Side Effects of Duloxetine

Common Side Effects

The American College of Cardiology recommends monitoring for gastrointestinal side effects, including nausea, dry mouth, constipation, diarrhea, vomiting, and abdominal discomfort, which are common complaints 1
Dizziness, headache, somnolence, and insomnia are frequently reported neurological effects, according to the American Academy of Neurology 2, 1
Increased sweating is a characteristic side effect related to norepinephrine reuptake inhibition, as noted by the American College of Cardiology 1
Sexual dysfunction, including decreased libido and performance, occurs commonly, as reported by the American Urological Association 1
Cardiovascular effects, such as increased blood pressure and pulse, should be monitored, as recommended by the American Heart Association 1

The American Psychiatric Association warns that duloxetine carries a black box warning for increased risk of suicidal thinking and behavior, particularly in patients through age 24 years 1
Hepatic failure is a serious potential complication, presenting with abdominal pain, hepatomegaly, elevated transaminases, and jaundice, as noted by the American Association for the Study of Liver Diseases 1
Duloxetine is contraindicated in patients with severe hepatic impairment, according to the American Gastroenterological Association 2
Serotonin syndrome can occur, especially when combined with MAOIs, SSRIs, SNRIs, triptans, tramadol, or other serotonergic agents, as warned by the American College of Emergency Physicians 1
Concomitant use with MAOIs is absolutely contraindicated, as stated by the American Psychiatric Association 1
Abnormal bleeding or bruising can occur, especially when combined with NSAIDs, aspirin, or warfarin, as reported by the American College of Cardiology 1
Erythema multiforme and Stevens-Johnson syndrome are rare but serious complications, as noted by the American Academy of Dermatology 1

Elderly patients have greater sensitivity to adverse effects, particularly hyponatremia and falls, as reported by the American Geriatrics Society 1
Lower doses and slower titration are recommended for elderly patients, as suggested by the American Geriatrics Society 1
Pregnancy should be carefully considered when prescribing duloxetine, as noted by the American College of Obstetricians and Gynecologists 1

Blood pressure and pulse should be monitored before starting and throughout treatment, as recommended by the American Heart Association 1
Hepatic function monitoring for signs of liver dysfunction is necessary, as noted by the American Association for the Study of Liver Diseases 1
Mental status for suicidality, especially in young adults, should be monitored, as recommended by the American Psychiatric Association 1

Most adverse effects are mild to moderate and transient, occurring early in treatment, as reported by the European Association for the Study of Diabetes 3