A tiny number of youngsters, teenagers, and young adults (up to 24 years old) who took mood-elevating antidepressants like duloxetine during clinical research developed suicide thoughts (thinking about harming or killing oneself or planning or trying to do so). Children, teenagers, and young adults who take antidepressants to treat depression or other mental diseases may have a higher risk of committing suicide than those who do not take these medications. However, experts disagree on how significant this risk is and how much it has to be taken into account when determining whether or not a kid or adolescent should take an antidepressant. Duloxetine is typically not recommended for use in people under the age of 18, however in some circumstances, a doctor may determine that it is the best treatment option for a child’s illness.

Even if you are an adult above the age of 24, you should be aware that taking duloxetine or other antidepressants may cause your mental health to change in unexpected ways. Even if you don’t have a mental disorder and are taking duloxetine to treat anything else, these changes could still happen. Suicidal thoughts may come to mind, especially at the start of treatment and whenever your dose is changed. If you have any of the following symptoms, you should call your doctor right once. This goes for you, your family, or your carer. A new or worsening depression, thoughts of self-harm or suicide, plans or attempts to carry them out, excessive worry, agitation, panic attacks, trouble falling or staying asleep, hostile or aggressive behaviour, irritability, acting without thinking, extreme restlessness, frenzied abnormal excitement, or any other unusual changes in behaviour should be reported. Make sure your family or carer keeps an eye on you every day and is aware of any symptoms that might be dangerous so they can call the doctor if you are unable to call for help yourself.

If you are taking duloxetine, your doctor will want to visit you frequently, especially at the start of your treatment. Make sure to show up for all of your doctor’s appointment times.

When you start your duloxetine treatment, your doctor or pharmacist will give you the patient information sheet (Medication Guide) from the manufacturer. If you have any questions, carefully read the material and contact your doctor or pharmacist. The FDA website (http://www.fda.gov/Drugs/DrugSafety/ucm085729.htm) also offers the Medication Guide.

No of your age, you, your parent, or your carer should discuss the advantages and disadvantages of treating your disease with an antidepressant or with alternative treatments with your doctor before starting an antidepressant. The dangers and advantages of not treating your ailment should also be discussed. You should be aware that your chance of committing suicide is significantly increased if you suffer from depression or any mental disorder. This risk is increased if you or anybody in your family currently has, or previously had, depression, mania (a frenetic, overly exuberant mood), bipolar disorder, or has had suicidal thoughts or attempts. Discuss your ailment, symptoms, and personal and family medical history with your doctor. The best course of therapy for you will be decided by you and your doctor.

Generalized anxiety disorder (GAD; excessive concern and stress that interferes with daily living and lasts for six months or longer) in adults and children seven years of age and older is treated with duloxetine. Duloxetine is also used to treat fibromyalgia, a chronic condition that can cause pain, muscle stiffness and tenderness, fatigue, and difficulty falling or staying asleep in adults and children 13 years of age and older. Diabetic neuropathy is a condition in which damage to the nerves can occur in people who have diabetes. It is also used to treat individuals with osteoarthritis (joint pain or stiffness that may increase over time), lower back pain, and other chronic bone or muscle discomfort. A group of drugs known as selective serotonin and norepinephrine reuptake inhibitors includes duloxetine (SNRIs). It functions by raising levels of serotonin and norepinephrine, two naturally occurring chemicals in the brain that support mental equilibrium and slow the transmission of pain impulses.

Duloxetine is available as a delayed-release capsule that must be swallowed. This prevents the medication from being broken down by stomach acids. Duloxetine is often used once or twice day, with or without food, to treat depression. Duloxetine is often given once day with or without food to treat generalised anxiety disorder, the discomfort of diabetic neuropathy, fibromyalgia, or persistent bone or muscular pain. Every day, take duloxetine around the same time(s). Ask your doctor or pharmacist to explain any instructions on your prescription label that you are unsure about following. Administer duloxetine as prescribed. Never take it in larger or less amounts, more frequently, or for a longer period of time than your doctor has instructed.

Do not break, chew, or crush the delayed-release capsules; instead, swallow them whole. The contents of the delayed-release capsules should not be mixed with beverages or sprinkled on food.

After a week, your doctor may raise the medicine dose that you are taking.

Although it won’t treat your disease, duloxetine may help you manage your symptoms. Before you experience the full benefits of duloxetine, it could take 1 to 4 weeks or longer. Even if you are feeling OK, keep taking duloxetine. Without consulting your doctor, do not discontinue taking duloxetine. Your dose will likely be gradually reduced by your doctor. Duloxetine withdrawal symptoms include nausea, vomiting, diarrhoea, anxiety, dizziness, fatigue, headache, pain, burning, numbness, or tingling in the hands or feet, irritability, difficulty falling asleep or staying asleep, sweating, and nightmares. These symptoms may occur if you abruptly stop taking duloxetine. When your duloxetine dosage is reduced, let your doctor know if you encounter any of these side effects.

In addition, duloxetine is occasionally prescribed to women who experience stress incontinence, which is the loss of urine while laughing, sneezing, coughing, or exercising. Discuss using this medication to treat your condition with your doctor.

Ask your doctor or pharmacist for more details if you believe this drug should be used for something else.

Before taking duloxetine,

• If you have any allergies, including to drugs, foods, or any of the substances in duloxetine delayed-release capsules, notify your doctor right away. For a list of the ingredients, ask your doctor or pharmacist.
• Inform your physician if you’re using thioridazine, an MAO inhibitor (such as isocarboxazid (Marplan), linezolid (Zyvox), methylene blue, phenelzine (Nardil), selegiline (Emsam, Zelapar), or tranylcypromine (Parnate), or if you’ve just discontinued taking an MAO inhibitor. Most likely, your doctor will advise against using duloxetine. You should wait at least 5 days after stopping duloxetine before starting an MAO inhibitor.
• Inform your doctor and pharmacist about any additional prescription drugs, over-the-counter remedies, and vitamins you are now taking or intend to use. Incorporate any of the following: amphetamines such as methamphetamine (Desoxyn), dextroamphetamine (Dexedrine), and amphetamine (in Adderall, among others); warfarin (Coumadin, Jantoven), an anticoagulant (also known as “blood thinner”); antidepressants such amitriptyline (Elavil), amoxapine (Asendin), clomipramine (Anafranil), desipramine (Norpramin), doxepin (Adapin, Sinequan), imipramine (Tofranil), nortriptyline (Aventyl, Pamelor); ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), and other nonsteroidal anti-inflammatory medicines (NSAIDs); buspirone; cimetidine (Tagamet); ciprofloxacin (Cipro); diuretics (water pills); and fentanyl (Abstral, Actiq, Fentora, Onsolis, and others); pharmaceuticals for anxiety, high blood pressure, mental illness, pain, and nausea; medications for irregular heartbeat such as amiodarone (Cordarone), flecainide (Tambocor), moricizine (Ethmozine), propafenone (Rythmol), and quinidine (in Nuedexta);such as sumatriptan (Imitrex, Onzetra, Tosmyra, in Treximet), almotriptan (Relpax), eletriptan (Relpax), frovatriptan (Frova), naratriptan (Amerge), rizatriptan (Maxalt), and zolmitriptan (Zomig); sedatives; lansoprazole (Prevacid), omeprazole (Prilosec), pantoprazole (Protonix), and rabeprazole (Aciphex) are examples of proton pump inhibitors, Some selective serotonin reuptake inhibitors (SSRIs), including sleeping medications, theophylline (Theo-24, Theochron), tramadol (Ultram), and fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), and paroxetine (Paxil). Tell your doctor about all the medications you are taking, including any not on this list, as many other drugs may interact with duloxetine. Your physician might need to adjust the dosage of your drugs or keep a close eye on you for side effects.
• Inform your doctor about any dietary supplements and herbal remedies you are using, especially if they contain tryptophan or St. John’s wort.
• Inform your doctor if you regularly consume excessive amounts of alcohol, have ever used street drugs, or have ever taken prescription medications in excess. Tell your doctor if you have glaucoma, high blood pressure, seizures, coronary artery disease, bleeding issues, slow stomach emptying, heart, liver, or kidney disease, as well as any of the following: low sodium levels in your blood, glaucoma (increased eye pressure that may result in blindness), recent heart attack, high blood pressure, or any of the following: seizures, coronary artery disease, bleeding issues, bleeding problems. If you have diabetes, be careful to discuss the severity of your illness with your doctor so they can determine whether duloxetine is a good fit for you.
• If you are pregnant, particularly if you are in the last few months of your pregnancy, if you plan to get pregnant, or if you are breast-feeding, let your doctor know. Call your doctor if you become pregnant while taking duloxetine. If duloxetine is taken in the final months of pregnancy, it may have negative effects on babies after birth.
• You should let your doctor or dentist know if you are taking duloxetine if you are having surgery, including dental surgery.
• Duloxetine may cause you to feel sleepy, lightheaded, or impact your judgement, thinking, or coordination. Prior to understanding how this drug affects you, avoid using machinery or driving a car.
• Inquire with your doctor if drinking alcohol is okay for you to do while taking duloxetine. Duloxetine’s potentially harmful side effects can be made more likely by alcohol.
• You should be aware that if you stand up too rapidly from a laying position while taking duloxetine, you could have dizziness, lightheadedness, and fainting. When you initially start taking duloxetine or when the amount is increased, this happens more frequently. Get out of bed gradually, resting your feet on the floor for a few minutes before standing up, to avoid this issue.
• You need to be aware that duloxetine might raise blood pressure. Before commencing treatment and on a frequent basis going forward, get your blood pressure tested.
• Duloxetine may cause angle-closure glaucoma, as you should be aware (a condition where the fluid is suddenly blocked and unable to flow out of the eye causing a quick, severe increase in eye pressure which may lead to a loss of vision). Ask your doctor if you should get your eyes checked before beginning this medicine. Call your doctor or get emergency medical attention right away if you are experiencing nausea, eye pain, changes in your vision, such as seeing coloured rings around lights, or swelling or redness in or around your eyes.

Keep eating normally unless your doctor instructs you otherwise.

If you miss a dosage, take it as soon as you recall. If the next dose is soon due, skip the missed one and carry on with your regular dosing plan. To make up for a missing dose, do not take a second one.

Side effects from duloxetine are possible. If any of these symptoms are severe or do not go away, let your doctor know right once:

• Nausea
• Vomiting
• Constipation
• Diarrhoea
• Weight fluctuates
• Heartburn
• Abdominal pain
• Reduction in appetite
• Mouth ache
• More frequent urination
• Nocturnal sweats or perspiration
• Dizziness
• Headache
• Weight fluctuates
• Tiredness
• Drowsiness
• Cramping or aching muscles
• Male sexual dysfunction includes reduced sex desire, difficulty getting or maintaining an erection, and delayed or nonexistent ejaculation
• Sexual issues in women, including diminished sex desire, delayed orgasm, orgasm incapacity
• Body part shaking that is uncontrollable

Some adverse effects may be severe. Get emergency medical care or call your doctor right away if you develop any of the side effects listed below or those in the IMPORTANT WARNING or SPECIAL PRECAUTIONS sections:

• Significant bruising or bleeding
• Stomach ache in the top right corner
• Abdomen-related edoema
• Itching
• Eyes or skin that have a yellow tint
• Urine with a dark colour
• Reduced appetite
• Excessive fatigue or sluggishness
• Confusion
• Shaky gait that could lead to falling
• Flu-like signs
• Significant muscle stiffness or twitching, lack of coordination, fever, sweating, confusion, anxiety, nausea, vomiting, or diarrhoea
• Seizures
• Hallucinations (seeing things or hearing voices that do not exist)
• Fever
• Flaking or blistering skin
• Rash
• Hives
• Breathing or swallowing challenges
• Edoema of the hands, feet, ankles, lower legs, cheeks, neck, tongue, lips, and eyes
• Hoarseness
• Having trouble urinating

Children who use duloxetine may experience decreased appetite and weight loss. The physician for your child will keep a close eye on their development. If you are worried about your child’s weight gain or growth while taking this medicine, talk to your child’s doctor. The hazards of providing your child duloxetine should be discussed with your child’s doctor.

Further negative effects of duloxetine could exist. If you experience any strange issues while taking this medicine, contact your doctor right away.

You or your doctor can submit a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting programme online or by phone if you have a serious side event (1-800-332-1088).

Keep this medication tightly closed in the original container and out of the reach of children. Keep it away from excessive heat and moisture at room temperature (not in the bathroom).

Unused prescriptions must be disposed of carefully to prevent pets, kids, and other people from ingesting them. You should not, however, dispose of this medication in the toilet. Instead, utilising a medicine take-back programme is the easiest approach to get rid of your medication. To find out about take-back programmes in your area, speak with your pharmacist or the garbage/recycling department in your city. If you do not have access to a take-back programme, see the FDA’s Safe Disposal of Medications website at http://goo.gl/c4Rm4p for additional information.

Although many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and are simple for young children to open, it is crucial to keep all medications out of sight and out of reach of children. Always lock safety caps and promptly stash medication up and away from young children where it is out of their sight and reach to prevent poisoning. http://www.upandaway.org

Call the poison control hotline at 1-800-222-1222 in the event of an overdose. Moreover, information can be found online at https://www.poisonhelp.org/help. Call 911 right once if the person has collapsed, experienced a seizure, is having difficulty breathing, or cannot be roused.

Symptoms of overdose may include the following:

• Agitation
• Hallucinating (seeing things or hearing voices that do not exist)
• Rapid heart rate
• Fever
• Inability to coordinate
• Nausea
• Vomiting
• Diarrhea
• Drowsiness
• Seizures
• Dizziness
• Lightheadedness
• Fainting
• Unresponsiveness

Keep all of your doctor’s appointments.

No one else should take your medication. Any queries you may have regarding medication refills should be directed to your pharmacist.

You should keep a written record of every medication you take, including any over-the-counter (OTC) items, prescription drugs, and dietary supplements like vitamins and minerals. This list should be brought with you whenever you see a doctor or are admitted to the hospital. You should always have this information with you in case of emergencies.