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Dulata

Dulata (Duloxetine 20–60 mg DR) — SNRI for MDD, GAD, DPN, fibromyalgia, MSK pain. pain benefit at 1–2 weeks, mood at 4–6 weeks.

Медицински преглед от Morgan Ellis — Фармацевтичен изследовател · 8 години опит  · Последен преглед: май 2026 г.

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⚡ Бърз отговор

Dulata (Duloxetine 20 / 30 / 40 / 60 mg) is a serotonin-noradrenaline reuptake inhibitor used for major depression, generalised anxiety, diabetic peripheral neuropathy, fibromyalgia, and chronic musculoskeletal pain. Particularly useful when depression is paired with chronic pain.

Какво получавате с MedsBase: Производител, сертифициран от WHO-GMP · Дискретна опаковка · Доставка по целия свят · Над 1400 потвърдени отзива от клиенти

📦 Всяка поръчка е покрита от нашата Политика за повторна изпратка — ако вашата пратка не пристигне в рамките на 20 работни дни, ние я изпращаме отново.

Защо да поръчвате от MedsBase

Dulata at MedsBase is supplied directly from a WHO-GMP certified manufacturer in plain, discreet packaging. Every order is covered by our Политика за повторна изпратка — 20-работнодневен срок за доставка или безплатно преизпращане — и дава право на участие в нашата програма за лоялност. Доставката е налична в повечето държави по света.

What Dulata is and how it works

Dulata is a 20 / 30 / 40 / 60 mg duloxetine delayed-release capsule supplied by Sun Pharma. Duloxetine is a balanced inhibitor of both serotonin (5-HT) and noradrenaline (NA) reuptake at their presynaptic transporters. The dual-action profile is what makes it effective for both mood and pain.

The therapeutic effect on mood and anxiety builds over 4–6 weeks; analgesic effects on neuropathic and musculoskeletal pain often appear within 1–2 weeks at the same dose.

Показания и дозиране

ПоказаниеНачална дозаЦелева дозаМаксимална доза
Голяма депресия30 mg OD × 1 wk60 mg OD120 mg (split BID)
Generalised anxiety30 mg OD × 1 wk60 mg OD120 mg
Diabetic peripheral neuropathy30 mg OD × 1 wk60 mg OD60 mg
Fibromyalgia30 mg OD × 1 wk60 mg OD60 mg
Chronic musculoskeletal pain30 mg OD × 1 wk60 mg OD60 mg
Stress urinary incontinence (off-label, EU)20 mg BID40 mg BID40 mg BID

Важни мерки за безопасност

Hepatic — avoid in significant alcohol use or hepatic impairment

Duloxetine has a baseline hepatotoxicity signal that becomes clinically important in patients with significant alcohol intake (≥3 drinks/day) or chronic liver disease. Avoid in any clinically significant hepatic impairment. Check baseline LFTs in older adults and patients on multiple hepatically-cleared drugs.

Кръвно налягане

Duloxetine produces a small but real rise in BP — average +2–3 mmHg systolic at therapeutic doses. Less than venlafaxine, but enough to matter in poorly-controlled hypertension. Check BP at baseline, at 2 weeks, and at every dose increase.

Discontinuation syndrome

Duloxetine has a short elimination half-life (12 hours) — abrupt cessation produces dizziness, paraesthesia (“zaps”), nausea, headache, and dysphoria within 24–72 hours. Always taper over at least 2–4 weeks. The lowest available capsule strength (20 mg or 30 mg, depending on market) sets the floor of the taper — beading the capsule contents is sometimes used clinically for the final step.

Предупреждение за суицидалност (при лица под 25 години)

Всички антидепресанти носят черно-кутийно предупреждение от FDA за повишен риск от суицидални мисли при пациенти под 25 години.

Често срещани странични ефекти

  • Чести: nausea (worst in first week), dry mouth, constipation, hyperhidrosis, somnolence or insomnia, fatigue.
  • Sexual: reduced libido, delayed orgasm — similar incidence to SSRIs.
  • BP / HR: small mean increase in BP and HR — usually clinically silent.
  • Чернодробни: transient AST/ALT rises; clinically significant hepatotoxicity is rare but described.
  • Други: hyponatraemia (especially older adults), abnormal bleeding (additive with NSAIDs), urinary hesitancy.

Взаимодействия с лекарства

  • MAOIs — absolute contraindication; 14-day washout each direction.
  • Strong CYP1A2 inhibitors (fluvoxamine, ciprofloxacin, enoxacin) — significantly raise duloxetine levels; avoid co-prescription.
  • Strong CYP2D6 inhibitors (paroxetine, fluoxetine, bupropion, quinidine) — moderate rise in duloxetine levels.
  • Other serotonergic drugs (triptans, tramadol, linezolid, methylene blue, St John’s wort) — serotonin syndrome risk.
  • NSAIDs / aspirin / anticoagulants — additive bleeding risk.

Бременност, кърмене, педиатрични

Pregnancy: limited data; weigh against untreated maternal depression. Late-pregnancy exposure can produce a neonatal adaptation syndrome. Breastfeeding: small amounts pass into milk; usually compatible with monitoring. Paediatric: not first-line; evidence base for adolescent depression is weaker than for SSRIs.

Съхранение

Съхранявайте при 15–30 °C в оригиналната опаковка.

Често задавани въпроси

How is Dulata different from an SSRI?

Duloxetine adds noradrenergic reuptake inhibition on top of serotonergic action. The clinical translation: better evidence for chronic pain conditions (DPN, fibromyalgia), useful when fatigue or motivation is the dominant depressive symptom, and a small BP signal that SSRIs don’t carry. Tolerability profiles overlap heavily — nausea is the dominant first-week issue for both classes.

Why is Dulata a delayed-release capsule?

Duloxetine is acid-labile and would be destroyed in stomach acid. The enteric coating delays release until the duodenum, producing reliable absorption. Do not crush, chew, or open the capsule (contents can be sprinkled on apple sauce in difficulty-swallowing patients but should not be saved or chewed).

Can I take Dulata with chronic pain medications?

Duloxetine is often paired with gabapentin or pregabalin in DPN — the combination outperforms monotherapy. Combining with tramadol or methadone is possible but raises serotonin-syndrome risk; clinician supervision required.

How quickly does Dulata help neuropathic pain?

Pain benefit often appears within 1–2 weeks, faster than the mood benefit (4–6 weeks). Many patients on duloxetine for DPN or fibromyalgia notice the pain change first.

Will Dulata cause weight gain?

Modest — typically 1–3 kg over 6–12 months. Less than mirtazapine, less than most TCAs, comparable to SSRIs.

Can I drink alcohol on Dulata?

Avoid heavy alcohol use entirely — there is a defined hepatotoxicity interaction. Light-to-moderate alcohol (1 drink, occasional) is usually tolerated but worsens depression.

How do I stop Dulata?

Taper over at least 2–4 weeks. Switching from 60 mg to 30 mg for 2 weeks before stopping is the most common pattern. Some patients need slower tapers using the 20 mg or 30 mg capsule and skipping doses every other day at the bottom.

Какво да направя, ако пропусна доза?

Take it as soon as you remember the same day. If it’s nearly time for the next dose, skip and continue. Do not double up. A missed dose at 12+ hours often produces noticeable withdrawal — take it as soon as possible.

Is Dulata addictive?

No — duloxetine produces no euphoria, no compulsive use, and no escalating tolerance. It does produce physical dependence (withdrawal on abrupt cessation), which is a different phenomenon from addiction.

Can Dulata cause urinary retention?

Yes — duloxetine has mild noradrenergic action on the bladder neck and can produce hesitancy or retention, particularly in older men with BPH. Mild symptoms usually resolve; severe symptoms warrant dose reduction or switch.

Други лекарства за психично здраве

Медицинска декларация. Тази страница е с образователна цел и не замества индивидуалния медицински съвет. Фармакотерапията на психичното здраве трябва да се инициира, следи и регулира от квалифициран клиницист. Ако вие или някой, когото познавате, е в суицидална криза, свържете се незабавно с местните спешни служби или се обадете на телефонната линия за превенция на самоубийства във вашата държава (САЩ/Канада: 988; Обединеното кралство: Samaritans 116 123; международен списък: findahelpline.com).

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Сила

20 mg, 30 mg, 40 mg, 60 mg

Количество

30 Таблетки, 60 Таблетки, 90 Таблетки, 180 Таблетки

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