Duloxetine
Brand: Cymbalta
Boxed warning
Suicidal thoughts and behaviors in children, adolescents, and young adults.
- Caution
- Liver injury: avoid with chronic liver disease or heavy alcohol use.
- Pregnancy
- Use only if clearly needed; third-trimester exposure can cause neonatal adaptation symptoms.
Common side effects
- Nausea
- Dry mouth
- Drowsiness
- Constipation
- Dizziness
Key interactions
- Serotonin syndrome risk with other serotonergic drugs
- Avoid combining with MAO inhibitors
- Increased bleeding risk with NSAIDs or blood thinners
- Limit alcohol due to liver risk
Counseling points
- Do not stop suddenly; taper as directed
- May take a few weeks to work fully
- Swallow capsule whole; do not crush
- Report worsening mood or suicidal thoughts
- Rise slowly to reduce dizziness
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