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SNRI Antidepressant

Duloxetine

Brand names: Cymbalta, Yentreve

Used in: Depression & Anxiety

Duloxetine is a serotonin-noradrenaline reuptake inhibitor (SNRI) used for depression, generalised anxiety disorder and diabetic peripheral neuropathic pain.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

US labelling (FDA)

Reference — US labelling, may differ from UK

Take Duloxetine delayed-release capsules once daily, with or without food. Swallow whole; do not crush, chew, or open capsule ( 2.1 ) Indication Starting Dose Target Dose Maximum Dose MDD ( 2.2 ) 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 ( 2.3 ) Adults 60 mg/day 60 mg/day (once daily) 120 mg/day Geriatric 30 mg/day 60 mg/day (once daily) 120 mg/day Pediatrics (7 to 17 years of age) 30 mg/day 30 to 60 mg/day (once daily) 120 mg/day DPNP ( 2.4 ) 60 mg/day 60 mg/day (once daily) 60 mg/day FM ( 2.5 ) Adults and Pediatrics (13 to 17 years of age) 30 mg/day 60 mg/day …

Source: US FDA prescribing information (openFDA / DailyMed), label dated 2025-03-21. Accessed 2026-06-12. US dosing and indications can differ from UK practice — use UK sources for prescribing decisions.

Clinical monograph

How it works

It inhibits reuptake of serotonin and noradrenaline, increasing their synaptic availability.

Prescribing in practice

  • It can affect blood pressure and heart rate; avoid in significant hepatic impairment and in substantial alcohol use (hepatotoxicity).
  • Discontinuation effects can occur — taper to stop.
  • Risk of serotonin syndrome with other serotonergic drugs.

Monitoring

Review mood and suicidal ideation early; monitor blood pressure; check liver function where indicated.

Counselling the patient

  • It can take a few weeks to work.
  • Do not stop suddenly.
  • Report worsening mood or thoughts of self-harm.

Evidence & guidelines

An option for depression and generalised anxiety disorder (NICE NG222) and a treatment for diabetic peripheral neuropathic pain (NICE CG173).

Reference: NICE CG173 (Neuropathic Pain); NICE CG90 (Depression); MHRA Drug Safety Update; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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