{"id":4509,"date":"2025-03-31T18:12:10","date_gmt":"2025-03-31T18:12:10","guid":{"rendered":"https:\/\/kidneydiseaseclinic.net\/kdc\/duloxetine-txt\/"},"modified":"2025-03-31T18:12:10","modified_gmt":"2025-03-31T18:12:10","slug":"duloxetine-txt","status":"publish","type":"post","link":"https:\/\/kidneydiseaseclinic.net\/kdc\/duloxetine-txt\/","title":{"rendered":"duloxetine.txt"},"content":{"rendered":"

duloxetine<\/h1>\n

CLINICAL USE <\/H3>
\nModerate to severe stress urinary incontinenceDepression Diabetic peripheral neuropathy

DOSE IN NORMAL RENAL FUNCTION <\/H3>Incontinence: 20\u201340 mg twice daily Depression and diabetic peripheral neuropathy: 60 mg daily

PHARMACOKINETICS <\/H3>
  • Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :333.9 (as hydrochloride)<\/li>\n
  • %Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :95\u201396<\/li>\n
  • %Excreted unchanged in urine &nbsp &nbsp : <1 (77% as metabolites)<\/li>\n

  • Volume of distribution (L\/kg) &nbsp &nbsp &nbsp :1640 litres<\/li>\n

  • half-life \u2013 normal\/ESRD (hrs)&nbsp &nbsp &nbsp :8\u201317\/Unchanged

    DOSE IN RENAL IMPAIRMENT <\/H3>

    GFR (mL\/MIN)<\/H4>30\u201350 Dose as in normal renal function; start with a low dose10\u201330 Start at low dose and increase according to response
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : Start at very low dose and increase according to response

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES <\/H3>
  • CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:Not dialysed. Dose as in GFR
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : mL\/min<\/p>\n
  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Not dialysed. Dose as in GFR
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : mL\/min
  • HDF\/high flux &nbsp :Unlikely to be dialysed. Dose as in GFR
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : mL\/min
  • CAV\/VVHD &nbsp &nbsp &nbsp:Not dialysed. Dose as in GFR =10\u201330 mL\/min

    IMPORTANT DRUG INTERACTIONS <\/H3>Potentially hazardous interactions with other drugs\n
  • Antibacterials: metabolism inhibited by ciprofloxacin \u2013 avoid concomitant use\n
  • Other CNS medication: enhanced effect\n
  • Antidepressants: avoid concomitant use with MAOIs, moclobemide, St John\u2019s wort, tryptophan, venlafaxine, amitriptyline, clomipramine and SSRIs due to increased risk of serotonin syndrome; increased risk of side effects with tricyclic antidepressants; fluvoxamine decreases the clearance of duloxetine by 77% \u2013 avoid concomitant use\n
  • Antimalarials: avoid concomitant use with artemether\/lumefantrine\n
  • Sibutramine: increased risk of CNS toxicity \u2013 avoid concomitant use

    ADMINISTRATION <\/H3>

    Reconstition<\/H4>\u2013

    Route <\/H4>Oral

    Rate of Administration <\/H4>\u2013

    Comments<\/H4>\u2013

    OTHER INFORMATION <\/H4>In CKD 5 there is a 2-fold increase in C max and AUC. The renally excreted metabolites 4-hydroxy duloxetine glucuronide and 5-hydroxy, 6-methoxy duloxetine sulphate were 7\u20139 times higher than in people with normal renal function\n
  • Contraindicated in uncontrolled hypertension due to potential risk of hypertensive crisis
    \n","protected":false},"excerpt":{"rendered":"

    duloxetine CLINICAL USE Moderate to severe stress urinary incontinenceDepression Diabetic<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[7],"class_list":["post-4509","post","type-post","status-publish","format-standard","hentry","category-blog","tag-post-by-auto-php"],"_links":{"self":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/4509","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/comments?post=4509"}],"version-history":[{"count":0,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/4509\/revisions"}],"wp:attachment":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/media?parent=4509"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/categories?post=4509"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/tags?post=4509"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}