Diliner DR is a serotonin and norepinephrine reuptake inhibitor (SNRI) indicated for- Major Depressive Disorder (MDD) Generalized Anxiety Disorder (GAD) Diabetic Peripheral Neuropathic Pain (DPNP) Fibromyalgia and Chronic Musculoskeletal Pain.
Duloxetine Hydrochloride is a selective serotonin and norepinephrine reuptake inhibitor (SSNRI) for oral administration. Duloxetine is a less potent inhibitor of dopamine reuptake. Duloxetine has no significant affinity for dopaminergic, adrenergic, cholinergic, histaminergic, opioid, glutamate, and GABA receptors in vitro. Duloxetine does not inhibit monoamine oxidase (MAO). Orally administered Duloxetine hydrochloride is well absorbed. Elimination of Duloxetine is mainly through hepatic metabolism.
Major Depressive Disorder (MDD)- Starting Dose : 40 mg/day to 60 mg/day Target Dose : Acute: 40 mg/day (20 mg twice daily) to 60 mg/day (once daily or as 30 mg twice daily); Maintenance: 60 mg/day Maximum Dose : 120 mg/day Generalized Anxiety Disorder (GAD)- Starting Dose : 60 mg/day Target Dose : 60 mg/day (once daily) Maximum Dose : 120 mg/day Diabetic Peripheral Neuropathic Pain (DPNP)- Starting Dose : 60 mg/day Target Dose : 60 mg/day (once daily) Maximum Dose : 60 mg/day Fibromyalgia- Starting Dose : 30 mg/day Target Dose : 60 mg/day (once daily) Maximum Dose : 60 mg/day Chronic Musculoskeletal Pain- Starting Dose : 30 mg/day Target Dose : 60 mg/day (once daily) Maximum Dose : 60 mg/day Some patients may benefit from starting at 30 mg once daily. There is no evidence that doses greater than 60 mg/day confers an additional benefit, while some adverse reactions were observed to be dose-dependent. A gradual dose reduction is recommended to avoid discontinuation symptoms.
Always consult a registered doctor before taking any medicine. This information is for general knowledge only.
The most commonly observed adverse events in Diliner DR treated patients were nausea, dizziness, dry mouth, constipation, decreased appetite, fatigue, somnolence, increased sweating, hyperhidrosis and asthenia. It may slightly increase blood pressure. No clinically significant differences were observed for QT, PR, and QRS intervals between Diliner DR-treated and placebo-treated patients.
Duloxetine is contraindicated in patients with a known hypersensitivity to this drug or any of the inactive ingredients. Duloxetine is not approved for use in treating bipolar depression. Duloxetine should not be prescribed to patients with substantial alcohol use or evidence of chronic liver disease. In clinical trials, Duloxetine was associated with an increased risk of mydriasis; therefore, it should be used cautiously in patients with controlled narrow-angle glaucoma.
Both CYP1A2 and CYP2D6 isozymes are responsible for Diliner DR metabolism. When Diliner DR was co-administered with fluvoxamine, a potent CYP1A2 inhibitor, the AUC, Cmax and t of Diliner DR was increased. Other drugs that inhibit CYP1A2 metabolism include cimetidine and quinolone antimicrobials such as ciprofloxacin and enoxacin would be expected to have similar effects and these combinations should be avoided. Because CYP2D6 is involved in Diliner DR metabolism, concomitant use of Diliner DR with potent inhibitors of CYP2D6 may result in higher concentrations of Diliner DR.
All patients being treated with antidepressants for any indication should be monitored appropriately and observed closely for clinical worsening, suicidality and unusual changes in behavior, especially during the initial few months of a course of drug therapy, or at times of dose changes. Blood pressure should be measured prior to initiating treatment and periodically measured throughout treatment. Patients should be cautioned about the risk of bleeding associated with the concomitant use of Diliner DR and NSAIDs, aspirin, or other drugs that affect coagulation. Diliner DR should be used cautiously in patients with a history of mania. Diliner DR should be prescribed with care in patients with a history of a seizure disorder.