Duzela M 20 Tablet
Duloxetine + Methylcobalamin
20mg + 1.5mg
Sun Pharmaceutical Industries Ltd.
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Available as:
Indications
Duzela M 20 Tablet is used for:
Treatment of depression and diabetic neuropathic pain (DPNP).
Treatment of generalized anxiety disorder (GAD).
Adult Dose
Oral
Diabetic neuropathy
Adult: 60 mg once daily. Max: 120 mg/day in divided doses.
Fibromyalgia
Adult: Initially, 30 mg once daily for 1 wk, then increase to 60 mg once daily.
Depression
Adult: Initially, 20-30 mg bid or 60 mg once daily, then increase dose in increments of 30 mg/day over 1 wk as tolerated. Max: 120 mg/day.
Anxiety
Adult: 30 or 60 mg once daily. Max: 120 mg/day.
Hepatic Impairment
Avoid use.
Child Dose
Renal Dose
Mild to moderate: Consider lower starting dose and titrate dose gradually.
Severe: Avoid use.
Administration
May be taken with or without food. Swallow whole, do not chew/crush.
Contra Indications
Hepatic impairment, severe renal impairment, uncontrolled HTN or narrow-angle glaucoma. Concomitant use w/ MAOIs or w/in 14 days of discontinuing the MAOI. Use w/ linezolid or IV methylene blue. Concomitant use w/ potent CYP1A2 inhibitors (e.g. ciprofloxacin, enoxacin).
Precautions
Patient w/ HTN, gastroparesis, mania or hypomania, increased intraocular pressure or at risk of acute narrow-angle glaucoma, seizure, bleeding disorders, mild to moderate renal impairment. Smokers. Gradual dose reduction is recommended rather than abrupt withdrawal. Pregnancy and lactation.
Pregnancy-Lactation
Interactions
Increased risk of serotonin syndrome w/ TCA, SSRI, SNRI, lithium. May increase bleeding risk w/ aspirin, NSAIDs, warfarin and other anticoagulants.
Potentially Fatal: Increased risk of serotonin syndrome w/ MAOIs, linezolid and methylene blue. Increased serum levels and risk of toxicity w/ potent CYP1A2 inhibitors (e.g. ciprofloxacin, enoxacin).
Adverse Effects
Side effects of Duloxetine + Methylcobalamin :
Changes in behaviour, suicidal ideation, HTN, headache, somnolence, fatigue, dizziness, insomnia, agitation, tremor, anxiety, insomnia, lethargy, abnormal dreams, nausea, xerostomia, palpitation, hyperhydrosis, decreased libido, hot flushes, sexual dysfunction, vomiting, constipation, diarrhoea, dyspepsia, abdominal pain, wt gain, decreased appetite, erectile dysfunction, increased hepatic enzymes, muscle spasms, paraesthesia, tinnitus, blurred vision, mydriasis, nasopharyngitis, hyponatraemia, may impair platelet aggregation. Stevens-Johnson syndrome and erythema multiforme.
Potentially Fatal: Hepatic failure w/ or w/o jaundice.
Mechanism of Action
Duloxetine is a potent inhibitor of neuronal reuptake of serotonin, norepinephrine and to a lesser extent dopamine. It has no significant affinity for adrenergic, muscarinic, cholinergic, histaminergic, opioid, glutamate and GABA receptors. It also does not inhibit monoamine oxidase.
Note
Duzela M 20 20mg + 1.5mg Tablet manufactured by Sun Pharmaceutical Industries Ltd.. Its generic name is Duloxetine + Methylcobalamin. Duzela M 20 is availble in Nepal.
Farmaco Nepal drug index information on Duzela M 20 Tablet is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.