Medicine Overview of Loxetine 20mg Tablet
Loxetine 20 is a prescription medicine used in the treatment of depression, anxiety disorder, diabetic nerve pain, fibromyalgia (a condition in which there are generalized pain and tenderness in the body), neuropathic pain and stress urinary incontinence.
Loxetine 20 works by increasing the level of chemical messengers (serotonin and noradrenaline) in the brain that have a calming effect on the brain and relax the nerves, thus treating your illness. It may be taken with or without food. It is advised to take this medicine at a fixed time each day to maintain a consistent level in the blood. If you miss any doses, take it as soon as you remember. Do not skip any doses and finish the full course of treatment even if you feel better. It is important that this medication is not stopped suddenly as it may worsen your symptoms.
Some common side effects of this medicine include nausea, headache, and dry mouth. It even causes dizziness and sleepiness, so do not drive or do anything that requires mental focus until you know how this medicine affects you. However, these side effects are temporary and usually resolve on their own in some time. Please consult your doctor if these do not subside or bother you.
Before taking Loxetine 20, inform your doctor if you have any problems with your kidneys, heart, liver, or have a history of seizures (epilepsy or fits). Inform your doctor if you develop any unusual changes in mood or behavior, new or worsening depression, or if you have any suicidal thoughts.
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- Depression
- Anxiety disorder
- Diabetic nerve pain
- Fibromyalgia
- Neuropathic pain
- Stress urinary incontinence
- Nausea
- Headache
- Dryness in mouth
- Sleepiness
- Dizziness
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Duzela 20 Capsule DR helps in treating depression and anxiety.
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It may also be used to treat nerve pain from diabetes and some other forms of chronic pain.
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It may take 2 to 4 weeks for Duzela 20 Capsule DR to start working. Keep taking it as prescribed.
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It may cause dizziness and sleepiness. Do not drive or do anything requiring concentration until you know how it affects you.
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Avoid consuming alcohol when taking Duzela 20 Capsule DR as it may cause excessive drowsiness and increase the risk of liver damage.
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It may cause an increase in blood pressure, especially during the first month of treatment. Monitor your blood pressure regularly.
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It may cause a sensation of restlessness, especially when you first start taking it. Inform your doctor if this happens to you.
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Talk to your doctor if you notice sudden mood changes or develop suicidal thoughts.
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Do not stop taking the medication suddenly without talking to your doctor.
Oral
Major Depressive Disorder
Adult: Initially, 20-30 mg bid or 60 mg once daily, then increase dose in increments of 30 mg/day over 1 wk as tolerated. Max: 120 mg/day.
Diabetic Peripheral Neuropathic Pain
Adult: 60 mg once daily. Max: 120 mg/day in divided doses.
Generalized Anxiety Disorder
Adult: 30 or 60 mg once daily. Max: 120 mg/day.
Fibromyalgia
Adult: Initially, 30 mg once daily for 1 wk, then increase to 60 mg once daily.
Elderly
Major Depressive Disorder
May initiate at 20 mg PO qDay or divided BID; increase to 40-60 mg qDay or divided doses; alternatively, initiate at 30 mg/day for 1 week, then increase to 60 mg/day as tolerated
Generalized Anxiety Disorder
30 mg/day PO qDay initially; after 2 weeks, consider increasing to target dose of 60 mg/day
Some patients may benefit from doses >60 mg/day; if increased beyond 60 mg/day, use increments of 30 mg/day
Maximum dose studied was 120 mg/day; safety of doses >120 mg/day has not been evaluated
Hepatic Impairment
Avoid use in patients with chronic liver disease or cirrhosis
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Generalized Anxiety Disorder
<7 years: Safety and efficacy not established
7-17 years: 30 mg PO qDay initially; after 2 weeks, may consider increasing dose to 60 mg/day
Recommended dosage range: 30-60 mg/day
Some patients may benefit from doses >60 mg/day; if increased beyond 60 mg/day, use increments of 30 mg/day
Maximum dose studied was 120 mg/day; safety of doses >120 mg/day has not been evaluated
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Renal Impairment
Avoid use in patients with severe renal impairment (GFR <30 mL/min)
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Duloxetine is a potent inhibitor of neuronal reuptake of serotonin, norepinephrine and to a lesser extent dopamine. It has no significant affinity for adrenergic, muscarinic, cholinergic, histaminergic, opioid, glutamate and GABA receptors. It also does not inhibit monoamine oxidase.
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Avoid alcohol and abrupt cessation. May impair ability to drive or engage in task requiring alertness. Increased risk of suicidal thinking and behaviour when used in children and adolescents. Pregnancy, lactation.
Lactation: Drug enters breast milk; use not recommended unless benefits greatly outweigh risks
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>10%
Nausea (23-25%),Dry mouth (13-15%),Headache (13-14%),Somnolence (10-12%),Fatigue (10-11%)
1-10%
Constipation (10%),Dizziness (10%),Insomnia (10%),Diarrhea (9-10%),Anorexia (8%),Decreased appetite (7-8%),Abdominal pain (6%),Hyperhidrosis (6%),Increased sweating (6%),Agitation (5%),Nasopharyngitis (5%),Vomiting (3-5%),Male sexual dysfunction (2-5%),Abdominal pain (4%),Decreased libido (4%),Musculoskeletal pain (4%),Upper respiratory tract infection (URTI) (4%),Abnormal orgasm (3%),Agitation (3%),Anxiety (3%),Blurred vision (3%),Cough (3%),Influenza (3%),Muscle spasms (3%),Tremor (3%),Abnormal dreams (2%),Dyspepsia (2%),Hot flushes (2%),Nausea (2%),Oropharyngeal pain (2%),Palpitations (2%),Paresthesia (2%),Weight loss (2%),Yawning (2%),Dysuria (>1%),Gastritis (>1%),Rash (>1%)
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Pregnancy
There are no adequate and well-controlled studies administration in pregnant women
Use in pregnancy only if the potential benefit justifies the potential risk to the fetus
Clinical considerations
Neonates exposed during pregnancy to serotonin – norepinephrine reuptake inhibitors (SNRIs) or selective serotonin reuptake inhibitors (SSRIs) have developed complications requiring prolonged hospitalization, respiratory support, and tube feeding which can arise immediately upon delivery
Reported clinical findings have included respiratory distress, cyanosis, apnea, seizures, temperature instability, feeding difficulty, vomiting, hypoglycemia, hypotonia, hypertonia, hyperreflexia, tremor, jitteriness, irritability, and constant crying
These features are consistent with either a direct toxic effect of the SNRIs or SSRIs, or possibly, a drug discontinuation syndrome
In some cases, the clinical picture is consistent with serotonin syndrome
Data from the published literature report the presence of duloxetine in human milk
There are no data on the effect of duloxetine on the breastfed infant or on milk production
Women given 40 mg of duloxetine PO BID for 3.5 days; peak concentration measured in breast milk occurred at a median of 3 hrs post-dose
Amount of duloxetine in breast milk was ~7 mcg/day while on that dose; estimated daily infant dose was ~2 mcg/kg/day, which is <1% of the maternal dose
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Increased risk of serotonin syndrome w/ TCA, SSRI, SNRI, lithium. May increase bleeding risk w/ aspirin, NSAIDs, warfarin and other anticoagulants.
Potentially Fatal: Increased risk of serotonin syndrome w/ MAOIs, linezolid and methylene blue. Increased serum levels and risk of toxicity w/ potent CYP1A2 inhibitors (e.g. ciprofloxacin, enoxacin).
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