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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
SynonymsNot Available
Salts
Name/CAS Structure Properties
Duloxetine Hydrochloride
Thumb
  • InChI Key: BFFSMCNJSOPUAY-UHFFFAOYNA-N
  • Monoisotopic Mass: 333.095412664
  • Average Mass: 333.875
DBSALT000378
Brand names
NameCompany
AriclaimNot Available
CymbaltaNot Available
DulaneNot Available
DuzelaNot Available
XeristarNot Available
YentreveNot Available
Brand mixturesNot Available
CategoriesNot Available
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[C@H](OC1=CC=CC2=CC=CC=C12)C1=CC=CS1
Mass SpecNot Available
Taxonomy
KingdomOrganic Compounds
SuperclassBenzenoids
ClassAcenes and Derivatives
SubclassNaphthalenes
Direct parentNaphthalenes
Alternative parentsPhenol Ethers; Alkyl Aryl Ethers; Thiophenes; Dialkylamines; Polyamines
Substituentsphenol ether; alkyl aryl ether; benzene; thiophene; secondary amine; secondary aliphatic amine; ether; polyamine; amine; organonitrogen compound
Classification descriptionThis compound belongs to the naphthalenes. These are compounds containing a naphthalene moiety, which consists of two fused benzene rings.
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.
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
    4-hydroxy duloxetine glucuronideDetails
    Duloxetine
      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
      Property Value Probability
      Human Intestinal Absorption + 1.0
      Blood Brain Barrier + 0.9804
      Caco-2 permeable + 0.6358
      P-glycoprotein substrate Substrate 0.7078
      P-glycoprotein inhibitor I Inhibitor 0.5987
      P-glycoprotein inhibitor II Non-inhibitor 0.5519
      Renal organic cation transporter Inhibitor 0.6525
      CYP450 2C9 substrate Non-substrate 0.5964
      CYP450 2D6 substrate Substrate 0.6482
      CYP450 3A4 substrate Substrate 0.5799
      CYP450 1A2 substrate Inhibitor 0.839
      CYP450 2C9 substrate Non-inhibitor 0.7721
      CYP450 2D6 substrate Inhibitor 0.6977
      CYP450 2C19 substrate Non-inhibitor 0.572
      CYP450 3A4 substrate Inhibitor 0.5108
      CYP450 inhibitory promiscuity High CYP Inhibitory Promiscuity 0.6689
      Ames test Non AMES toxic 0.5422
      Carcinogenicity Non-carcinogens 0.9293
      Biodegradation Not ready biodegradable 0.935
      Rat acute toxicity 2.5700 LD50, mol/kg Not applicable
      hERG inhibition (predictor I) Strong inhibitor 0.5926
      hERG inhibition (predictor II) Inhibitor 0.6386
      Pharmacoeconomics
      Manufacturers
      • Eli lilly and co
      Packagers
      Dosage forms
      FormRouteStrength
      Capsule, coated pelletsOral
      Prices
      Unit descriptionCostUnit
      Cymbalta 30 mg Enteric Coated Capsule5.38USDcapsule
      Cymbalta 60 mg Enteric Coated Capsule5.38USDcapsule
      Cymbalta 30 mg capsule5.18USDcapsule
      Cymbalta 60 mg capsule5.18USDcapsule
      Cymbalta 20 mg Enteric Coated Capsule4.64USDcapsule
      Cymbalta 20 mg capsule4.62USDcapsule
      DrugBank does not sell nor buy drugs. Pricing information is supplied for informational purposes only.
      Patents
      CountryPatent NumberApprovedExpires (estimated)
      United States65967561999-09-102019-09-10
      United States50232691993-06-112013-06-11
      Canada23440572008-11-182019-09-10
      Canada21538562005-05-102015-07-13
      Properties
      Statesolid
      Experimental Properties
      PropertyValueSource
      logP4Not Available
      Predicted Properties
      PropertyValueSource
      water solubility2.96e-03 g/lALOGPS
      logP4.72ALOGPS
      logP4.2ChemAxon
      logS-5ALOGPS
      pKa (strongest basic)9.7ChemAxon
      physiological charge1ChemAxon
      hydrogen acceptor count2ChemAxon
      hydrogen donor count1ChemAxon
      polar surface area21.26ChemAxon
      rotatable bond count6ChemAxon
      refractivity87.73ChemAxon
      polarizability33.15ChemAxon
      number of rings3ChemAxon
      bioavailability1ChemAxon
      rule of fiveYesChemAxon
      Ghose filterYesChemAxon
      Veber's ruleYesChemAxon
      MDDR-like ruleYesChemAxon
      Spectra
      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 Reference
      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
      2. Anttila S, Leinonen E: Duloxetine Eli Lilly. Curr Opin Investig Drugs. 2002 Aug;3(8):1217-21. Pubmed
      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
      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
      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
      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
      External Links
      ResourceLink
      KEGG DrugD01179
      PubChem Compound60835
      PubChem Substance46507937
      ChemSpider54822
      ChEBI36795
      ChEMBLCHEMBL1175
      Therapeutic Targets DatabaseDAP000494
      PharmGKBPA10066
      IUPHAR202
      Guide to Pharmacology202
      RxListhttp://www.rxlist.com/cgi/generic/cymbalta.htm
      Drugs.comhttp://www.drugs.com/cdi/duloxetine-delayed-release-capsules.html
      WikipediaDuloxetine
      ATC CodesN06AX21
      AHFS CodesNot Available
      PDB EntriesNot Available
      FDA labelshow(104 KB)
      MSDSshow(76.3 KB)
      Interactions
      Drug Interactions
      Drug
      AmitriptylinePossible increase in the levels of this agent when used with duloxetine
      CiprofloxacinCiprofloxacin, a strong CYP1A2 inhibitor, may decrease the metabolism of duloxetine. Monitor for changes in the therapeutic and adverse effects of duloxetine if ciprofloxacin is initiated or discontinued.
      DesipraminePossible increase in the levels of this agent when used with duloxetine
      DesvenlafaxineIncreased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome.
      FlecainidePossible increase in the levels of this agent when used with duloxetine
      FluvoxamineFluvoxamine increases the effect and toxicity of duloxetine
      ImipraminePossible increase in the levels of this agent when used with duloxetine
      IsocarboxazidPossible severe adverse reaction with this combination
      NortriptylinePossible increase in the levels of this agent when used with duloxetine
      PhenelzinePossible severe adverse reaction with this combination
      PropafenonePossible increase in the levels of this agent when used with duloxetine
      RasagilinePossible severe adverse reaction with this combination
      TamoxifenDuloxetine may decrease the therapeutic effect of Tamoxifen by decreasing the production of active metabolites. Consider alternate therapy.
      TamsulosinDuloxetine, a CYP2D6 inhibitor, may decrease the metabolism and clearance of Tamsulosin, a CYP2D6 substrate. Monitor for changes in therapeutic/adverse effects of Tamsulosin if Duloxetine is initiated, discontinued, or dose changed.
      TerbinafineTerbinafine may reduce the metabolism and clearance of Duloxetine. Consider alternate therapy or monitor for therapeutic/adverse effects of Duloxetine if Terbinafine is initiated, discontinued or dose changed.
      ThiabendazoleThe strong CYP1A2 inhibitor, Thiabendazole, may increase the effects and toxicity of Duloxetine by decreasing Duloxetine metabolism and clearance. Monitor for changes in the therapeutic and adverse effects of Duloxetine if Thiabendazole is initiated, discontinued or dose changed.
      ThioridazineIncreased risk of cardiotoxicity and arrhythmias
      TramadolDuloxetine may decrease the effect of Tramadol by decreasing active metabolite production. Increased risk of serotonin syndrome. Monitor for Tramadol efficacy and symptoms of serotonin syndrome.
      TranylcypromineIncreased risk of serotonin syndrome. Concomitant therapy should be avoided. A significant washout period, dependent on the half-lives of the agents, should be employed between therapies.
      TrazodoneIncreased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome.
      TrimipramineIncreased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome.
      TriprolidineThe CNS depressants, Triprolidine and Duloxetine, may increase adverse/toxic effects due to additivity. Monitor for increased CNS depressant effects during concomitant therapy.
      VenlafaxineIncreased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome.
      ZolmitriptanUse of two serotonin modulators, such as zolmitriptan and duloxetine, increases the risk of serotonin syndrome. Consider alternate therapy or monitor for serotonin syndrome during concomitant therapy.
      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.

      1. Sodium-dependent serotonin transporter

      Kind: protein

      Organism: Human

      Pharmacological action: yes

      Actions: inhibitor

      Components

      Name UniProt ID Details
      Sodium-dependent serotonin transporter P31645 Details

      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
      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
      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
      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
      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
      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
      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
      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
      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
      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. Pubmed
      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
      12. Khullar V, Cardozo L, Dmochowski R: Mixed incontinence: current evidence and future perspectives. Neurourol Urodyn. 2010 Apr;29(4):618-22. Pubmed
      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. Pubmed
      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

      2. Sodium-dependent noradrenaline transporter

      Kind: protein

      Organism: Human

      Pharmacological action: yes

      Actions: inhibitor

      Components

      Name UniProt ID Details
      Sodium-dependent noradrenaline transporter P23975 Details

      References:

      1. Chen X, Ji ZL, Chen YZ: TTD: Therapeutic Target Database. Nucleic Acids Res. 2002 Jan 1;30(1):412-5. Pubmed
      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
      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
      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
      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
      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
      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
      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
      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
      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
      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. Pubmed
      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
      13. Khullar V, Cardozo L, Dmochowski R: Mixed incontinence: current evidence and future perspectives. Neurourol Urodyn. 2010 Apr;29(4):618-22. Pubmed
      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. Pubmed
      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

      3. Sodium-dependent dopamine transporter

      Kind: protein

      Organism: Human

      Pharmacological action: unknown

      Actions: inhibitor

      Components

      Name UniProt ID Details
      Sodium-dependent dopamine transporter Q01959 Details

      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
      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
      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. Pubmed
      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. Epub 2008 Oct 5. Pubmed
      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

      1. Cytochrome P450 1A2

      Kind: protein

      Organism: Human

      Pharmacological action: unknown

      Actions: substrate

      Components

      Name UniProt ID Details
      Cytochrome P450 1A2 P05177 Details

      References:

      1. Knadler MP, Lobo E, Chappell J, Bergstrom R: Duloxetine: clinical pharmacokinetics and drug interactions. Clin Pharmacokinet. 2011 May 1;50(5):281-94. doi: 10.2165/11539240-000000000-00000. Pubmed
      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
      3. Duloxetine: new indication. Depression and diabetic neuropathy: too many adverse effects. Prescrire Int. 2006 Oct;15(85):168-72. Pubmed
      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

      2. Cytochrome P450 2D6

      Kind: protein

      Organism: Human

      Pharmacological action: unknown

      Actions: substrate inhibitor

      Components

      Name UniProt ID Details
      Cytochrome P450 2D6 P10635 Details

      References:

      1. Flockhart DA. Drug Interactions: Cytochrome P450 Drug Interaction Table. Indiana University School of Medicine (2007). Accessed May 28, 2010.
      2. Knadler MP, Lobo E, Chappell J, Bergstrom R: Duloxetine: clinical pharmacokinetics and drug interactions. Clin Pharmacokinet. 2011 May 1;50(5):281-94. doi: 10.2165/11539240-000000000-00000. Pubmed
      3. 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. Pubmed
      4. Duloxetine: new indication. Depression and diabetic neuropathy: too many adverse effects. Prescrire Int. 2006 Oct;15(85):168-72. Pubmed
      5. 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

      Comments
      Drug created on June 13, 2005 07:24 / Updated on September 16, 2013 17:10