The NICE British National Formulary (BNF) and British National Formulary for Children (BNFc) sites are only available to users in the UK, Crown Dependencies and British Overseas Territories. If you believe you are seeing this page in error please contact us. Cymbalta (Eli Lilly)30 mg and 60 mg capsules Approved indication: major depression Australian Medicines Handbook section 18.1.2 Duloxetine is a new antidepressant which selectively inhibits serotonin and noradrenaline reuptake. After oral administration of duloxetine, maximum plasma concentrations are reached after six hours. Duloxetine is extensively metabolised in the liver and has an overall half-life of about 12 hours. The efficacy of duloxetine (60 mg/day) has been compared to that of escitalopram (10 mg/day) and placebo in a randomised study of 684 patients (randomised in a 2:2:1 ratio). The onset of efficacy was defined as a 20% sustained reduction in the patient's score on the Hamilton Rating Scale for Depression Maier subscale, by the second week of treatment. The probability of meeting these criteria was 42.6% in patients given duloxetine, 35.2% in patients given escitalopram and 21.5% in patients given placebo. After eight weeks, the probability of responding to treatment (defined as a 50% improvement from baseline on the Hamilton Rating Scale for Depression) was not statistically different between patients given active drug or placebo. Response rates were 48.7% for duloxetine, 45.3% for escitalopram and 36.9% for placebo. In a review analysing efficacy data from nine duloxetine trials, the number needed to treat for a duloxetine dose of 60 mg/day or more was 6 for a response (based on the Hamilton Rating Scale for Depression), 7-9 for remission and 6-7 for a Clinical Global Impression-defined improvement by eight weeks. Buy generic cialis online safely Buy tretinoin Buy bactrim for dogs Sildenafil for dogs If linezolid or IV methylene blue must be administered, discontinue duloxetine immediately and monitor for central nervous system CNS toxicity; duloxetine may be resumed 24 hours after last linezolid or methylene blue dose or after 2 weeks of monitoring, whichever comes first Jan 3, 2014. The usual dose of duloxetine is 60 mg. At this dose, there was moderate quality evidence that duloxetine reduced pain in both painful diabetic. Detailed Duloxetine dosage information for adults, the elderly and children. Includes dosages for Depression, Pain, Fibromyalgia and more;. The starting and recommended maintenance dose is 60 mg once daily with or without food. Dosages above 60 mg once daily, up to a maximum dose of 120 mg per day have been evaluated from a safety perspective in clinical trials. However, there is no clinical evidence suggesting that patients not responding to the initial recommended dose may benefit from dose up-titrations. After consolidation of the antidepressive response, it is recommended to continue treatment for several months, in order to avoid relapse. In patients responding to duloxetine, and with a history of repeated episodes of major depression, further long-term treatment at a dose of 60 to 120 mg/day could be considered. The recommended starting dose in patients with generalised anxiety disorder is 30 mg once daily with or without food. In patients with insufficient response the dose should be increased to 60 mg, which is the usual maintenance dose in most patients. 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) 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. Initial dose: 60 mg orally once a day 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 -The dose may be increased in increments of 30 mg once a day if clinically appropriate -There is no evidence that doses greater than 60 mg per day confer additional benefit 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. Duloxetine dose Cymbalta duloxetine dosing, indications, interactions, adverse effects., Duloxetine for treating painful neuropathy, chronic pain or fibromyalgia. Buy lexapro 10 mgMetformin by teva In a review analysing efficacy data from nine duloxetine trials, the number needed to treat for a duloxetine dose of 60 mg/day or more was 6 for. Duloxetine Australian Prescriber - NPS MedicineWise. Duloxetine Dosage Guide with Precautions -. Duloxetine Oral Uses, Side Effects, Interactions, Pictures, Warnings.. Detailed dosage guidelines and administration information for Cymbalta duloxetine hydrochloride. Includes dose adjustments, warnings and precautions. If a dose of CYMBALTA is missed, take the missed dose as soon as it is remembered. If it is almost time for the next dose, skip the missed dose and take the next dose at the regular time. Do. In patients responding to duloxetine, and with a history of repeated episodes of major depression, further long-term treatment at a dose of 60 to 120 mg/day. The no-effect dose was 50 mg/kg/day 2 times the MRHD. Tumor incidence was not increased in male mice receiving duloxetine at doses up to 100 mg/kg/day.