Duloxetine Side Effects
Medically reviewed by Drugs.com. Last updated on Oct 5, 2020.
Commonly reported side effects of duloxetine include: asthenia, constipation, diarrhea, dizziness, drowsiness, fatigue, hypersomnia, insomnia, nausea, sedated state, headache, and xerostomia. Other side effects include: agitation, erectile dysfunction, nervousness, psychomotor agitation, tension, vomiting, abdominal pain, anorexia, decreased appetite, decreased libido, hyperhidrosis, loss of libido, and restlessness. See below for a comprehensive list of adverse effects.
For the Consumer
Applies to duloxetine: oral capsule delayed release
Oral route (Capsule, Delayed Release)
Antidepressants increased the risk of suicidal thinking 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 or older.Closely monitor all antidepressant-treated patients for clinical worsening, and for emergence of suicidal thoughts and behaviors. Advise families and caregivers of the need for close observation and communication with the prescriber.
Side effects requiring immediate medical attention
Along with its needed effects, duloxetine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur while taking duloxetine:
Incidence not known
- Abdominal or stomach pain
- area rash
- blistering, peeling, or loosening of the skin
- blurred vision
- change in consciousness
- clay-colored stools
- cold sweats
- dark urine
- decreased urine output
- decreased vision
- difficulty with swallowing
- dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
- eye pain
- fast or irregular heartbeat
- general tiredness or weakness
- hives or welts, itching, or skin rash
- hives, itching, puffiness, or swelling of the eyelids or around the eyes, face, lips, or tongue
- increased thirst
- joint or muscle pain
- large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
- light-colored stools
- loss of consciousness
- red skin lesions, often with a purple center
- red, irritated eyes
- redness of the skin
- sores, ulcers, or white spots in the mouth or on the lips
- swelling of the face, ankles, or hands
- tightness in the chest
- unpleasant breath odor
- upper right stomach pain
- vomiting of blood
- yellow eyes and skin
Get emergency help immediately if any of the following symptoms of overdose occur while taking duloxetine:
Symptoms of overdose
- loss of bladder control
- muscle spasm or jerking of all extremities
- overactive reflexes
- poor coordination
- sleepiness or unusual drowsiness
- sudden loss of consciousness
- talking or acting with excitement you cannot control
- trembling or shaking
- unusual tiredness or weakness
Side effects not requiring immediate medical attention
Some side effects of duloxetine may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.
Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
- Body aches or pain
- difficulty having a bowel movement (stool)
- dry mouth
- ear congestion
- frequent urination
- lack or loss of strength
- loss of appetite
- loss of voice
- muscle aches
- sleepiness or unusual drowsiness
- sore throat
- stuffy or runny nose
- sweating increased
- trouble sleeping
- weight loss
- Abnormal orgasm
- acid or sour stomach
- burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
- change in taste
- change or problem with discharge of semen
- decreased interest in sexual intercourse
- difficulty with moving
- feeling of warmth or redness of the face, neck, arms, and occasionally, upper chest
- inability to have or keep an erection
- longer than usual time to ejaculation of semen
- loose stools
- loss in sexual ability, desire, drive, or performance
- loss of taste
- muscle cramps, pains, or stiffness
- shakiness in the legs, arms, hands, or feet
- stomach discomfort or upset
- sudden sweating
- swollen joints
- trembling or shaking of the hands or feet
For Healthcare Professionals
Applies to duloxetine: oral delayed release capsule
The most commonly reported side effects included nausea, somnolence, headache, and dizziness.[Ref]
Abdominal pain more commonly occurred in pediatric patients.
Constipation occurred most frequently in patients given 60 mg orally 2 times a day (N=225); the side effect occurred in 11% of patients given 60 mg orally once a day, and in 5% of patients given 20 mg orally once a day.
Diarrhea occurred most frequently in patients given 20 mg orally once a day (N=115); the side effect occurred in 7% of patients given 60 mg orally 2 times a day, and in 11% of patients given 60 mg orally once a day.
Nausea occurred most frequently in patients given 60 mg orally 2 times a day (N=225); the side effect occurred in 22% of patients given 60 mg orally once a day, and in 14% of patients given 20 mg orally once a day.
Very common (10% or more): Nausea (up to 30%), constipation (up to 15%), dry mouth (up to 15%), vomiting (up to 15%), abdominal pain (up to 13%), diarrhea (up to 13%)
Rare (0.01% to 0.1%): Gastric ulcer, hematochezia, microscopic colitis
Frequency not reported: Abdominal discomfort, abdominal tenderness, gastrointestinal pain, lower abdominal pain, upper abdominal pain
Very common (10% or more): Somnolence (up to 21%), headache (up to 18%), dizziness (up to 17%)
Rare (0.01% to 0.1%): Convulsion, dysarthria, extrapyramidal disorder, psychomotor restlessness, serotonin syndrome
Very rare (less than 0.01%): Electric shock-like sensation, seizures
Frequency not reported: Hypersomnia, psychomotor hyperactivity, sedation, sensory disturbances
Postmarketing reports: Intracerebral bleeding[Ref]
Dizziness occurred most frequently in patients given 60 mg orally 2 times a day (N=225); the side effect occurred in 14% of patients given 60 mg orally once a day, and in 6% of patients given 20 mg orally once a day.
Headache more commonly occurred in pediatric patients.
Convulsion and seizures were reported during treatment discontinuation.
Somnolence occurred most frequently in patients given 60 mg orally 2 times a day (N=225); the side effect occurred in 15% of patients given 60 mg orally once a day, and in 7% of patients given 20 mg orally once a day.
Syncope was reported, especially during treatment initiation.[Ref]
Very common (10% or more): Decreased weight (up to 16%), decreased appetite (up to 16%)
Common (1% to 10%): Anorexia, increased weight
Decreased appetite occurred more frequently in patients 13 to 17 years of age with fibromyalgia.
Decreased weight of at least 3.5% occurred more frequently in patients 7 to 17 years of age with GAD and/or MDD.
Hyperglycemia was more commonly reported in patients with diabetes.[Ref]
Very common (10% or more): Nasopharyngitis (up to 14%)
Common (1% to 10%): Cough, oropharyngeal pain, pharyngolaryngeal pain, upper respiratory tract infection, yawning
Uncommon (0.1% to 1%): Epistaxis, throat tightness
Nasopharyngitis occurred more frequently in patients 13 to 17 years of age with fibromyalgia.[Ref]
Very common (10% or more): Insomnia (up to 13%)
Common (1% to 10%): Abnormal dreams, abnormal orgasm, agitation, anorgasmia, anxiety, decreased libido, restlessness, sleep disorder, tension
Rare (0.01% to 0.1%): Aggression, anger, completed suicide, hallucinations, mania, suicidal behavior
Aggression and/or anger usually occurred initially or after stopping treatment.
Insomnia occurred most frequently in patients given 60 mg orally 2 times a day (N=225); the side effect occurred in 8% of patients given 60 mg orally once a day, and in 9% of patients given 20 mg orally once a day.[Ref]
Very common (10% or more): Fatigue (up to 12%)
Common (1% to 10%): Asthenia, chills, falls, feeling jittery, pyrexia, rigors, tinnitus
Uncommon (0.1% to 1%): Ear pain, feeling abnormal, feeling cold/hot, malaise
Frequency not reported: Clinically important drug interactions[Ref]
Fatigue occurred most frequently in patients given 60 mg orally 2 times a day (N=225); the side effect occurred in 10% of patients given 60 mg orally once a day, and in 2% of patients given 20 mg orally once a day.
Falls were more common in patients 65 years and older.
Tinnitus was reported during treatment discontinuation.[Ref]
Uncommon (0.1% to 1%): Abnormal urine odor, dysuria, ejaculation dysfunction, ejaculation failure, menopausal symptoms, micturition urgency, nocturia, sexual dysfunction, testicular pain, urinary hesitation, urinary retention
Rare (0.01% to 0.1%): Decreased urine flow, menstrual disorder
Very rare (less than 0.01%): Galactorrhea, gynecological bleeding
Frequency not reported: Genital hypoesthesia[Ref]
Common (1% to 10%): Muscle cramp, muscle spasms, musculoskeletal pain, myalgia, neck pain
Postmarketing reports: Rhabdomyolysis[Ref]
Common (1% to 10%): Blood pressure increased, flushing/hot flush, palpitations
Uncommon (0.1% to 1%): Atrial fibrillation, chest pain, hypertension, increased diastolic blood pressure, increased systolic blood pressure, myocardial infarction, orthostatic hypertension, peripheral coldness, supraventricular arrhythmia, tachycardia, Takotsubo cardiomyopathy
Rare (0.01% to 0.1%): Hypertensive crisis, supraventricular fibrillation
Frequency not reported: Diastolic hypertension, essential hypertension, labile hypertension, pulse increased, secondary hypertension, systolic hypertension
Postmarketing reports: Cardiac events, ventricular arrhythmias[Ref]
Rare (0.01% to 0.1%): Ecchymosis
Very rare (less than 0.01%): Cutaneous vasculitis, contusion, Stevens-Johnson syndrome
Frequency not reported: Severe skin reactions, subcutaneous tissue disorder[Ref]
Common (1% to 10%): Blurred vision
Uncommon (0.1% to 1%): Diplopia, dry eye, mydriasis, visual impairment
Rare (0.01% to 0.1%): Glaucoma
Frequency not reported: Angle-closure glaucoma[Ref]
Common (1% to 10%): Influenza
Uncommon (0.1% to 1%): Laryngitis[Ref]
Uncommon (0.1% to 1%): Acute liver injury, ALT elevation, alkaline phosphatase elevation, AST elevation, blood bilirubin increased, elevated liver enzymes, GGT increased, hepatitis
Rare (0.01% to 0.1%): Hepatic failure, jaundice
Frequency not reported: Hepatotoxicity, liver failure[Ref]
Uncommon (0.1% to 1%): Hypothyroidism
Rare (0.01% to 0.1%): Hyperprolactinemia, syndrome of inappropriate antidiuretic hormone secretion (SIADH)[Ref]
Uncommon (0.1% to 1%): Hypersensitivity disorder
Rare (0.01% to 0.1%): Anaphylactic reaction
Uncommon (0.1% to 1%): Increased tendency to bruise
Postmarketing reports: Abnormal bleeding events, blood dyscrasias[Ref]
Postmarketing reports: Renal dysfunction[Ref]
1. Cerner Multum, Inc. "Australian Product Information." O 0
2. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
3. "Product Information. Cymbalta (duloxetine)." Lilly, Eli and Company, Indianapolis, IN.
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Some side effects may not be reported. You may report them to the FDA.