Duloxetine Oral Capsule

• This drug has a Black Box Warning. This is the most serious warning from the Food and Drug Administration (FDA). A black box warning alerts doctors and patients to potentially dangerous effects.
• This drug may increase the risk of suicidal thoughts and behaviors in people aged 24 years and younger. This drug can make depression worse in the early stages of treatment. Tell your doctor right away if your depression gets worse or if you have thoughts about suicide.

• Drowsiness warning: This drug can cause sleepiness or affect your ability to make decisions, think clearly, or react quickly. You shouldn’t drive, operate heavy machinery, or do other dangerous activities until you know how the drug affects you.
• Serotonin syndrome warning: This drug affects a chemical in your brain called serotonin. Taking this drug with other medications that affect serotonin may result in increased risk of a serious side effect called serotonin syndrome. Symptoms may include:
  • agitation
  • confusion
  • increased blood pressure or heart rate
  • sweating
  • loss of coordination
• Dizziness and falling warning: This drug can cause a sudden drop in blood pressure if you stand up too fast. This can cause dizziness and increase your risk of falling.

Duloxetine oral capsule can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Examples of drugs that can cause interactions with promethazine are listed below.

Serotonergic drugs

Taking these drugs with duloxetine may increase your risk of serotonin syndrome, which can be fatal. If you take any of these drugs, your doctor will start you on a lowered dosage of duloxetine and monitor you for signs of serotonin syndrome. Symptoms can include agitation, sweating, muscle twitches, and confusion. Examples are: 

• selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine and sertraline
• serotonin-norepinephrine reuptake inhibitors (SSNRIs) such as venlafaxine
• tricyclic antidepressants (TCAs) such as amitriptyline and clomipramine
• monoamine oxidase inhibitors (MAOIs) such as selegiline and phenelzine
• the opioids fentanyl and tramadol
• the anxiolytic buspirone
• triptans
• lithium
• tryptophan
• St. John’s wort
• amphetamines

Schizophrenia drug

An example of this drug is:

• thioridazine

Taking both duloxetine and thioridazine can increase the amount of thioridazine in your body. This may increase your risk of an abnormal heart rate, or arrhythmia.

Nonsteroidal anti-inflammatory drugs

Taking both duloxetine and NSAIDs may increase your risk of abnormal bleeding. Examples are:

• ibuprofen
• indomethacin
• naproxen

Mental health drug

An example of this drug is:

• aripiprazole

Taking both duloxetine and aripiprazole may increase the amount of aripiprazole in your body. This can lead to unwanted side effects.

Iron toxicity drug

An example of this drug is:

• deferasirox

Taking both duloxetine and deferasirox may increase the amount of duloxetine in your body. This can lead to side effects.

Anticoagulants, blood thinners

These include:

• apixaban
• warfarin
• clopidogrel
• dabigatran
• edoxaban
• prasugrel
• rivaroxaban
• ticagrelor

Taking both duloxetine and blood thinners may increase your risk of abnormal bleeding.

Gaucher disease drug

An example of this drug is:

• eliglustat

Taking both duloxetine and eliglustat can increase the amount of eliglustat in your body. This may cause side effects on your heart.

Depression, and drug to stop smoking

• bupropion

Taking both duloxetine and bupropion may increase your risk of seizures.

Cancer drug

• doxorubicin

Taking both duloxetine and doxorubicin may increase the amount of doxorubicin in your body. This can lead to side effects.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

Keep these considerations in mind if your doctor prescribes duloxetine oral capsule for you.

General

Don’t crush or chew the delayed-release capsule.

Storage

Store this drug at room temperature: 68–77°F (20-25°C).

Refills

A prescription for this medication is refillable. You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Travel

When traveling with your medication:

• Always carry it with you or in your carry-on bag.
• Don’t worry about airport X-ray machines. They can’t hurt your medication.
• You may need to show your pharmacy’s preprinted label to identify the medication. Keep the original prescription-labeled box with you when traveling.

Clinical monitoring

Your doctor may monitor you for worsening or new suicidal thoughts and behaviors.

Insurance

Many insurance companies will require a prior authorization before they approve the prescription and pay for this drug.

There are other drugs available to treat your condition. Some may be more suitable for you than others. Talk to your doctor about possible alternatives.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.