, anxiety, and some pain conditions, but it should only be used under medical supervision.
- Tell your doctor about any other medications you are taking and any medical conditions you have before starting the medication.
- Do not stop taking the medication suddenly. If you do, do so as directed by your doctor, gradually reducing the dosage.
- Be very aware of any changes in your mood , especially suicidal thoughts, during the initial stages of taking the medication. If you notice any changes, seek help immediately.
- If you experience any serious side effects (skin blisters, difficulty breathing, high fever), see a doctor immediately.
- If you have any questions about this medicine, don't be shy and ask your doctor . You have every right to be informed about your health.
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