Duloxetine hydrochloride is a serotonin and noradrenaline reuptake inhibitor (SNRI). Duloxetine is used in the treatment of depression in usual initial doses of 20 or 30 mg twice daily, or 60 mg once daily. A lower starting dose of 30 mg once daily for the first week may be suitable for some patients, to allow them to adjust to the effects of duloxetine before increasing the dose. A dose of 60 mg once daily may be used for maintenance therapy.
Duloxetine is also used in the treatment of generalised anxiety disorder, in a usual dose of 60 mg once daily. A lower starting dose of 30 mg daily for the first week may be considered in some patients, before increasing to 60 mg daily.
In the treatment of diabetic peripheral neuropathic pain the usual dose is 60 mg once daily. Some patients who respond insufficiently to this dose may benefit from up to 120 mg daily in divided doses.
Response to therapy should be evaluated after 2 months and every 3 months thereafter. Duloxetine is also used in the treatment of moderate to severe stress urinary incontinence in women. Usual initial doses are 40 mg twice daily; however, some patients may benefit from an initial dose of 20 mg twice daily for 2 weeks before increasing to 40 mg twice daily.