Duloxetine Dosage

The information at Drugs.com is not a substitute for medical advice. ALWAYS consult your doctor or pharmacist.

Usual Adult Dose for:

Additional dosage information:

Usual Adult Dose for Depression

Initial dose: 20 mg orally twice a day
Maintenance dose: 60 mg per day, given either once a day or as 30 mg orally twice a day
Maximum dose: 120 mg orally per day
Duration: Acute episodes generally require several months or more of sustained pharmacological therapy; a periodic review of the need for ongoing maintenance treatment and appropriate dosing is recommended.

Comments:
-Some patients may require 30 mg orally once day for 1 week, before increasing the dose to 60 mg per day
-Data are lacking to show that doses greater than 60 mg per day confer any additional benefits.

Use: Treatment of major depressive disorder (MDD)

Usual Adult Dose for Fibromyalgia

Initial dose: 30 mg orally once a day for 1 week
Maintenance dose: 30 to 60 mg orally once a day
Duration: Efficacy has been demonstrated for up to 3 months in placebo-controlled studies; effectiveness beyond this has not been demonstrated in longer studies; therefore, continued treatment should be based on individual patient response.

Comments:
-There is no evidence that doses greater than 60 mg per day confer additional benefit; higher doses are associated with a higher rate of side effects.

Usual Adult Dose for Generalized Anxiety Disorder

Initial dose: 60 mg orally once a day, increased in increments of 30 mg once a day if clinically appropriate
Maintenance dose: 60 to 120 mg orally once a day
Maximum dose: 120 mg orally once a day
Duration: Episodes generally require several months or more of sustained pharmacological therapy; a periodic review of the need for ongoing maintenance treatment and appropriate dosing is recommended.

Comments:
-Some patients may require 30 mg orally once day for 1 week, before increasing the dose to 60 mg per day
-Data are lacking to show that doses greater than 60 mg per day confer any additional benefit.
-Maintenance of efficacy has been demonstrated with duloxetine monotherapy.

Usual Adult Dose for Pain

Initial dose: 30 to 60 mg orally once a day
Maintenance dose: 60 mg orally once a day
Duration:
-Diabetic peripheral neuropathy pain: Efficacy beyond 12 weeks has not been established; effectiveness should be based on individual patient response.
-Chronic musculoskeletal pain: Efficacy beyond 13 weeks has not been established.

Comments:
-Some patients for whom tolerability may be a concern may require 30 mg orally once day for 1 week, before increasing the dose to 60 mg per day.
-There is no evidence that doses greater than 60 mg per day confer additional benefit; higher doses are associated with a higher rate of side effects.

Uses: Management of neuropathic pain associated with diabetic peripheral neuropathy; management of chronic musculoskeletal pain in patients with chronic low back pain and chronic pain due to osteoarthritis.

Renal Dose Adjustments

CrCl 30 mL/min or less: Use is not recommended

Liver Dose Adjustments

Liver dysfunction: Use is not recommended

Dose Adjustments

Treatment withdrawal:
-Tapering of the dose is recommended for therapy lasting over 1 week.
-The dose should be gradually reduced over at least 2 weeks
-If intolerable symptoms occur, it is recommended to consider resuming the previously prescribed dose and to decrease the dose at a more gradual rate.

Switching from duloxetine to a MAOI intended to treat psychiatric disorders: At least 5 days should elapse after stopping duloxetine and starting a MAOI

Switching from a MAOI intended to treat of psychiatric disorders to duloxetine: At least 14 days should elapse after stopping a MAOI and starting duloxetine therapy

Patients with substantial alcohol use: Use is not recommended

Caution is recommended when increasing the dose in elderly patients.

Precautions

US BOXED WARNING(S):
Suicidal thoughts and behaviors
-Antidepressants increased the risk of suicidal thoughts and behavior in children, adolescents, and young adults in short-term studies. These studies did not show an increase in the risk of suicidal thoughts and behavior with antidepressant use in patients over age 24; there was a reduction in risk with antidepressant use in patients aged 65 and older.
-In patients of all ages who are started on antidepressant therapy, monitor closely for worsening, and for emergence of suicidal thoughts and behaviors. Advise families and caregivers of the need for close observation and communication with the prescriber.
-Duloxetine is not approved for use in pediatric patients.

Consult WARNINGS section for additional precautions.

Dialysis

Hemodialysis: Use is not recommended
Peritoneal dialysis: Data not available

Other Comments

Administration advice:
-Doses may be taken without regard to meals
-Swallow doses whole; do not chew or crush the capsules
-The capsule should not be opened nor its contents sprinkled on food or mixed with liquids

General:
-Caution is recommended in patients with conditions that may slow gastric emptying as duloxetine is rapidly hydrolyzed under acidic conditions and there are no data regarding the effect that alterations in gastric motility may have on the stability of duloxetine's enteric coating.

Monitoring:
-Cardiovascular: Blood pressure
-Psychiatric: Emergence or worsening of depression, suicidal thoughts or behavior, and/or unusual changes in mood or behavior
-Renal: Renal function

Patient advice:
-Antidepressant drugs, including this medicine, may increase the risk of suicidal thoughts and behavior. Be alert for the emergence or worsening of symptoms of depression, any unusual changes in mood or behavior, or the emergence of suicidal thoughts, behavior, or thoughts about self-harm. Report any behavior of concern to your healthcare provider as soon as possible.
-Tell your healthcare provider about all of the medicines that you take, including prescription and non-prescription medicines.
-This medicine may cause drowsiness and dizziness; do not drive a car or operate dangerous machinery until you know how this drug affects you.

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