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Identification
NameDuloxetine
Accession NumberDB00476  (APRD00060)
TypeSmall Molecule
GroupsApproved
Description

Duloxetine (brand names Cymbalta, Yentreve, and in parts of Europe, Xeristar or Ariclaim) is a drug which primarily targets major depressive disorder (MDD), generalized anxiety disorder (GAD), pain related to diabetic peripheral neuropathy and in some countries stress urinary incontinence (SUI). It is manufactured and marketed by Eli Lilly and Company.

Duloxetine has not yet been FDA approved for stress urinary incontinence or for fibromyalgia.

Duloxetine is a selective SNRI (selective serotonin-norepinephrine reuptake inhibitor). Duloxetine is a systemic drug therapy which affects the body as a whole. Known also under the code name LY248686, it is a potent dual reuptake inhibitor of serotonin (5-hydroxytryptamine, 5-HT) and norepinephrine (NE), possessing comparable affinities in binding to NE- and 5-HT transporter sites. It is a less potent inhibitor of dopamine reuptake.

Structure
Thumb
Synonyms
(3S)-N-Methyl-3-(1-naphthyloxy)-3-(2-thienyl)propan-1-amine
LY 248686
External Identifiers Not Available
Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing End
Cymbaltacapsule, delayed release60 mg/1oralH.J. Harkins Company, Inc.2010-01-152016-04-05Us
Cymbaltacapsule, delayed release30 mg/1oralSTAT Rx USA LLC2004-08-242016-04-05Us
Cymbaltacapsule, delayed release20 mg/1oralEli Lilly and Company2004-08-242016-04-23Us
Cymbaltacapsule, delayed release60 mg/1oralClinical Solutions Wholesale2010-01-152016-04-05Us
Cymbaltacapsule, delayed release60 mg/1oralPhysicians Total Care, Inc.2009-11-232016-04-05Us
Cymbaltacapsule, delayed release20 mg/1oralCarilion Materials Management2004-08-242016-04-05Us
Cymbaltacapsule, delayed release60 mg/1oralUnit Dose Services2010-01-152016-04-05Us
Cymbaltacapsule, delayed release60 mg/1oralLake Erie Medical DBA Quality Care Products LLC2010-01-152016-04-05Us
Cymbaltacapsule, delayed release30 mg/1oralCarilion Materials Management2004-08-242016-04-05Us
Cymbaltacapsule, delayed release30 mg/1oralPd Rx Pharmaceuticals, Inc.2004-08-242016-04-05Us
Cymbaltacapsule, delayed release30 mg/1oralUnit Dose Services2004-08-242016-04-05Us
Cymbaltacapsule, delayed release30 mg/1oralREMEDYREPACK INC.2013-04-102016-04-05Us
Cymbaltacapsule, delayed release60 mg/1oralPd Rx Pharmaceuticals, Inc.2010-01-152016-04-05Us
Cymbaltacapsule, delayed release20 mg/1oralUnit Dose Services2004-08-242016-04-05Us
Cymbaltacapsule, delayed release20 mg/1oralRebel Distributors Corp2004-08-242016-04-05Us
Cymbaltacapsule, delayed release60 mg/1oralCardinal Health2004-08-242016-04-05Us
Cymbaltacapsule, delayed release60 mg/1oralLake Erie Medical Surgical & Supply DBA Quality Care Products LLC2011-07-142016-04-05Us
Cymbaltacapsule, delayed release60 mg/1oralRebel Distributors Corp.2004-08-242016-04-05Us
Cymbaltacapsule, delayed release30 mg/1oralbryant ranch prepack2004-08-242016-04-05Us
Cymbaltacapsule, delayed release20 mg/1oralCardinal Health2004-08-242016-04-05Us
Cymbaltacapsule, delayed release30 mg/1oralCardinal Health2004-08-242016-04-05Us
Cymbaltacapsule (delayed release)60 mgoralEli Lilly Canada Inc2008-01-18Not applicableCanada
Cymbaltacapsule, delayed release30 mg/1oralLake Erie Medical Surgical & Supply DBA Quality Care Products LLC2011-07-142016-04-05Us
Cymbaltacapsule, delayed release30 mg/1oralRebel Distributors Corp.2004-08-242016-04-05Us
Cymbaltacapsule, delayed release60 mg/1oralbryant ranch prepack2010-01-152016-04-05Us
Cymbaltacapsule, delayed release60 mg/1oralREMEDYREPACK INC.2010-12-232016-04-05Us
Cymbaltacapsule, delayed release60 mg/1oralEli Lilly and Company2010-01-152016-04-23Us
Cymbaltacapsule, delayed release30 mg/1oralSt Marys Medical Park Pharmacy2010-12-312016-04-05Us
Cymbaltacapsule, delayed release30 mg/1oralPhysicians Total Care, Inc.2008-11-212016-04-05Us
Cymbaltacapsule (delayed release)30 mgoralEli Lilly Canada Inc2008-01-18Not applicableCanada
Cymbaltacapsule, delayed release30 mg/1oralAphena Pharma Solutions Tennessee, Llc2004-08-242016-04-05Us
Cymbaltacapsule, delayed release30 mg/1oralEli Lilly and Company2004-08-242016-04-23Us
Cymbaltacapsule, delayed release60 mg/1oralSt Marys Medical Park Pharmacy2010-12-312016-04-05Us
Cymbaltacapsule, delayed release20 mg/1oralPhysicians Total Care, Inc.2008-04-282016-04-05Us
Duloxetinecapsule, delayed release60 mg/1oralCarilion Materials Management2014-01-242016-04-05Us
Duloxetinecapsule, delayed release30 mg/1oralPrasco Laboratories2014-01-242016-09-30Us
Duloxetinecapsule, delayed release20 mg/1oralPrasco Laboratories2014-01-242016-11-30Us
Duloxetinecapsule, delayed release60 mg/1oralPrasco Laboratories2014-01-242015-11-30Us
Generic Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing End
Duloxetinecapsule, delayed release30 mg/1oralTrigen Laboratories, LLC2014-08-192016-04-05Us
Duloxetinecapsule, delayed release20 mg/1oralKAISER FOUNDATION HOSPITALS2014-01-202016-04-23Us
Duloxetinecapsule, delayed release60 mg/1oralTrigen Laboratories, LLC2014-08-192016-04-05Us
Duloxetinecapsule, delayed release60 mg/1oralCardinal Health2013-12-232016-04-05Us
Duloxetinecapsule, delayed release60 mg/1oralTYA Pharmaceuticals2013-12-112016-04-05Us
Duloxetinecapsule, delayed release60 mg/1oralDIRECT RX2014-01-012016-04-05Us
Duloxetinecapsule, delayed release30 mg/1oralBlue Point Laboratories2014-03-142016-04-05Us
Duloxetinecapsule, delayed release60 mg/1oralAurobindo Pharma Limited2013-12-112016-04-05Us
Duloxetinecapsule, delayed release60 mg/1oralAvera Mc Kennan Hospital2015-03-092016-04-05Us
Duloxetinecapsule, delayed release20 mg/1oralCadila Healthcare Limited2014-02-152016-04-05Us
Duloxetinecapsule, delayed release20 mg/1oralZydus Pharmaceuticals (USA) Inc.2014-05-272016-04-05Us
Duloxetinecapsule, delayed release60 mg/1oralBlue Point Laboratories2014-03-142016-04-05Us
Duloxetinecapsule, delayed release20 mg/1oralTrigen Laboratories, LLC2014-08-192016-04-05Us
Duloxetinecapsule, delayed release60 mg/1oralCitron Pharma LLC2013-12-112016-04-05Us
Duloxetinecapsule, delayed release30 mg/1oralCardinal Health2013-12-232016-04-05Us
Duloxetinecapsule, delayed release20 mg/1oralBlue Point Laboratories2014-03-142016-04-05Us
Duloxetinecapsule, delayed release30 mg/1oralAurobindo Pharma Limited2013-12-112016-04-05Us
Duloxetinecapsule, delayed release40 mg/1oralLupin Pharmaceuticals, Inc.2015-05-252016-04-05Us
Duloxetinecapsule, delayed release30 mg/1oralProficient Rx LP2013-12-112016-04-05Us
Duloxetinecapsule, delayed release pellets60 mg/1oralMedsource Pharmaceuticals2014-06-182016-04-05Us
Duloxetinecapsule, delayed release30 mg/1oralCitron Pharma LLC2013-12-112016-04-05Us
Duloxetinecapsule, delayed release pellets60 mg/1oralDr. Reddy's Laboratories Limited2014-06-182016-04-05Us
Duloxetinecapsule, delayed release60 mg/1oralAscend Laboratories, LLC2012-05-012016-04-05Us
Duloxetinecapsule, delayed release20 mg/1oralAurobindo Pharma Limited2013-12-112016-04-05Us
Duloxetinecapsule, delayed release60 mg/1oralLupin Pharmaceuticals, Inc.2013-12-112016-04-05Us
Duloxetinecapsule, delayed release30 mg/1oralREMEDYREPACK INC.2016-01-262016-04-05Us
Duloxetinecapsule, delayed release pellets30 mg/1oralMedsource Pharmaceuticals2014-06-182016-04-05Us
Duloxetinecapsule, delayed release20 mg/1oralCitron Pharma LLC2013-12-112016-04-05Us
Duloxetinecapsule, delayed release pellets30 mg/1oralDr. Reddy's Laboratories Limited2014-06-182016-04-05Us
Duloxetinecapsule, delayed release60 mg/1oralbryant ranch prepack2013-12-112016-04-05Us
Duloxetinecapsule, delayed release30 mg/1oralAscend Laboratories, LLC2012-05-012016-04-05Us
Duloxetinecapsule, delayed release60 mg/1oralCadila Healthcare Limited2014-05-272016-04-05Us
Duloxetinecapsule, delayed release30 mg/1oralLupin Pharmaceuticals, Inc.2013-12-112016-04-05Us
Duloxetinecapsule, delayed release30 mg/1oralAvera Mc Kennan Hospital2015-03-022016-04-05Us
Duloxetinecapsule, delayed release60 mg/1oralSun Pharma Global FZE2013-12-112016-04-05Us
Duloxetinecapsule, delayed release60 mg/1oralAv Kare, Inc.2014-07-082016-04-05Us
Duloxetinecapsule, delayed release60 mg/1oralCardinal Health2013-12-112016-04-05Us
Duloxetinecapsule, delayed release pellets20 mg/1oralDr. Reddy's Laboratories Limited2014-06-182016-04-05Us
Duloxetinecapsule, delayed release30 mg/1oralbryant ranch prepack2013-12-112016-04-05Us
Duloxetinecapsule, delayed release20 mg/1oralAscend Laboratories, LLC2012-05-012016-04-05Us
Duloxetinecapsule, delayed release30 mg/1oralCadila Healthcare Limited2014-05-272016-04-05Us
Duloxetinecapsule, delayed release pellets30 mg/1oralPreferred Pharmaceuticals, Inc.2014-11-182016-04-05Us
Duloxetinecapsule, delayed release20 mg/1oralLupin Pharmaceuticals, Inc.2013-12-112016-04-05Us
Duloxetinecapsule, delayed release60 mg/1oralTeva Pharmaceuticals Usa, Inc.2013-12-112016-04-23Us
Duloxetinecapsule, delayed release60 mg/1oralCipla USA Inc.2015-12-052016-04-05Us
Duloxetinecapsule, delayed release30 mg/1oralAv Kare, Inc.2014-07-082016-04-05Us
Duloxetinecapsule, delayed release30 mg/1oralCardinal Health2013-12-112016-04-05Us
Duloxetinecapsule, delayed release30 mg/1oralREMEDYREPACK INC.2014-04-242016-04-05Us
Duloxetinecapsule, delayed release60 mg/1oralPrasco Laboratories2013-12-112016-04-05Us
Duloxetinecapsule, delayed release20 mg/1oralCadila Healthcare Limited2014-05-272016-04-05Us
Duloxetinecapsule, delayed release60 mg/1oralPreferred Pharmaceuticals, Inc.2014-11-252016-04-05Us
Duloxetinecapsule, delayed release60 mg/1oralAmerican Health Packaging2013-12-232016-04-05Us
Duloxetinecapsule, delayed release30 mg/1oralTeva Pharmaceuticals Usa, Inc.2013-12-112016-04-23Us
Duloxetinecapsule, delayed release30 mg/1oralCipla USA Inc.2015-12-052016-04-05Us
Duloxetinecapsule, delayed release60 mg/1oralActavis Pharma, Inc.2013-12-172016-04-23Us
Duloxetinecapsule, delayed release30 mg/1oralSun Pharma Global FZE2013-12-112016-04-05Us
Duloxetinecapsule, delayed release30 mg/1oralPrasco Laboratories2013-12-112016-04-05Us
Duloxetinecapsule, delayed release60 mg/1oralCadila Healthcare Limited2014-02-152016-04-05Us
Duloxetinecapsule, delayed release60 mg/1oralZydus Pharmaceuticals (USA) Inc.2014-05-272016-04-05Us
Duloxetinecapsule, delayed release30 mg/1oralAmerican Health Packaging2013-12-232016-04-05Us
Duloxetinecapsule, delayed release20 mg/1oralTeva Pharmaceuticals Usa, Inc.2013-12-112016-04-23Us
Duloxetinecapsule, delayed release20 mg/1oralCipla USA Inc.2015-12-052016-04-05Us
Duloxetinecapsule, delayed release30 mg/1oralActavis Pharma, Inc.2013-12-172016-04-23Us
Duloxetinecapsule, delayed release20 mg/1oralSun Pharma Global FZE2013-12-112016-04-05Us
Duloxetinecapsule, delayed release20 mg/1oralAv Kare, Inc.2014-07-082016-04-05Us
Duloxetinecapsule, delayed release20 mg/1oralCardinal Health2013-12-112016-04-05Us
Duloxetinecapsule, delayed release20 mg/1oralREMEDYREPACK INC.2014-01-302016-04-05Us
Duloxetinecapsule, delayed release30 mg/1oralZydus Pharmaceuticals (USA) Inc.2014-05-272016-04-05Us
Duloxetinecapsule, delayed release20 mg/1oralAmerican Health Packaging2013-12-232016-04-05Us
Duloxetinecapsule, delayed release60 mg/1oralProficient Rx LP2013-12-112016-04-01Us
Duloxetinecapsule, delayed release30 mg/1oralA S Medication Solutions2013-12-112016-04-05Us
Duloxetinecapsule, delayed release20 mg/1oralActavis Pharma, Inc.2013-12-172016-04-23Us
Duloxetinecapsule, delayed release30 mg/1oralREMEDYREPACK INC.2014-01-302016-04-05Us
Duloxetinecapsule, delayed release20 mg/1oralPrasco Laboratories2013-12-112016-04-05Us
Duloxetinecapsule, delayed release30 mg/1oralCadila Healthcare Limited2014-02-152016-04-05Us
Duloxetine Delayed-releasecapsule, delayed release pellets60 mg/1oralA S Medication Solutions2014-06-112016-04-05Us
Duloxetine Delayed-releasecapsule, delayed release pellets30 mg/1oralBreckenridge Pharmaceutical, Inc.2014-06-112016-04-05Us
Duloxetine Delayed-releasecapsule, delayed release pellets20 mg/1oralGolden State Medical Supply, Inc.2014-06-112016-04-05Us
Duloxetine Delayed-releasecapsule, delayed release pellets60 mg/1oralBreckenridge Pharmaceutical, Inc.2014-06-112016-04-05Us
Duloxetine Delayed-releasecapsule, delayed release pellets30 mg/1oralGolden State Medical Supply, Inc.2014-06-112016-04-05Us
Duloxetine Delayed-releasecapsule, delayed release pellets20 mg/1oralBreckenridge Pharmaceutical, Inc.2014-06-112016-04-05Us
Duloxetine Delayed-releasecapsule, delayed release pellets30 mg/1oralTYA Pharmaceuticals2014-06-112016-04-05Us
Duloxetine Delayed-releasecapsule, delayed release pellets30 mg/1oralPreferred Pharmaceuticals, Inc.2015-03-232016-04-05Us
Duloxetine Delayed-releasecapsule, delayed release pellets60 mg/1oralGolden State Medical Supply, Inc.2014-06-112016-04-05Us
Duloxetine Delayed-release Delayed-releasecapsule, delayed release pellets30 mg/1oralREMEDYREPACK INC.2016-03-142016-04-05Us
Duloxetine Hydrochloridecapsule, delayed release60 mg/1oralMajor Pharmaceuticals2013-12-112016-04-05Us
Duloxetine Hydrochloridecapsule, delayed release30 mg/1oralMajor Pharmaceuticals2013-12-112016-04-05Us
Duloxetine Hydrochloridecapsule, delayed release30 mg/1oralTYA Pharmaceuticals2013-12-112016-04-05Us
Duloxetine Hydrochloridecapsule, delayed release pellets30 mg/1oralDIRECT RX2014-01-012016-04-05Us
Duloxetine Hydrochloridecapsule, delayed release20 mg/1oralPreferred Pharmaceuticals, Inc.2014-08-202016-04-05Us
Duloxetine Hydrochloridecapsule, delayed release60 mg/1oralTorrent Pharmaceuticals Limited2013-12-112016-04-05Us
Duloxetine Hydrochloridecapsule, delayed release20 mg/1oralMajor Pharmaceuticals2013-12-112016-04-05Us
Duloxetine Hydrochloridecapsule, delayed release60 mg/1oralUnit Dose Services2013-12-112016-04-05Us
Duloxetine Hydrochloridecapsule, delayed release pellets60 mg/1oralDIRECT RX2014-01-012016-04-05Us
Duloxetine Hydrochloridecapsule, delayed release30 mg/1oralPreferred Pharmaceuticals, Inc.2014-08-202016-04-05Us
Duloxetine Hydrochloridecapsule, delayed release30 mg/1oralTorrent Pharmaceuticals Limited2013-12-112016-04-05Us
Duloxetine Hydrochloridecapsule, delayed release60 mg/1oralNcs Health Care Of Ky, Inc Dba Vangard Labs2013-12-112016-04-23Us
Duloxetine Hydrochloridecapsule, delayed release30 mg/1oralUnit Dose Services2013-12-112016-04-05Us
Duloxetine Hydrochloridecapsule, delayed release60 mg/1oralApotex Corp.2014-06-132016-04-05Us
Duloxetine Hydrochloridecapsule, delayed release20 mg/1oralTorrent Pharmaceuticals Limited2013-12-112016-04-05Us
Duloxetine Hydrochloridecapsule, delayed release30 mg/1oralNcs Health Care Of Ky, Inc Dba Vangard Labs2013-12-112016-04-23Us
Duloxetine Hydrochloridecapsule, delayed release60 mg/1oralApotex Corp.2014-06-132016-04-05Us
Duloxetine Hydrochloridecapsule, delayed release60 mg/1oralProficient Rx LP2013-12-112016-04-05Us
Duloxetine Hydrochloridecapsule, delayed release30 mg/1oralApotex Corp.2014-06-132016-04-05Us
Duloxetine Hydrochloridecapsule, delayed release60 mg/1oralMajor Pharmaceuticals2014-06-132016-04-05Us
Duloxetine Hydrochloridecapsule, delayed release60 mg/1oralProficient Rx LP2014-06-132016-04-05Us
Duloxetine Hydrochloridecapsule, delayed release20 mg/1oralApotex Corp.2014-06-132016-04-05Us
Duloxetine Hydrochloridecapsule, delayed release30 mg/1oralMajor Pharmaceuticals2014-06-132016-04-05Us
Duloxetine Hydrochloridecapsule, delayed release20 mg/1oralMajor Pharmaceuticals2014-06-132016-04-05Us
Duloxetine Hydrochloridecapsule, delayed release30 mg/1oralCardinal Health2013-12-112016-04-05Us
Duloxetine Hydrochloridecapsule, delayed release30 mg/1oralProficient Rx LP2014-06-132016-04-05Us
Duloxetine Hydrochloride 20 mgcapsule, delayed release20 mg/1oralAlembic Pharmaceuticals Limited2014-06-092016-04-05Us
Duloxetine Hydrochloride 30 mgcapsule, delayed release30 mg/1oralAlembic Pharmaceuticals Limited2014-06-092016-04-05Us
Duloxetine Hydrochloride 60 mgcapsule, delayed release60 mg/1oralAlembic Pharmaceuticals Limited2014-06-092016-04-05Us
Irenkacapsule, delayed release40 mg/1oralLupin Pharma2015-06-012016-04-05Us
Over the Counter ProductsNot Available
International Brands
NameCompany
AriclaimNot Available
DulaneNot Available
DuzelaNot Available
XeristarNot Available
YentreveNot Available
Brand mixturesNot Available
Salts
Name/CASStructureProperties
Duloxetine Hydrochloride
Thumb
  • InChI Key: BFFSMCNJSOPUAY-UHFFFAOYNA-N
  • Monoisotopic Mass: 333.095412664
  • Average Mass: 333.875
DBSALT000378
Categories
UNII9044SC542W
CAS number136434-34-9
WeightAverage: 297.415
Monoisotopic: 297.118734925
Chemical FormulaC18H19NOS
InChI KeyInChIKey=ZEUITGRIYCTCEM-KRWDZBQOSA-N
InChI
InChI=1S/C18H19NOS/c1-19-12-11-17(18-10-5-13-21-18)20-16-9-4-7-14-6-2-3-8-15(14)16/h2-10,13,17,19H,11-12H2,1H3/t17-/m0/s1
IUPAC Name
methyl[(3S)-3-(naphthalen-1-yloxy)-3-(thiophen-2-yl)propyl]amine
SMILES
CNCC[[email protected]](OC1=CC=CC2=CC=CC=C12)C1=CC=CS1
Taxonomy
DescriptionThis compound belongs to the class of organic compounds known as naphthalenes. These are compounds containing a naphthalene moiety, which consists of two fused benzene rings.
KingdomOrganic compounds
Super ClassBenzenoids
ClassNaphthalenes
Sub ClassNot Available
Direct ParentNaphthalenes
Alternative Parents
Substituents
  • Naphthalene
  • Aralkylamine
  • Alkyl aryl ether
  • Heteroaromatic compound
  • Thiophene
  • Organoheterocyclic compound
  • Secondary amine
  • Ether
  • Secondary aliphatic amine
  • Hydrocarbon derivative
  • Organooxygen compound
  • Organonitrogen compound
  • Amine
  • Aromatic heteropolycyclic compound
Molecular FrameworkAromatic heteropolycyclic compounds
External Descriptors
Pharmacology
IndicationFor the acute and maintenance treatment of major depressive disorder (MDD), as well as acute management of generalized anxiety disorder. Also used for the management of neuropathic pain associated with diabetic peripheral neuropathy, and fibromyalgia. Has been used in the management of moderate to severe stress urinary incontinence (SUI) in women.
PharmacodynamicsDuloxetine is in a class of medications called selective serotonin and norepinephrine reuptake inhibitors (SSNRIs) and primarily targets major depressive disorders (MDD) and stress urinary incontinence (SUI). Duloxetine is also used to treat pain and tingling caused by diabetic neuropathy (damage to nerves that can develop in people who have diabetes). Known also as LY248686, it is a potent dual inhibitor of serotonin (5-hydroxytryptamine, 5-HT) and norepinephrine (NE) reuptake, possessing comparable affinities in binding to NE and 5-HT transport sites. Interestingly, its behavior contrasts to most other dual-reuptake inhibitors. Furthermore, duloxentine lacks affinity for monoamine receptors within the central nervous system.
Mechanism of actionDuloxetine is a potent inhibitor of neuronal serotonin and norepinephrine reuptake and a less potent inhibitor of dopamine reuptake. Duloxetine has no significant affinity for dopaminergic, adrenergic, cholinergic, histaminergic, opioid, glutamate, and GABA receptors. The antidepressant and pain inhibitory actions of duloxetine are believed to be related to its potentiation of serotonergic and noradrenergic activity in the CNS. The mechanism of action of duloxetine in SUI has not been determined, but is thought to be associated with the potentiation of serotonin and norepinephrine activity in the spinal cord, which increases urethral closure forces and thereby reduces involuntary urine loss.
Related Articles
AbsorptionOrally administered duloxetine hydrochloride is well absorbed.
Volume of distribution
  • 1640 L
Protein bindingProtein binding is greater than 90%.
Metabolism

The major biotransformation pathways for duloxetine involve oxidation of the naphthyl ring followed by conjugation and further oxidation. Both CYP2D6 and CYP1A2 catalyze the oxidation of the naphthyl ring in vitro. Metabolites found in plasma include 4-hydroxy duloxetine glucuronide and 5-hydroxy, 6-methoxy duloxetine sulfate. The major circulating metabolites have not been shown to contribute significantly to the pharmacologic activity of duloxetine.

SubstrateEnzymesProduct
Duloxetine
Not Available
4-hydroxy duloxetine glucuronideDetails
Duloxetine
Not Available
5-hydroxy, 6-methoxy duloxetine sulfateDetails
Route of eliminationMany additional metabolites have been identified in urine, some representing only minor pathways of elimination. Most (about 70%) of the duloxetine dose appears in the urine as metabolites of duloxetine; about 20% is excreted in the feces.
Half life12 hours (range 8-17 hours)
ClearanceNot Available
ToxicityOral, rat LD50: 491 mg/kg for males and 279 mg/kg for females. Symptoms of overdose include tremors, convulsions, reduced activity, slow pupillary response, intermittent tremors, and rigidity.
Affected organisms
  • Humans and other mammals
PathwaysNot Available
SNP Mediated EffectsNot Available
SNP Mediated Adverse Drug ReactionsNot Available
ADMET
Predicted ADMET features
PropertyValueProbability
Human Intestinal Absorption+1.0
Blood Brain Barrier+0.9804
Caco-2 permeable+0.6358
P-glycoprotein substrateSubstrate0.7078
P-glycoprotein inhibitor IInhibitor0.5987
P-glycoprotein inhibitor IINon-inhibitor0.5519
Renal organic cation transporterInhibitor0.6525
CYP450 2C9 substrateNon-substrate0.5964
CYP450 2D6 substrateSubstrate0.6482
CYP450 3A4 substrateSubstrate0.5799
CYP450 1A2 substrateInhibitor0.839
CYP450 2C9 inhibitorNon-inhibitor0.7721
CYP450 2D6 inhibitorInhibitor0.6977
CYP450 2C19 inhibitorNon-inhibitor0.572
CYP450 3A4 inhibitorInhibitor0.5108
CYP450 inhibitory promiscuityHigh CYP Inhibitory Promiscuity0.6689
Ames testNon AMES toxic0.5422
CarcinogenicityNon-carcinogens0.9293
BiodegradationNot ready biodegradable0.935
Rat acute toxicity2.5700 LD50, mol/kg Not applicable
hERG inhibition (predictor I)Strong inhibitor0.5926
hERG inhibition (predictor II)Inhibitor0.6386
ADMET data is predicted using admetSAR, a free tool for evaluating chemical ADMET properties. (23092397 )
Pharmacoeconomics
Manufacturers
  • Eli lilly and co
Packagers
Dosage forms
FormRouteStrength
Capsule (delayed release)oral30 mg
Capsule (delayed release)oral60 mg
Capsule, delayed releaseoral20 mg/1
Capsule, delayed releaseoral30 mg/1
Capsule, delayed releaseoral60 mg/1
Capsule, delayed release pelletsoral30 mg/1
Capsule, delayed release pelletsoral60 mg/1
Capsule, delayed release pelletsoral20 mg/1
Capsule, delayed releaseoral40 mg/1
Prices
Unit descriptionCostUnit
Cymbalta 30 mg Enteric Coated Capsule5.38USD capsule
Cymbalta 60 mg Enteric Coated Capsule5.38USD capsule
Cymbalta 30 mg capsule5.18USD capsule
Cymbalta 60 mg capsule5.18USD capsule
Cymbalta 20 mg Enteric Coated Capsule4.64USD capsule
Cymbalta 20 mg capsule4.62USD capsule
DrugBank does not sell nor buy drugs. Pricing information is supplied for informational purposes only.
Patents
Patent NumberPediatric ExtensionApprovedExpires (estimated)
CA2153856 No2005-05-102015-07-13Canada
CA2344057 No2008-11-182019-09-10Canada
US5023269 No1993-06-112013-06-11Us
US6596756 Yes2000-03-102020-03-10Us
Properties
StateSolid
Experimental Properties
PropertyValueSource
logP4Not Available
Predicted Properties
PropertyValueSource
Water Solubility0.00296 mg/mLALOGPS
logP4.72ALOGPS
logP4.2ChemAxon
logS-5ALOGPS
pKa (Strongest Basic)9.7ChemAxon
Physiological Charge1ChemAxon
Hydrogen Acceptor Count2ChemAxon
Hydrogen Donor Count1ChemAxon
Polar Surface Area21.26 Å2ChemAxon
Rotatable Bond Count6ChemAxon
Refractivity87.73 m3·mol-1ChemAxon
Polarizability33.15 Å3ChemAxon
Number of Rings3ChemAxon
Bioavailability1ChemAxon
Rule of FiveYesChemAxon
Ghose FilterYesChemAxon
Veber's RuleYesChemAxon
MDDR-like RuleYesChemAxon
Spectra
Mass Spec (NIST)Not Available
SpectraNot Available
References
Synthesis Reference

Richard A. Berglund, “Intermediate useful for the asymmetric synthesis of duloxetine.” U.S. Patent US5491243, issued June, 1991.

US5491243
General References
  1. Turcotte JE, Debonnel G, de Montigny C, Hebert C, Blier P: Assessment of the serotonin and norepinephrine reuptake blocking properties of duloxetine in healthy subjects. Neuropsychopharmacology. 2001 May;24(5):511-21. [PubMed:11282251 ]
  2. Anttila S, Leinonen E: Duloxetine Eli Lilly. Curr Opin Investig Drugs. 2002 Aug;3(8):1217-21. [PubMed:12211418 ]
  3. Karpa KD, Cavanaugh JE, Lakoski JM: Duloxetine pharmacology: profile of a dual monoamine modulator. CNS Drug Rev. 2002 Winter;8(4):361-76. [PubMed:12481192 ]
  4. van Groeningen CJ, Peters GJ, Pinedo HM: Lack of effectiveness of combined 5-fluorouracil and leucovorin in patients with 5-fluorouracil-resistant advanced colorectal cancer. Eur J Cancer Clin Oncol. 1989 Jan;25(1):45-9. [PubMed:2784100 ]
  5. Jost W, Marsalek P: Duloxetine: mechanism of action at the lower urinary tract and Onuf's nucleus. Clin Auton Res. 2004 Aug;14(4):220-7. [PubMed:15316838 ]
  6. Carter NJ, McCormack PL: Duloxetine: a review of its use in the treatment of generalized anxiety disorder. CNS Drugs. 2009;23(6):523-41. doi: 10.2165/00023210-200923060-00006. [PubMed:19480470 ]
External Links
ATC CodesN06AX21
AHFS CodesNot Available
PDB EntriesNot Available
FDA labelDownload (104 KB)
MSDSDownload (76.3 KB)
Interactions
Drug Interactions
Drug
AbciximabDuloxetine may increase the anticoagulant activities of Abciximab.
AbirateroneThe serum concentration of Duloxetine can be increased when it is combined with Abiraterone.
AcebutololAcebutolol may increase the orthostatic hypotensive activities of Duloxetine.
AcenocoumarolDuloxetine may increase the anticoagulant activities of Acenocoumarol.
AcepromazineThe risk or severity of adverse effects can be increased when Duloxetine is combined with Acepromazine.
AcetazolamideAcetazolamide may increase the orthostatic hypotensive activities of Duloxetine.
AcetophenazineThe risk or severity of adverse effects can be increased when Duloxetine is combined with Acetophenazine.
Acetylsalicylic acidDuloxetine may increase the antiplatelet activities of Acetylsalicylic acid.
AldesleukinAldesleukin may increase the orthostatic hypotensive activities of Duloxetine.
AliskirenAliskiren may increase the orthostatic hypotensive activities of Duloxetine.
AlteplaseDuloxetine may increase the anticoagulant activities of Alteplase.
AmilorideAmiloride may increase the orthostatic hypotensive activities of Duloxetine.
AmisulprideThe risk or severity of adverse effects can be increased when Duloxetine is combined with Amisulpride.
AmitriptylineDuloxetine may increase the serotonergic activities of Amitriptyline.
AmlodipineAmlodipine may increase the orthostatic hypotensive activities of Duloxetine.
AmoxapineDuloxetine may increase the serotonergic activities of Amoxapine.
Amyl NitriteAmyl Nitrite may increase the orthostatic hypotensive activities of Duloxetine.
AnistreplaseDuloxetine may increase the anticoagulant activities of Anistreplase.
ApixabanThe risk or severity of adverse effects can be increased when Duloxetine is combined with Apixaban.
ApraclonidineApraclonidine may increase the orthostatic hypotensive activities of Duloxetine.
AripiprazoleThe risk or severity of adverse effects can be increased when Aripiprazole is combined with Duloxetine.
AtenololAtenolol may increase the orthostatic hypotensive activities of Duloxetine.
Azilsartan medoxomilAzilsartan medoxomil may increase the orthostatic hypotensive activities of Duloxetine.
BenazeprilBenazepril may increase the orthostatic hypotensive activities of Duloxetine.
BenzquinamideThe risk or severity of adverse effects can be increased when Duloxetine is combined with Benzquinamide.
BetaxololBetaxolol may increase the orthostatic hypotensive activities of Duloxetine.
BisoprololBisoprolol may increase the orthostatic hypotensive activities of Duloxetine.
BortezomibThe metabolism of Duloxetine can be decreased when combined with Bortezomib.
BretyliumBretylium may increase the orthostatic hypotensive activities of Duloxetine.
BrexpiprazoleThe serum concentration of Brexpiprazole can be increased when it is combined with Duloxetine.
BrimonidineBrimonidine may increase the orthostatic hypotensive activities of Duloxetine.
BumetanideBumetanide may increase the orthostatic hypotensive activities of Duloxetine.
BupropionThe serum concentration of Duloxetine can be increased when it is combined with Bupropion.
CandesartanCandesartan may increase the orthostatic hypotensive activities of Duloxetine.
CaptoprilCaptopril may increase the orthostatic hypotensive activities of Duloxetine.
CarbamazepineThe metabolism of Duloxetine can be increased when combined with Carbamazepine.
CarphenazineThe risk or severity of adverse effects can be increased when Duloxetine is combined with Carphenazine.
CarteololCarteolol may increase the orthostatic hypotensive activities of Duloxetine.
CarvedilolCarvedilol may increase the orthostatic hypotensive activities of Duloxetine.
ChlormezanoneThe risk or severity of adverse effects can be increased when Duloxetine is combined with Chlormezanone.
ChlorothiazideChlorothiazide may increase the orthostatic hypotensive activities of Duloxetine.
ChlorpromazineThe risk or severity of adverse effects can be increased when Duloxetine is combined with Chlorpromazine.
ChlorprothixeneThe risk or severity of adverse effects can be increased when Duloxetine is combined with Chlorprothixene.
ChlorthalidoneChlorthalidone may increase the orthostatic hypotensive activities of Duloxetine.
CilazaprilCilazapril may increase the orthostatic hypotensive activities of Duloxetine.
CinacalcetThe serum concentration of Duloxetine can be increased when it is combined with Cinacalcet.
CiprofloxacinThe serum concentration of Duloxetine can be increased when it is combined with Ciprofloxacin.
Citric AcidDuloxetine may increase the anticoagulant activities of Citric Acid.
ClevidipineClevidipine may increase the orthostatic hypotensive activities of Duloxetine.
ClomipramineDuloxetine may increase the serotonergic activities of Clomipramine.
ClonidineClonidine may increase the orthostatic hypotensive activities of Duloxetine.
ClozapineThe risk or severity of adverse effects can be increased when Duloxetine is combined with Clozapine.
CocaineThe serum concentration of Duloxetine can be increased when it is combined with Cocaine.
CodeineThe therapeutic efficacy of Codeine can be decreased when used in combination with Duloxetine.
CollagenaseThe risk or severity of adverse effects can be increased when Duloxetine is combined with Collagenase.
Cyproterone acetateThe serum concentration of Duloxetine can be decreased when it is combined with Cyproterone acetate.
Dabigatran etexilateDuloxetine may increase the anticoagulant activities of Dabigatran etexilate.
DalteparinDuloxetine may increase the anticoagulant activities of Dalteparin.
DapagliflozinDapagliflozin may increase the orthostatic hypotensive activities of Duloxetine.
DapoxetineThe risk or severity of adverse effects can be increased when Dapoxetine is combined with Duloxetine.
DasatinibDasatinib may increase the anticoagulant activities of Duloxetine.
DeferasiroxThe serum concentration of Duloxetine can be increased when it is combined with Deferasirox.
DelavirdineThe serum concentration of Duloxetine can be increased when it is combined with Delavirdine.
Deoxycholic AcidThe risk or severity of adverse effects can be increased when Duloxetine is combined with Deoxycholic Acid.
DesipramineDuloxetine may increase the serotonergic activities of Desipramine.
DesmopressinDuloxetine may increase the antiplatelet activities of Desmopressin.
DexmedetomidineDexmedetomidine may increase the orthostatic hypotensive activities of Duloxetine.
DiclofenamideDiclofenamide may increase the orthostatic hypotensive activities of Duloxetine.
DicoumarolDuloxetine may increase the anticoagulant activities of Dicoumarol.
DiltiazemDiltiazem may increase the orthostatic hypotensive activities of Duloxetine.
DinutuximabDinutuximab may increase the orthostatic hypotensive activities of Duloxetine.
DipivefrinDuloxetine may increase the tachycardic activities of Dipivefrin.
DipyridamoleDipyridamole may increase the orthostatic hypotensive activities of Duloxetine.
DoxazosinDoxazosin may increase the orthostatic hypotensive activities of Duloxetine.
DoxepinDuloxetine may increase the serotonergic activities of Doxepin.
DoxorubicinThe serum concentration of Doxorubicin can be increased when it is combined with Duloxetine.
DroperidolThe risk or severity of adverse effects can be increased when Duloxetine is combined with Droperidol.
Edetic AcidDuloxetine may increase the anticoagulant activities of Edetic Acid.
EliglustatThe serum concentration of Eliglustat can be increased when it is combined with Duloxetine.
EmpagliflozinEmpagliflozin may increase the orthostatic hypotensive activities of Duloxetine.
EnalaprilEnalapril may increase the orthostatic hypotensive activities of Duloxetine.
EnalaprilatEnalaprilat may increase the orthostatic hypotensive activities of Duloxetine.
EnoxaparinDuloxetine may increase the anticoagulant activities of Enoxaparin.
EplerenoneEplerenone may increase the orthostatic hypotensive activities of Duloxetine.
EprosartanEprosartan may increase the orthostatic hypotensive activities of Duloxetine.
EsmololEsmolol may increase the orthostatic hypotensive activities of Duloxetine.
Etacrynic acidEthacrynic acid may increase the orthostatic hypotensive activities of Duloxetine.
EthanolThe risk or severity of adverse effects can be increased when Ethanol is combined with Duloxetine.
Ethyl biscoumacetateDuloxetine may increase the anticoagulant activities of Ethyl biscoumacetate.
FelodipineFelodipine may increase the orthostatic hypotensive activities of Duloxetine.
FencamfamineThe risk or severity of adverse effects can be increased when Duloxetine is combined with Fencamfamine.
FesoterodineThe serum concentration of the active metabolites of Fesoterodine can be increased when Fesoterodine is used in combination with Duloxetine.
FluoxetineThe serum concentration of Duloxetine can be increased when it is combined with Fluoxetine.
FlupentixolThe risk or severity of adverse effects can be increased when Duloxetine is combined with Flupentixol.
FluphenazineThe risk or severity of adverse effects can be increased when Duloxetine is combined with Fluphenazine.
FluspirileneThe risk or severity of adverse effects can be increased when Duloxetine is combined with Fluspirilene.
FluvoxamineThe serum concentration of Duloxetine can be increased when it is combined with Fluvoxamine.
Fondaparinux sodiumDuloxetine may increase the anticoagulant activities of Fondaparinux sodium.
FosinoprilFosinopril may increase the orthostatic hypotensive activities of Duloxetine.
FurosemideFurosemide may increase the orthostatic hypotensive activities of Duloxetine.
GlucosamineGlucosamine may increase the antiplatelet activities of Duloxetine.
GranisetronGranisetron may increase the serotonergic activities of Duloxetine.
GuanfacineGuanfacine may increase the orthostatic hypotensive activities of Duloxetine.
HaloperidolThe risk or severity of adverse effects can be increased when Duloxetine is combined with Haloperidol.
HeparinDuloxetine may increase the anticoagulant activities of Heparin.
HydralazineHydralazine may increase the orthostatic hypotensive activities of Duloxetine.
HydrochlorothiazideHydrochlorothiazide may increase the orthostatic hypotensive activities of Duloxetine.
Ibritumomab tiuxetanThe risk or severity of adverse effects can be increased when Duloxetine is combined with Ibritumomab.
IbrutinibThe risk or severity of adverse effects can be increased when Ibrutinib is combined with Duloxetine.
ImipramineDuloxetine may increase the serotonergic activities of Imipramine.
IndapamideIndapamide may increase the orthostatic hypotensive activities of Duloxetine.
IobenguaneThe therapeutic efficacy of Iobenguane can be decreased when used in combination with Duloxetine.
Ioflupane I 123Duloxetine may decrease effectiveness of Ioflupane I 123 as a diagnostic agent.
IrbesartanIrbesartan may increase the orthostatic hypotensive activities of Duloxetine.
IsosorbideIsosorbide may increase the orthostatic hypotensive activities of Duloxetine.
Isosorbide DinitrateIsosorbide Dinitrate may increase the orthostatic hypotensive activities of Duloxetine.
Isosorbide MononitrateIsosorbide Mononitrate may increase the orthostatic hypotensive activities of Duloxetine.
IsoxsuprineIsoxsuprine may increase the orthostatic hypotensive activities of Duloxetine.
IsradipineIsradipine may increase the orthostatic hypotensive activities of Duloxetine.
LabetalolLabetalol may increase the orthostatic hypotensive activities of Duloxetine.
LevobunololLevobunolol may increase the orthostatic hypotensive activities of Duloxetine.
LimaprostLimaprost may increase the antiplatelet activities of Duloxetine.
LinezolidLinezolid may increase the serotonergic activities of Duloxetine.
LisinoprilLisinopril may increase the orthostatic hypotensive activities of Duloxetine.
LosartanLosartan may increase the orthostatic hypotensive activities of Duloxetine.
LoxapineThe risk or severity of adverse effects can be increased when Duloxetine is combined with Loxapine.
MannitolMannitol may increase the orthostatic hypotensive activities of Duloxetine.
MecamylamineMecamylamine may increase the orthostatic hypotensive activities of Duloxetine.
MesoridazineThe risk or severity of adverse effects can be increased when Duloxetine is combined with Mesoridazine.
MethazolamideMethazolamide may increase the orthostatic hypotensive activities of Duloxetine.
MethotrimeprazineThe serum concentration of Duloxetine can be increased when it is combined with Methotrimeprazine.
MethoxsalenThe serum concentration of Duloxetine can be increased when it is combined with Methoxsalen.
MethyclothiazideMethyclothiazide may increase the orthostatic hypotensive activities of Duloxetine.
MethyldopaMethyldopa may increase the orthostatic hypotensive activities of Duloxetine.
Methylene blueDuloxetine may increase the serotonergic activities of Methylene blue.
MetipranololMetipranolol may increase the orthostatic hypotensive activities of Duloxetine.
MetoclopramideThe risk or severity of adverse effects can be increased when Metoclopramide is combined with Duloxetine.
MetolazoneMetolazone may increase the orthostatic hypotensive activities of Duloxetine.
MetoprololThe serum concentration of Metoprolol can be increased when it is combined with Duloxetine.
MexiletineThe serum concentration of Duloxetine can be increased when it is combined with Mexiletine.
MinoxidilMinoxidil may increase the orthostatic hypotensive activities of Duloxetine.
MoexiprilMoexipril may increase the orthostatic hypotensive activities of Duloxetine.
MolindoneThe risk or severity of adverse effects can be increased when Duloxetine is combined with Molindone.
NadololNadolol may increase the orthostatic hypotensive activities of Duloxetine.
NebivololThe serum concentration of Nebivolol can be increased when it is combined with Duloxetine.
NesiritideNesiritide may increase the orthostatic hypotensive activities of Duloxetine.
NicardipineNicardipine may increase the orthostatic hypotensive activities of Duloxetine.
NifedipineNifedipine may increase the orthostatic hypotensive activities of Duloxetine.
NimodipineNimodipine may increase the orthostatic hypotensive activities of Duloxetine.
NisoldipineNisoldipine may increase the orthostatic hypotensive activities of Duloxetine.
NitroglycerinNitroglycerin may increase the orthostatic hypotensive activities of Duloxetine.
NitroprussideNitroprusside may increase the orthostatic hypotensive activities of Duloxetine.
NortriptylineDuloxetine may increase the serotonergic activities of Nortriptyline.
ObinutuzumabThe risk or severity of adverse effects can be increased when Duloxetine is combined with Obinutuzumab.
OfloxacinThe serum concentration of Duloxetine can be increased when it is combined with Ofloxacin.
OlanzapineThe risk or severity of adverse effects can be increased when Duloxetine is combined with Olanzapine.
OlmesartanOlmesartan may increase the orthostatic hypotensive activities of Duloxetine.
Omega-3 fatty acidsOmega-3 fatty acids may increase the antiplatelet activities of Duloxetine.
OndansetronThe risk or severity of adverse effects can be increased when Duloxetine is combined with Ondansetron.
PaliperidoneThe risk or severity of adverse effects can be increased when Duloxetine is combined with Paliperidone.
PapaverinePapaverine may increase the orthostatic hypotensive activities of Duloxetine.
ParoxetineDuloxetine may increase the serotonergic activities of Paroxetine.
Peginterferon alfa-2bThe serum concentration of Duloxetine can be increased when it is combined with Peginterferon alfa-2b.
PenbutololPenbutolol may increase the orthostatic hypotensive activities of Duloxetine.
Pentosan PolysulfateThe risk or severity of adverse effects can be increased when Pentosan Polysulfate is combined with Duloxetine.
PentoxifyllinePentoxifylline may increase the antiplatelet activities of Duloxetine.
PerindoprilPerindopril may increase the orthostatic hypotensive activities of Duloxetine.
PerphenazineThe risk or severity of adverse effects can be increased when Duloxetine is combined with Perphenazine.
PhenelzinePhenelzine may increase the serotonergic activities of Duloxetine.
PhenindioneDuloxetine may increase the anticoagulant activities of Phenindione.
PhenprocoumonDuloxetine may increase the anticoagulant activities of Phenprocoumon.
PimozideThe risk or severity of adverse effects can be increased when Duloxetine is combined with Pimozide.
PindololPindolol may increase the orthostatic hypotensive activities of Duloxetine.
PiperacetazineThe risk or severity of adverse effects can be increased when Duloxetine is combined with Piperacetazine.
PrazosinPrazosin may increase the orthostatic hypotensive activities of Duloxetine.
PrimaquineThe serum concentration of Duloxetine can be increased when it is combined with Primaquine.
ProchlorperazineThe risk or severity of adverse effects can be increased when Duloxetine is combined with Prochlorperazine.
PromazineThe risk or severity of adverse effects can be increased when Duloxetine is combined with Promazine.
PropafenoneThe serum concentration of Duloxetine can be increased when it is combined with Propafenone.
PropranololPropranolol may increase the orthostatic hypotensive activities of Duloxetine.
ProtriptylineDuloxetine may increase the serotonergic activities of Protriptyline.
QuetiapineQuetiapine may increase the orthostatic hypotensive activities of Duloxetine.
QuinaprilQuinapril may increase the orthostatic hypotensive activities of Duloxetine.
QuinidineThe serum concentration of Duloxetine can be increased when it is combined with Quinidine.
RamiprilRamipril may increase the orthostatic hypotensive activities of Duloxetine.
RemoxiprideThe risk or severity of adverse effects can be increased when Duloxetine is combined with Remoxipride.
ReserpineReserpine may increase the orthostatic hypotensive activities of Duloxetine.
ReteplaseDuloxetine may increase the anticoagulant activities of Reteplase.
RidogrelDuloxetine may increase the anticoagulant activities of Ridogrel.
RiociguatRiociguat may increase the orthostatic hypotensive activities of Duloxetine.
RisperidoneThe risk or severity of adverse effects can be increased when Duloxetine is combined with Risperidone.
RitonavirThe serum concentration of Duloxetine can be increased when it is combined with Ritonavir.
RivaroxabanDuloxetine may increase the anticoagulant activities of Rivaroxaban.
SertindoleThe risk or severity of adverse effects can be increased when Duloxetine is combined with Sertindole.
SotalolSotalol may increase the orthostatic hypotensive activities of Duloxetine.
SpironolactoneSpironolactone may increase the orthostatic hypotensive activities of Duloxetine.
StiripentolThe serum concentration of Duloxetine can be increased when it is combined with Stiripentol.
StreptokinaseDuloxetine may increase the anticoagulant activities of Streptokinase.
SulodexideDuloxetine may increase the anticoagulant activities of Sulodexide.
SulpirideThe risk or severity of adverse effects can be increased when Duloxetine is combined with Sulpiride.
TamoxifenThe serum concentration of the active metabolites of Tamoxifen can be reduced when Tamoxifen is used in combination with Duloxetine resulting in a loss in efficacy.
Tedizolid PhosphateTedizolid Phosphate may increase the serotonergic activities of Duloxetine.
TelmisartanTelmisartan may increase the orthostatic hypotensive activities of Duloxetine.
TenecteplaseDuloxetine may increase the anticoagulant activities of Tenecteplase.
TerazosinTerazosin may increase the orthostatic hypotensive activities of Duloxetine.
TerbinafineThe serum concentration of Duloxetine can be increased when it is combined with Terbinafine.
TeriflunomideThe serum concentration of Duloxetine can be decreased when it is combined with Teriflunomide.
ThioridazineThe serum concentration of Thioridazine can be increased when it is combined with Duloxetine.
ThiothixeneThe risk or severity of adverse effects can be increased when Duloxetine is combined with Thiothixene.
TimololTimolol may increase the orthostatic hypotensive activities of Duloxetine.
TipranavirTipranavir may increase the antiplatelet activities of Duloxetine.
TizanidineTizanidine may increase the orthostatic hypotensive activities of Duloxetine.
TorasemideTorasemide may increase the orthostatic hypotensive activities of Duloxetine.
TositumomabThe risk or severity of adverse effects can be increased when Duloxetine is combined with Tositumomab.
TramadolThe risk or severity of adverse effects can be increased when Tramadol is combined with Duloxetine.
TrandolaprilTrandolapril may increase the orthostatic hypotensive activities of Duloxetine.
TranylcypromineTranylcypromine may increase the serotonergic activities of Duloxetine.
TreprostinilDuloxetine may increase the anticoagulant activities of Treprostinil.
TriamtereneTriamterene may increase the orthostatic hypotensive activities of Duloxetine.
TrifluoperazineThe risk or severity of adverse effects can be increased when Duloxetine is combined with Trifluoperazine.
TriflupromazineThe risk or severity of adverse effects can be increased when Duloxetine is combined with Triflupromazine.
TrimipramineDuloxetine may increase the serotonergic activities of Trimipramine.
UrokinaseDuloxetine may increase the anticoagulant activities of Urokinase.
ValsartanValsartan may increase the orthostatic hypotensive activities of Duloxetine.
VemurafenibThe serum concentration of Duloxetine can be increased when it is combined with Vemurafenib.
VerapamilVerapamil may increase the orthostatic hypotensive activities of Duloxetine.
Vitamin EVitamin E may increase the antiplatelet activities of Duloxetine.
WarfarinDuloxetine may increase the anticoagulant activities of Warfarin.
ZiprasidoneThe risk or severity of adverse effects can be increased when Duloxetine is combined with Ziprasidone.
ZuclopenthixolThe risk or severity of adverse effects can be increased when Duloxetine is combined with Zuclopenthixol.
Food Interactions
  • Food does not affect maximum levels reached, but delays it (from 6 to 10 hours) and total product exposure appears to be reduced by only 10%.
  • People taking this product who drink large amounts of alcohol are exposed to a higher risk of liver toxicity.
  • Take without regard to meals.

Targets

Kind
Protein
Organism
Human
Pharmacological action
yes
Actions
inhibitor
General Function:
Serotonin:sodium symporter activity
Specific Function:
Serotonin transporter whose primary function in the central nervous system involves the regulation of serotonergic signaling via transport of serotonin molecules from the synaptic cleft back into the pre-synaptic terminal for re-utilization. Plays a key role in mediating regulation of the availability of serotonin to other receptors of serotonergic systems. Terminates the action of serotonin an...
Gene Name:
SLC6A4
Uniprot ID:
P31645
Molecular Weight:
70324.165 Da
References
  1. Chen F, Larsen MB, Sanchez C, Wiborg O: The S-enantiomer of R,S-citalopram, increases inhibitor binding to the human serotonin transporter by an allosteric mechanism. Comparison with other serotonin transporter inhibitors. Eur Neuropsychopharmacol. 2005 Mar;15(2):193-8. [PubMed:15695064 ]
  2. Troelsen KB, Nielsen EO, Mirza NR: Chronic treatment with duloxetine is necessary for an anxiolytic-like response in the mouse zero maze: the role of the serotonin transporter. Psychopharmacology (Berl). 2005 Oct;181(4):741-50. Epub 2005 Sep 29. [PubMed:16032412 ]
  3. Gould GG, Javors MA, Frazer A: Effect of chronic administration of duloxetine on serotonin and norepinephrine transporter binding sites in rat brain. Biol Psychiatry. 2007 Jan 15;61(2):210-5. Epub 2006 May 2. [PubMed:16650830 ]
  4. Mirza NR, Nielsen EO, Troelsen KB: Serotonin transporter density and anxiolytic-like effects of antidepressants in mice. Prog Neuropsychopharmacol Biol Psychiatry. 2007 May 9;31(4):858-66. Epub 2007 Jan 30. [PubMed:17335951 ]
  5. Vaishnavi SN, Nemeroff CB, Plott SJ, Rao SG, Kranzler J, Owens MJ: Milnacipran: a comparative analysis of human monoamine uptake and transporter binding affinity. Biol Psychiatry. 2004 Feb 1;55(3):320-2. [PubMed:14744476 ]
  6. Beique JC, Lavoie N, de Montigny C, Debonnel G: Affinities of venlafaxine and various reuptake inhibitors for the serotonin and norepinephrine transporters. Eur J Pharmacol. 1998 May 15;349(1):129-32. [PubMed:9669506 ]
  7. Karpa KD, Cavanaugh JE, Lakoski JM: Duloxetine pharmacology: profile of a dual monoamine modulator. CNS Drug Rev. 2002 Winter;8(4):361-76. [PubMed:12481192 ]
  8. van Groeningen CJ, Peters GJ, Pinedo HM: Lack of effectiveness of combined 5-fluorouracil and leucovorin in patients with 5-fluorouracil-resistant advanced colorectal cancer. Eur J Cancer Clin Oncol. 1989 Jan;25(1):45-9. [PubMed:2784100 ]
  9. Jost W, Marsalek P: Duloxetine: mechanism of action at the lower urinary tract and Onuf's nucleus. Clin Auton Res. 2004 Aug;14(4):220-7. [PubMed:15316838 ]
  10. Trivedi MH, Desaiah D, Ossanna MJ, Pritchett YL, Brannan SK, Detke MJ: Clinical evidence for serotonin and norepinephrine reuptake inhibition of duloxetine. Int Clin Psychopharmacol. 2008 May;23(3):161-9. doi: 10.1097/YIC.0b013e3282f41d7e. [PubMed:18408530 ]
  11. Bymaster FP, Lee TC, Knadler MP, Detke MJ, Iyengar S: The dual transporter inhibitor duloxetine: a review of its preclinical pharmacology, pharmacokinetic profile, and clinical results in depression. Curr Pharm Des. 2005;11(12):1475-93. [PubMed:15892657 ]
  12. Khullar V, Cardozo L, Dmochowski R: Mixed incontinence: current evidence and future perspectives. Neurourol Urodyn. 2010 Apr;29(4):618-22. doi: 10.1002/nau.20907. [PubMed:20432324 ]
  13. Carter NJ, McCormack PL: Duloxetine: a review of its use in the treatment of generalized anxiety disorder. CNS Drugs. 2009;23(6):523-41. doi: 10.2165/00023210-200923060-00006. [PubMed:19480470 ]
  14. Hunziker ME, Suehs BT, Bettinger TL, Crismon ML: Duloxetine hydrochloride: a new dual-acting medication for the treatment of major depressive disorder. Clin Ther. 2005 Aug;27(8):1126-43. [PubMed:16199241 ]
Kind
Protein
Organism
Human
Pharmacological action
yes
Actions
inhibitor
General Function:
Norepinephrine:sodium symporter activity
Specific Function:
Amine transporter. Terminates the action of noradrenaline by its high affinity sodium-dependent reuptake into presynaptic terminals.
Gene Name:
SLC6A2
Uniprot ID:
P23975
Molecular Weight:
69331.42 Da
References
  1. Chen X, Ji ZL, Chen YZ: TTD: Therapeutic Target Database. Nucleic Acids Res. 2002 Jan 1;30(1):412-5. [PubMed:11752352 ]
  2. Gould GG, Javors MA, Frazer A: Effect of chronic administration of duloxetine on serotonin and norepinephrine transporter binding sites in rat brain. Biol Psychiatry. 2007 Jan 15;61(2):210-5. Epub 2006 May 2. [PubMed:16650830 ]
  3. Vaishnavi SN, Nemeroff CB, Plott SJ, Rao SG, Kranzler J, Owens MJ: Milnacipran: a comparative analysis of human monoamine uptake and transporter binding affinity. Biol Psychiatry. 2004 Feb 1;55(3):320-2. [PubMed:14744476 ]
  4. Beique JC, Lavoie N, de Montigny C, Debonnel G: Affinities of venlafaxine and various reuptake inhibitors for the serotonin and norepinephrine transporters. Eur J Pharmacol. 1998 May 15;349(1):129-32. [PubMed:9669506 ]
  5. Vincent S, Bieck PR, Garland EM, Loghin C, Bymaster FP, Black BK, Gonzales C, Potter WZ, Robertson D: Clinical assessment of norepinephrine transporter blockade through biochemical and pharmacological profiles. Circulation. 2004 Jun 29;109(25):3202-7. Epub 2004 Jun 7. [PubMed:15184278 ]
  6. Schou M, Halldin C, Pike VW, Mozley PD, Dobson D, Innis RB, Farde L, Hall H: Post-mortem human brain autoradiography of the norepinephrine transporter using (S,S)-[18F]FMeNER-D2. Eur Neuropsychopharmacol. 2005 Oct;15(5):517-20. Epub 2005 Apr 7. [PubMed:16139169 ]
  7. Mirza NR, Nielsen EO, Troelsen KB: Serotonin transporter density and anxiolytic-like effects of antidepressants in mice. Prog Neuropsychopharmacol Biol Psychiatry. 2007 May 9;31(4):858-66. Epub 2007 Jan 30. [PubMed:17335951 ]
  8. Karpa KD, Cavanaugh JE, Lakoski JM: Duloxetine pharmacology: profile of a dual monoamine modulator. CNS Drug Rev. 2002 Winter;8(4):361-76. [PubMed:12481192 ]
  9. van Groeningen CJ, Peters GJ, Pinedo HM: Lack of effectiveness of combined 5-fluorouracil and leucovorin in patients with 5-fluorouracil-resistant advanced colorectal cancer. Eur J Cancer Clin Oncol. 1989 Jan;25(1):45-9. [PubMed:2784100 ]
  10. Jost W, Marsalek P: Duloxetine: mechanism of action at the lower urinary tract and Onuf's nucleus. Clin Auton Res. 2004 Aug;14(4):220-7. [PubMed:15316838 ]
  11. Trivedi MH, Desaiah D, Ossanna MJ, Pritchett YL, Brannan SK, Detke MJ: Clinical evidence for serotonin and norepinephrine reuptake inhibition of duloxetine. Int Clin Psychopharmacol. 2008 May;23(3):161-9. doi: 10.1097/YIC.0b013e3282f41d7e. [PubMed:18408530 ]
  12. Bymaster FP, Lee TC, Knadler MP, Detke MJ, Iyengar S: The dual transporter inhibitor duloxetine: a review of its preclinical pharmacology, pharmacokinetic profile, and clinical results in depression. Curr Pharm Des. 2005;11(12):1475-93. [PubMed:15892657 ]
  13. Khullar V, Cardozo L, Dmochowski R: Mixed incontinence: current evidence and future perspectives. Neurourol Urodyn. 2010 Apr;29(4):618-22. doi: 10.1002/nau.20907. [PubMed:20432324 ]
  14. Carter NJ, McCormack PL: Duloxetine: a review of its use in the treatment of generalized anxiety disorder. CNS Drugs. 2009;23(6):523-41. doi: 10.2165/00023210-200923060-00006. [PubMed:19480470 ]
  15. Hunziker ME, Suehs BT, Bettinger TL, Crismon ML: Duloxetine hydrochloride: a new dual-acting medication for the treatment of major depressive disorder. Clin Ther. 2005 Aug;27(8):1126-43. [PubMed:16199241 ]
Kind
Protein
Organism
Human
Pharmacological action
unknown
Actions
inhibitor
General Function:
Monoamine transmembrane transporter activity
Specific Function:
Amine transporter. Terminates the action of dopamine by its high affinity sodium-dependent reuptake into presynaptic terminals.
Gene Name:
SLC6A3
Uniprot ID:
Q01959
Molecular Weight:
68494.255 Da
References
  1. Overington JP, Al-Lazikani B, Hopkins AL: How many drug targets are there? Nat Rev Drug Discov. 2006 Dec;5(12):993-6. [PubMed:17139284 ]
  2. Imming P, Sinning C, Meyer A: Drugs, their targets and the nature and number of drug targets. Nat Rev Drug Discov. 2006 Oct;5(10):821-34. [PubMed:17016423 ]
  3. Carter NJ, McCormack PL: Duloxetine: a review of its use in the treatment of generalized anxiety disorder. CNS Drugs. 2009;23(6):523-41. doi: 10.2165/00023210-200923060-00006. [PubMed:19480470 ]
  4. Pereira P, Gianesini J, da Silva Barbosa C, Cassol GF, Von Borowski RG, Kahl VF, Cappelari SE, Picada JN: Neurobehavioral and genotoxic parameters of duloxetine in mice using the inhibitory avoidance task and comet assay as experimental models. Pharmacol Res. 2009 Jan;59(1):57-61. doi: 10.1016/j.phrs.2008.09.014. Epub 2008 Oct 5. [PubMed:18973814 ]
  5. Hunziker ME, Suehs BT, Bettinger TL, Crismon ML: Duloxetine hydrochloride: a new dual-acting medication for the treatment of major depressive disorder. Clin Ther. 2005 Aug;27(8):1126-43. [PubMed:16199241 ]

Enzymes

Kind
Protein
Organism
Human
Pharmacological action
unknown
Actions
substrate
General Function:
Oxidoreductase activity, acting on paired donors, with incorporation or reduction of molecular oxygen, reduced flavin or flavoprotein as one donor, and incorporation of one atom of oxygen
Specific Function:
Cytochromes P450 are a group of heme-thiolate monooxygenases. In liver microsomes, this enzyme is involved in an NADPH-dependent electron transport pathway. It oxidizes a variety of structurally unrelated compounds, including steroids, fatty acids, and xenobiotics. Most active in catalyzing 2-hydroxylation. Caffeine is metabolized primarily by cytochrome CYP1A2 in the liver through an initial N...
Gene Name:
CYP1A2
Uniprot ID:
P05177
Molecular Weight:
58293.76 Da
References
  1. Knadler MP, Lobo E, Chappell J, Bergstrom R: Duloxetine: clinical pharmacokinetics and drug interactions. Clin Pharmacokinet. 2011 May;50(5):281-94. doi: 10.2165/11539240-000000000-00000. [PubMed:21366359 ]
  2. Lobo ED, Bergstrom RF, Reddy S, Quinlan T, Chappell J, Hong Q, Ring B, Knadler MP: In vitro and in vivo evaluations of cytochrome P450 1A2 interactions with duloxetine. Clin Pharmacokinet. 2008;47(3):191-202. [PubMed:18307373 ]
  3. Authors unspecified: Duloxetine: new indication. Depression and diabetic neuropathy: too many adverse effects. Prescrire Int. 2006 Oct;15(85):168-72. [PubMed:17121211 ]
  4. Carter NJ, McCormack PL: Duloxetine: a review of its use in the treatment of generalized anxiety disorder. CNS Drugs. 2009;23(6):523-41. doi: 10.2165/00023210-200923060-00006. [PubMed:19480470 ]
Kind
Protein
Organism
Human
Pharmacological action
unknown
Actions
substrateinhibitor
General Function:
Steroid hydroxylase activity
Specific Function:
Responsible for the metabolism of many drugs and environmental chemicals that it oxidizes. It is involved in the metabolism of drugs such as antiarrhythmics, adrenoceptor antagonists, and tricyclic antidepressants.
Gene Name:
CYP2D6
Uniprot ID:
P10635
Molecular Weight:
55768.94 Da
References
  1. Knadler MP, Lobo E, Chappell J, Bergstrom R: Duloxetine: clinical pharmacokinetics and drug interactions. Clin Pharmacokinet. 2011 May;50(5):281-94. doi: 10.2165/11539240-000000000-00000. [PubMed:21366359 ]
  2. Preskorn SH, Nichols AI, Paul J, Patroneva AL, Helzner EC, Guico-Pabia CJ: Effect of desvenlafaxine on the cytochrome P450 2D6 enzyme system. J Psychiatr Pract. 2008 Nov;14(6):368-78. doi: 10.1097/01.pra.0000341891.43501.6b. [PubMed:19057238 ]
  3. Authors unspecified: Duloxetine: new indication. Depression and diabetic neuropathy: too many adverse effects. Prescrire Int. 2006 Oct;15(85):168-72. [PubMed:17121211 ]
  4. Carter NJ, McCormack PL: Duloxetine: a review of its use in the treatment of generalized anxiety disorder. CNS Drugs. 2009;23(6):523-41. doi: 10.2165/00023210-200923060-00006. [PubMed:19480470 ]
  5. Drug Interactions: Cytochrome P450 Drug Interaction Table [Link]
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Drug created on June 13, 2005 07:24 / Updated on April 29, 2016 03:10