Why have I been prescribed this?
- Duloxetine is used to help reduce pain. It is especially good for nerve pain, such as burning, shooting, stabbing, pins and needles, crawling, electric shock like pain and pain that keeps you awake at night
- Duloxetine belongs to a group of medicines called ‘Serotonin Noradrenergic Reuptake Inhibitors’ that are also used to treat depression and anxiety
How does it work?
Duloxetine works by changing the amount of specific nerve transmitters in the nervous system, called serotonin and noradrenaline. This reduces pain messages arriving in the brain. You may find Duloxetine also gradually lifts your mood and helps you sleep better
When should I take it?
- Usually Duloxetine is started at a low dose of 30mg once daily and increased gradually up to a maximum of 120mg once daily
- It is best to take Duloxetine at the same time each day. Most people take it in the morning. If you find you feel drowsy after taking it in the morning, try taking it in the evening
- Some people are prescribed Duloxetine twice a day, up to a maximum dose of 60mg twice a day
How should I take it?
The capsules should be swallowed whole, with a glass of water. It can be taken with or without food
How long will it take to work?
- Every patient is different. You may notice some initial benefit within 1 week, however it may take up to 1 month for a full effect. Your doctor may need to increase the dose to get the maximum effect
- Duloxetine does not work for everyone. If after 6 weeks you do not feel any improvement in your pain, do not suddenly stop taking the tablets but speak to your GP, pharmacist or pain team
What if I forget or miss a dose?
If you usually take Duloxetine:
- Once a day: Take the missed dose as soon as you remember,unless it’s less than 12 hours until your next dose, in which case skip the missed dose
- Twice a day: Take the missed dose as soon as you remember, unless it’s less than 4 hours until your next dose, in which case skip the missed dose
Can I take it long term?
Yes, if it helps. You may wish to reduce treatment every so often, to check if your pain is still a problem. This should be done with the advice of your GP, pharmacist or pain team, gradually reducing your medication over a period of time
What are the possible side effects?
- Most side effects are mild and can be expected to reduce after a few doses
- Common side effects include; headache, drowsiness, sickness (nausea), dizziness, blurred vision and dry mouth. If you have these side effects and they are severe contact your GP, pharmacist or pain team for advice
- Less common side effects include loss of appetite, flushes, raised blood pressure, difficulty sleeping, feeling anxious, shaky and increased sweating. If any of these side effects occur contact your GP, pharmacist or pain team for advice
Tips to help manage side effects
- Difficulty sleeping
Try taking Duloxetine first thing in the morning
Make sure you rest and drink plenty of non-alcoholic fluids. Speak to your GP, pharmacist or pain team if they last longer than 1 week or are severe
If Duloxetine makes you feel dizzy when you stand up, try getting up slowly or stay sitting down until you feel better. If you begin to feel dizzy, lie down so you do not faint, then sit until you feel better. Do not drive or use tools or machines if you feel dizzy, have muscle cramps or muscle pain, or if you just feel a bit shaky
- Blurred vision
Avoid driving or using tools or machines. If it lasts for more than 1 to 2 days speak to your GP, pharmacist or pain team as they may need to change your treatment
- Dry mouth
Chew sugar free gum
Try wearing loose clothing, use a strong anti-perspirant and keep cool using a fan if possible. If this doesn’t help you may need to switch to a different treatment
Can I drink alcohol?
Alcohol increases the sedative effects of Duloxetine, it is best not to drink alcohol when you start taking it. Once settled on a steady dose, you may drink alcohol in moderation but it may make you more drowsy than normal
Can I drive?
Duloxetine may cause drowsiness. If this happens, do not drive. For further information on driving visit: https://www.gov.uk/drug-driving-law
What should I tell my doctor, pharmacist or pain team?
- If you are allergic to any drugs
- If you are taking any other medicines particularly medicines that cause sleepiness (for example, painkillers such as morphine) or increase the level of serotonin (for example, tramadol, sertraline, citalopram, fluoxetine, venlafaxine taken for depression) or any anticoagulants (for example, warfarin) or anti-platelets (for example, aspirin, clopidogrel) agents or other drugs to thin the blood
- If you are taking any herbal medicines
- If you have epilepsy, glaucoma, kidney problems, liver problems or have/ have had a mental health problem
- If you are pregnant or breastfeeding, or if you are planning to become pregnant in the future
- If you are taking ciprofloxacin, an antibiotic used to treat infections
What if I want to stop taking it?
If you stop taking Duloxetine suddenly, you might experience withdrawal symptoms including dizziness, nausea, numbness or tingling in the hands or feet, trouble sleeping, feeling agitated or anxious, headaches and shaking.
Speak to your GP, pharmacist or pain team who will be able to supervise a gradual reduction over at least 1 to 2 weeks
Further information: www.nhs.uk/medicines/duloxetine
South Tees Hospitals NHS Foundation Trust would like your feedback. If you wish to share your experience about your care and treatment or on behalf of a patient, please contact The Patient Experience Department who will advise you on how best to do this.
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