Duloxetine Online



How and where to order Duloxetine Hydrochloride (Cymbalta) 20 mg, 30 mg, 40 mg, 60 mg capsules or tablets online on psychotherapist Dr. David Hovey website:

Shop:DFH PHARMACY
Stores:PHARMA DOCTOR
Prices:from $0.60 per pill
Discount:10% coupon: DFHDCC
Forms:Cymbalta (Duloxetine HCl) 20 mg, 30 mg, 40 mg, 60 mg tablets or capsules
Quantity:30-360 pills
Type:Duloxetine brand, Cymbalta generic
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Delivery:Regular airmail and express courier
Shipping:Worldwide, including USA, UK, Europe, Canada, Australia


Duloxetine (trade names include Cymbalta, Andepra, Apo-Duloxetine, Ariclaim, Cymgen, Dulane, Duloxetine-DR, Dulsevia, Duxet, Duzac, Duzela, Teva-Duloxetine, Xeristar, Yelate, Yentreve) is an antidepressant from serotonin and noradrenaline reuptake inhibitors (SNRIs) pharmacological group. This medicine is used to treat major depressive disorder, generalized anxiety disorder, mood disorders, neuropathic pain, fibromyalgia. Duloxetine is also indicated for the treatment of diabetic peripheral neuropathy, chemotherapy-induced neuropathy, chronic musculoskeletal pain, stress urinary incontinence, chronic pain caused by complications of diabetes or pain caused by fibromyalgia. It works by affecting chemicals in the brain that may become unbalanced and cause depression.


Cymbalta (Duloxetine Hydrochloride) logo


Related medications:

  • Agomelatine (Valdoxan)
  • Amitriptyline (Elavil)
  • Bifemelane (Alnert)
  • Bupropion (Wellbutrin)
  • Citalopram (Celexa)
  • Clomipramine (Anafranil)
  • Desvenlafaxine (Pristiq)
  • Doxepin (Sinequan)
  • Escitalopram (Lexapro)
  • Fluvoxamine (Luvox)
  • Gepirone (Variza)
  • Imipramine (Tofranil)
  • Medifoxamine (Cledial)
  • Mianserin (Tolvon)
  • Milnacipran (Savella)
  • Minaprine (Isopulsan)
  • Mirtazapine (Remeron)
  • Nefazodone (Nefadar)
  • Nomifensine (Linamiphen)
  • Nortriptyline (Aventyl, Pamelor)
  • Oxaflozane (Conflictan)
  • Oxitriptan (Triptene)
  • Paroxetine (Paxil)
  • Pivagabine (Tonerg)
  • Reboxetine (Edronax)
  • Tianeptine (Stablon)
  • Trazodone (Desyrel)
  • Venlafaxine (Effexor)
  • Vilazodone (Viibryd)
  • Viloxazine (Vivalan)
  • Vortioxetine (Brintellix)


    Pharmacological and medical categories:

  • Anti anxiety meds
  • Antidepressants
  • Analgesics
  • Pain relief medications
  • Serotonin-norepinephrine reuptake inhibitors (SNRI)
  • Urological drugs


    ATC codes:

  • N - Nervous system
  • N06 - Psychoanaleptics
  • N06A - Antidepressants
  • N06AX - Other antidepressants
  • N06AX21 - Duloxetine


    ICD-10 codes:

  • Type 2 diabetes mellitus - E11
  • Type 2 diabetes mellitus with neurological complications - E11.4
  • Mood [affective] disorders - F30-F39
  • Major depressive disorder, single episode - F32
  • Major depressive disorder, recurren - F33
  • Other anxiety disorders - F41
  • Generalized anxiety disorder - F41.1
  • Other and unspecified polyneuropathies - G62
  • Drug-induced polyneuropathy - G62.0
  • Pain, not elsewhere classified - G89
  • Other and unspecified soft tissue disorders, not elsewhere classified - M79
  • Myalgia - M79.1
  • Neuralgia and neuritis, unspecified - M79.2
  • Fibromyalgia - M79.7
  • Other disorders of urinary system - N39
  • Stress incontinence (female) (male) - N39.3


    Indications and usage:

    Cymbalta (Duloxetine Hydrochloride) is a serotonin and norepinephrine reuptake inhibitor (SNRI) indicated for the treatment of the following conditions:

  • Major depressive disorder (MDD) in adults.
  • Generalized anxiety disorder (GAD) in adults and pediatric patients 7 years of age and older.
  • Diabetic peripheral neuropathic pain (DPNP) in adults.
  • Fibromyalgia (FM) in adults and pediatric patients 13 years of age and older.
  • Chronic musculoskeletal pain in adults.


    Dosage and administration:

  • Take Cymbalta once daily, with or without food. Swallow whole; do not crush, chew, or open capsule.

    MDD 40 mg/day to 60 mg/day Acute treatment: 40 mg/day (20 mg twice daily) to 60 mg/day (once daily or as 30 mg twice daily);
    Maintenance treatment: 60 mg/day
    120 mg/day
    GAD Adults 60 mg/day 60 mg/day (once daily) 120 mg/day
    GAD Geriatric 30 mg/day 60 mg/day (once daily) 120 mg/day
    GAD Pediatrics (7 to 17 years of age) 30 mg/day 30 to 60 mg/day (once daily) 120 mg/day
    FM (2.5) Adults and Pediatrics (13 to 17 years of age) 30 mg/day 60 mg/day (once daily) 60 mg/day
    Chronic Musculoskeletal Pain 30 mg/da 60 mg/day (once daily 60 mg/day


  • Discontinuing Duloxetine capsules: gradually reduce dosage to avoid discontinuation symptoms.


    Dosage forms and strengths:

    Cymbalta (Duloxetine Hydrochloride) delayed-release capsules: 20 mg, 30 mg, 40 mg, 60 mg.


    Overdosage:

    Signs and symptoms

    In postmarketing experience, fatal outcomes have been reported for acute Cymbalta overdoses, primarily with mixed overdoses, but also with Duloxetine only, including 1000 mg of Cymbalta (approximately 8.3 times the maximum recommended dosage). Signs and symptoms of overdose (Duloxetine Hydrochloride alone or with mixed drugs) included somnolence, coma, serotonin syndrome, seizures, syncope, tachycardia, hypotension, hypertension, and vomiting.

    Management of overdose

    There is no specific antidote to a Cymbalta overdosage, but if serotonin syndrome ensues, specific treatment (such as with cyproheptadine and/or temperature control) may be considered. In case of acute overdose with Duloxetine HCl, treatment should consist of those general measures employed in the management of overdose with any drug, such as assuring an adequate airway, oxygenation, and ventilation and monitoring cardiac rhythm and vital signs. Gastric lavage with a large-bore orogastric tube with appropriate airway protection, if needed, may be indicated if performed soon after ingestion or in symptomatic patients. Induction of emesis is not recommended. Activated charcoal may be useful in limiting absorption of duloxetine from the gastrointestinal tract. Administration of activated charcoal has been shown to decrease duloxetine AUC and Cmax by an average of one-third, although some patients had a limited effect of activated charcoal. Due to the large volume of distribution of duloxetine, forced diuresis, dialysis, hemoperfusion, and exchange transfusion are unlikely to be beneficial. In managing overdose, the possibility of multiple drug involvement should be considered. A specific caution involves patients who overdose with Cymbalta and tricyclic antidepressants. In such a case, decreased clearance of the parent tricyclic and/or its active metabolite may increase the possibility of clinically significant sequelae and extend the time needed for close medical observation.


    Contraindications:

  • Concomitant use of an MAOI antidepressant with Cymbalta is contraindicated.
  • Use of Duloxetine pills within 14 days of stopping an MAOI antidepressant is contraindicated.
  • In linezolid- or intravenous methylene blue-treated patients,initiation of Cymbalta (Duloxetine Hydrochloride) is contraindicated.


    Warnings and Precautions:

  • Increased risk of suicidal thinking and behavior in children, adolescents, and young adults taking antidepressants.
  • Monitor for worsening and emergence of suicidal thoughts and behaviors.
  • Hepatotoxicity: hepatic failure, sometimes fatal, has been reported. Discontinue Cymbalta in patients who develop jaundice or other evidence of clinically significant liver dysfunction and should not be resumed unless another cause can be established. Avoid use in patients with substantial alcohol use or evidence of chronic liver disease.
  • Orthostatic hypotension, falls and syncope: consider dosage reduction or discontinuation if these events occur.
  • Serotonin syndrome: increased risk when co-administered with other serotonergic agents (e.g., SSRIs, SNRIs, triptans), but also when taken alone. If it occurs, discontinue Duloxetine.
  • Increased risk of bleeding: may increase the risk of bleedingevents. Concomitant use of antiplatelet drugs and anticoagulants may increase this risk.
  • Severe skin reactions: severe skin reactions, including erythema multiforme and Stevens-Johnson Syndrome (SJS), can occur; Discontinue at the first appearance of blisters, peeling rash, mucosal erosions, or any other sign of hypersensitivity if no other etiology can be identified.
  • Activation of mania or hypomania: prior to initiating, screenpatients for personal or family history of bipolar disorder, mania, or hypomania.
  • Angle-closure glaucoma: has occurred in patients with untreated anatomically narrow angles treated with antidepressants.
  • Seizures: prescribe with care in patients with a history of seizure disorder.
  • Blood pressure increases: monitor blood pressure prior to initiating treatment and periodically throughout treatment.
  • Inhibitors of CYP1A2 or thioridazine: avoid co-administration with Cymbalta (Duloxetine) pills.
  • Hyponatremia: can occur in association with SIADH; consider discontinuation.
  • Glucose control in diabetes: in DPNP patients, increases in fasting blood glucose, and HbA1c have been observed.
  • Conditions that slow gastric emptying: use cautiously in these patients.


    Side effects, adverse reactions:

    Most common adverse reactions ( >= 5% and at least twice the incidence of placebo-treated patients):

    Adults: nausea, dry mouth, somnolence, constipation, decreased appetite, hyperhidrosis.

    Pediatric patients: decreased weight, decreased appetite, nausea, vomiting, fatigue, diarrhea.

    To report suspected adverse reactions of Cymbalta (Duloxetine Hydrochloride) capsules or tablets, contact Eli Lilly pharmaceutical company or your local FDA.


    Drug interactions:

  • Potent inhibitors of CYP1A2 should be avoided.
  • Potent inhibitors of CYP2D6 may increase Cymbalta concentrations.
  • Duloxetine HCl is a moderate inhibitor of CYP2D6.


    Use in specific populations:

  • Pregnancy: third trimester use may increase risk for symptoms of poor adaptation (respiratory distress, temperature instability, feeding difficulty, hypotonia, tremor, irritability) in the neonate.
  • Hepatic impairment: avoid use in patients with chronic liver disease or cirrhosis.
  • Renal impairment: avoid use in patients with severe renal impairment, GFR < 30 mL/minute.


    Pregnancy categories:

  • B3 - Australia
  • C - United States (Risk cannot be ruled out)


    Salts and other forms:

  • Duloxetine Base
  • Duloxetine Hydrochloride


    Synonyms, international and chemical names:

  • (R)-Duloxetine
  • (S)-Duloxetine
  • (S)-N-Methyl-gamma-(1-naphthalenyloxy)-2-thiophenepropanamine
  • 2-Thiophenepropanamine, N-methyl-gamma-(1-naphthalenyloxy)-, (S)-
  • Cloridrato de Duloxetina
  • Dulaxetine
  • Duloksetin
  • Duloksetiini
  • Duloksetyna
  • Duloxetin
  • Duloxetinhydrochlorid
  • Duloxetina Clorhidrato
  • Duloxetine HCl
  • Duloxetini Hydrochloridum
  • Duloxetinum


    Brands, generics, trade names:

  • Alacir - Roemmers Laboratorios
  • Andepra - Aspen
  • Apo-Duloxetine - Apotex
  • Ariclaim - Eli Lilly, Boehringer Ingelheim
  • Cymbalta - Eli Lilly, Aspen, Boehringer Ingelheim
  • Cymgen - Eli Lilly
  • Delok - Abbott, Nicholas Piramal India
  • DLX - Solitaire Pharmacia
  • Duceten - Drugtech Laboratorio, Recalcine Laboratorios
  • Dulane - Sun Pharmaceutical Industries
  • Dulot - Lupin Pharmaceuticals
  • Dulotin - Mesmer Pharmaceuticals, Icon Life Sciences
  • Duloxetin - Betapharm Arzneimittel, Merckle, Ratiopharm
  • Duloxetina - Dr. Reddy's Laboratories, Pensa Pharma, Saval Laboratorios
  • Duloxetine - Actavis, Biogaran, Eli Lilly, Generics UK, KRKA, Sandoz, TAD Pharma, Teva
  • Duloxetine-DR - Teva
  • Dulsevia - KRKA
  • Dupact - Wockhardt
  • Duxet - Nobel Ilac
  • Duzac - Sun Pharmaceutical Industries
  • Duzela - Sun Pharmaceutical Industries
  • DXT - Reliance Drugs & Surgicals
  • Nexetin - Nobel Ilac
  • Nitexol - Andromaco Laboratorios, ABL Pharma
  • Nitidex - IVAX
  • Sympta - Ipca Laboratories
  • Teva-Duloxetine - Teva
  • Velija - Libbs Farmaceutica
  • Xeristar - Eli Lilly, Boehringer Ingelheim, Dr. Esteve Laboratorios
  • Yelate - Dr. Reddy's Laboratories
  • Yentreve - Eli Lilly, Boehringer Ingelheim, Shrooq Pharmaceuticals


    APIs used in medicine in combinations with duloxetine:

  • Avanafil
  • Methylcobalamin
  • Sildenafil


    Here is a list of popular medications containing duloxetine as a main active pharmaceutical ingredient; their trade names, forms, doses, companies - manufacturers, distributors, suppliers, researchers and developers:

    Trade name of the drug Pharmaceutical forms and doses Companies
    Ariclaim
  • Capsules, Gastro-Resistant; Oral; Duloxetine Hydrochloride 20 mg
  • Capsules, Gastro-Resistant; Oral; Duloxetine Hydrochloride 40 mg
  • Eli Lilly
  • Boehringer Ingelheim
  • Cymbalta
  • Capsules, Delayed Release Pellets; Oral; Duloxetine Hydrochloride 20 mg
  • Capsules, Delayed Release Pellets; Oral; Duloxetine Hydrochloride 30 mg
  • Capsules, Delayed Release Pellets; Oral; Duloxetine Hydrochloride 60 mg
  • Eli Lilly
  • Aspen
  • Boehringer Ingelheim
  • DKSH
  • Four Star
  • Icepharma
  • Phadisco
  • Shionogi & Co.
  • Y.C. Woo
  • Zuellig Pharma
  • Duzela
  • Capsules, Delayed Release; Oral; Duloxetine Hydrochloride 40 mg
  • Capsules; Oral; Duloxetine Hydrochloride 20 mg
  • Capsules; Oral; Duloxetine Hydrochloride 30 mg
  • Capsules; Oral; Duloxetine Hydrochloride 40 mg
  • Capsules; Oral; Duloxetine Hydrochloride 60 mg
  • Sun Pharmaceutical Industries
  • S.J. & G. Fazul Ellahie
  • Teva-Duloxetine
  • Capsules, Delayed Release; Oral; Duloxetine Hydrochloride 30 mg
  • Capsules, Delayed Release; Oral; Duloxetine Hydrochloride 60 mg
  • Teva
  • Xeristar
  • Capsules, Gastro-Resistant; Oral; Duloxetine Hydrochloride 30 mg
  • Capsules, Gastro-Resistant; Oral; Duloxetine Hydrochloride 60 mg
  • Eli Lilly
  • Boehringer Ingelheim
  • Dr. Esteve Laboratorios
  • Yelate
  • Capsules; Oral; Duloxetine Hydrochloride 30 mg
  • Capsules; Oral; Duloxetine Hydrochloride 60 mg
  • Dr. Reddy's Laboratories



  • References:

  • Duloxetine main article on Wikipedia: https://en.wikipedia.org/wiki/Duloxetine
  • Duloxetine compound on PubChem: https://pubchem.ncbi.nlm.nih.gov/compound/60835
  • Duloxetine Hydrochloride on PubChem: https://pubchem.ncbi.nlm.nih.gov/compound/Duloxetine-hydrochloride
  • Duloxetine medicine on DrugBank: https://go.drugbank.com/drugs/DB00476
  • Duloxetine Hydrochloride on DrugBank: https://go.drugbank.com/salts/DBSALT000378
  • Duloxetine FAQ on MedlinePlus (revised 05/15/2020): https://medlineplus.gov/druginfo/meds/a604030.html
  • Cymbalta (Duloxetine Hydrochloride) capsules delayed-release drug label on DailyMed (revised November 3, 2020): https://dailymed.nlm.nih.gov/dailymed/drugInfo...
  • Duloxetine Direct Rx capsules delayed-release drug label on DailyMed (revised January 20, 2020): https://dailymed.nlm.nih.gov/dailymed/lookup...
  • Duloxetine containing drugs on Drugs-About.com: https://drugs-about.com/ing/duloxetine.html
  • Duloxetine for sale online on Pharma Doctor: https://pharma-doctor.com/duloxetine.html
  • Cymbalta (Duloxetine Hydrochloride) delayed-release capsules for oral use official prescribing information and medication guide from the U.S. FDA (revised 04/2020): https://www.accessdata.fda.gov/drugsatfda_docs/label/...
  • Cymbalta (Duloxetine Hydrochloride) delayed-release capsules for oral use prescribing information from Eli Lilly pharmaceutical company (revised 05/2020): https://pi.lilly.com/us/cymbalta-pi.pdf
  • Cymbalta (Duloxetine Hydrochloride) delayed-release capsules medication guide from Eli Lilly (revised 10/2019): http://pi.lilly.com/us/Cymbalta-Medguide.pdf
  • Ariclaim (Duloxetine) product information from European Medicines Agency: https://www.ema.europa.eu/en/medicines/human/EPAR/ariclaim
  • Teva-Duloxetine (Cymbalta generic) delayed-release capsules, USP product information from Teva Pharmaceuticals: https://www.tevagenerics.com/product/duloxetine-delayed-release-capsules-usp
  • Cymbalta (Duloxetine Hydrochloride) 30 mg, 60 mg hard gastro-resistant capsules package information leaflet from Medicines.org.uk (revised June 2020): https://www.medicines.org.uk/emc/files/pil.3880.pdf

    Revised: June 2021



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