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Ketan Patel NowPatientGreen tick
Written by Rajive Patel, BPharm
Updated on 4 Apr 2024

What to do if you missed your duloxetine dose

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About duloxetine

Duloxetine is a serotonin-norepinephrine reuptake inhibitor (SNRI) that works by increasing serotonin and noradrenaline, in your brain. Duloxetine is used to treat major depressive disorder (MDD), generalized anxiety disorder, nerve pain, such as fibromyalgia, diabetic peripheral neuropathy, and also stress urinary incontinence in women.

It is available with a prescription as generic duloxetine or under brand names such as Cymbalta or Yentreve. NowPatient offers duloxetine or Yentreve as treatments for urinary incontinence only, following an online consultation with a prescribing clinician.

Key facts about duloxetine

  • For the treatment of stress urinary incontinence in women
  • It can be dangerous if you take duloxetine with certain medications. If you’re not sure if it is safe, discuss this with the prescribing clinician
  • Duloxetine may take 2 to 4 weeks to start working, but may take longer if you’re using it for nerve pain
  • Common side effects of duloxetine include nausea, dry mouth, constipation and drowsiness
  • If you decide to stop taking duloxetine, your doctor may reduce your dose in steps, to prevent withdrawal symptoms

Who is duloxetine suitable for?

Duloxetine is suitable for:

  • Most adults 18 years of age and over

Who is duloxetine not suitable for?

Duloxetine may not be suitable for some people. To make sure it’s safe for you, speak to the prescribing clinician before taking duloxetine if you:

  • Have had an allergic reaction to duloxetine
  • Have kidney or liver problems
  • Have heart problems
  • Have taken other medication for depression within the last 14 days
  • Have glaucoma
  • Suffer from seizures, fits, manic episodes or bipolar disorder
  • Are pregnant, trying to get pregnant, or you’re breastfeeding

How and where to get duloxetine?

Duloxetine is available with a prescription only. It is not available over the counter at a pharmacy.

NowPatient does not allow customers to buy duloxetine directly. Our service is certified, safe and effective, and we only ever treat conditions. If you book a consultation with a prescribing clinician for the treatment of urinary incontinence, you can discuss if duloxetine is a suitable treatment option for you.

At the end of the consultation, the clinician will decide if a treatment plan is suitable for you. If it is, the clinician will issue you with a prescription which can then be ordered, paid for and delivered directly to your chosen address by Now Patient.

Dosage and strength for duloxetine for urinary incontinence

Duloxetine is available as delayed-release capsules when used for urinary incontinence. For stress urinary incontinence, duloxetine is available in strengths ranging from 20mg and 40mg capsules.

Information about how to take duloxetine for urinary incontinence

For stress urinary incontinence, the starting dose of duloxetine is 20mg twice a day, increased to 40mg twice a day, after 2 weeks. Take duloxetine with or without food, at the same time each day. Swallow duloxetine capsules whole with a glass of water. Duloxetine may be taken long-term for urinary incontinence, if it is helping your symptoms. Speak to a healthcare professional or read the patient information leaflet provided for further medical advice.

What happens if you take too much duloxetine?

If you take more than prescribed, then it can lead to some unpleasant side effects. You should talk to your doctor or reach out to one of our prescribing clinicians, if you have taken too much duloxetine and you experience any of the following side effects:

What are the side effects of duloxetine?

Side effects of duloxetine are split into common and serious.

Common side effects include:

  • Problems sleeping
  • Headaches, dizziness, blurred vision, drowsiness
  • Constipation, diarrhoea
  • Nausea or vomiting
  • Dry mouth
  • Tiredness
  • Loss of appetite, weight loss

Serious side effects include:

  • Serotonin syndrome – agitation, hallucinations, shivering, muscle stiffness, fast heart rate
  • Constant headaches
  • Liver problems -yellowing of the whites of your eyes or skin
  • Blurred vision or eye pain
  • Coughing up blood or blood in your stools or urine
  • Bruising easily

If you experience any serious side effects, you should contact NHS 111.

If you experience a serious allergic reaction with the signs shown below you should contact emergency services on 999.

  • Your lips, mouth, throat or tongue suddenly become swollen
  • You’re breathing very fast or struggling to breathe (you may become very wheezy or feel like you’re choking or gasping for air)
  • Your throat feels tight or you’re struggling to swallow
  • Your skin, tongue or lips turn blue, grey or pale (if you have black or brown skin, this may be easier to see on the palms of your hands or soles of your feet)
  • You suddenly become very confused, drowsy or dizzy
  • Someone faints and cannot be woken up

Information about taking duloxetine at the same time as other medications or herbal supplements

There is not enough evidence to suggest there are any drug interactions between herbal supplements and duloxetine. In any event, you should let your prescribing clinician know if you are taking any other medicines, such as:

  • Selective serotonin reuptake inhibitors (SSRIs) such as citalopram, fluoxetine, or sertraline
  • Serotonin-norepinephrine reuptake inhibitors such as venlafaxine
  • Tricyclic antidepressants such as amitriptyline
  • Monoamine oxidase inhibitors (MAOIs) such as linezolid, methylene blue, or phenelzine
  • Opioids such as fentanyl and tramadol
  • St. John’s wort
  • Warfarin
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen
  • Antibiotics such as ciprofloxacin

Can duloxetine taken for urinary incontinence be taken long-term?

Yes. Duloxetine may be taken long-term for urinary incontinence, if it is helping your symptoms. Speak to a healthcare professional or read the patient information leaflet provided for further medical advice.

Is there a herbal duloxetine?

No. Herbal duloxetine does not exist. If you have been marketed such a formulation, it may be fake.

Can women use duloxetine?

Women can only take duloxetine for the treatment of stress urinary incontinence. Duloxetine is not recommended during pregnancy. Speak to your doctor if you get pregnant. You may continue to take duloxetine while breastfeeding if your doctor says your baby is healthy. Duloxetine does pass into breast milk, but does not cause side effects in breastfed babies. Speak to your doctor if you’re breastfeeding, or planning to breastfeed.

Should I avoid any particular food or drink when taking duloxetine?

You can eat and drink normally when taking duloxetine.

What lifestyle changes can I make to help me with urinary incontinence?

Modifying your lifestyle may have a positive impact on your urinary incontinence. These may include:

  • Practice Kegel exercises to improve your bladder control
  • Stay well hydrated to maintain a healthy urinary function
  • Avoid caffeine, alcohol, and spicy foods
  • Urinate when you feel the urge to
  • When urinating, wait once you have finished for a few moments, and then try again to make sure the bladder is emptied completely

Alternatives to duloxetine

Alternatives for the treatment of urinary incontinence include tamsulosin and tolteridone.



Medical Disclaimer

NowPatient has taken all reasonable steps to ensure that all material is factually accurate, complete, and current. However, the knowledge and experience of a qualified healthcare professional should always be sought after instead of using the information in this page. Before taking any drug, you should always speak to your doctor or another qualified healthcare provider.

The information provided here about medications is subject to change and is not meant to include all uses, precautions, warnings, directions, drug interactions, allergic reactions, or negative effects. The absence of warnings or other information for a particular medication does not imply that the medication or medication combination is appropriate for all patients or for all possible purposes.

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