Duvanta
Duvanta (Duloxetine 20–60 mg DR) — SNRI for MDD, GAD, DPN, fibromyalgia, MSK pain. paired with gabapentinoid in DPN for combination effect.
✓ Lääketieteellinen tarkistus Morgan Ellis — Farmasian tutkija · 8 vuoden kokemus · Viimeisin arvio: toukokuu 2026
⚡ Pikaohje
Duvanta (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.
📦 Jokainen tilaus on katettuna meidän Reshipment Assurance Policy -politiikkamme piiriin — jos lähetyksesi ei saavu 20 arkipäivässä, lähetämme uuden.
Miksi tilata MedsBasesta
Duvanta at MedsBase is supplied directly from a WHO-GMP certified manufacturer in plain, discreet packaging. Every order is covered by our Reshipment Assurance Policy -politiikkamme piiriin — 20 arkipäivän toimitusaika tai toimitus uudelleen ilman lisäkustannuksia — ja oikeuttaa asiakasuskollisuusohjelmaan. Maailmanlaajuinen toimitus saatavilla useimpiin kohteisiin.
What Duvanta is and how it works
Duvanta is a 20 / 30 / 40 / 60 mg duloxetine delayed-release capsule supplied by Intas. 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.
Käyttöaiheet ja annostelu
| Käyttöaihe | Aloitusannos | Tavoiteannos | Enimmäisannos |
|---|---|---|---|
| Vakava masennus | 30 mg OD × 1 wk | 60 mg OD | 120 mg (split BID) |
| Generalised anxiety | 30 mg OD × 1 wk | 60 mg OD | 120 mg |
| Diabetic peripheral neuropathy | 30 mg OD × 1 wk | 60 mg OD | 60 mg |
| Fibromyalgia | 30 mg OD × 1 wk | 60 mg OD | 60 mg |
| Chronic musculoskeletal pain | 30 mg OD × 1 wk | 60 mg OD | 60 mg |
| Stress urinary incontinence (off-label, EU) | 20 mg BID | 40 mg BID | 40 mg BID |
Tärkeät turvallisuushuomiot
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.
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.
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.
Kaikki masennuslääkkeet sisältävät FDA:n mustan laatikon varoituksen itsemurha-aikeiden lisääntymisestä alle 25-vuotiailla potilailla.
Yleiset haittavaikutukset
- Yleisiä: 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.
- Hepaatiset: transient AST/ALT rises; clinically significant hepatotoxicity is rare but described.
- Muut: hyponatraemia (especially older adults), abnormal bleeding (additive with NSAIDs), urinary hesitancy.
Lääkevuorovaikutukset
- 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.
Raskaus, imetys, lasten käyttö
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.
Säilytys
Säilytä alkuperäispakkauksessa 15–30 °C lämpötilassa.
Usein Kysytyt Kysymykset
How is Duvanta 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 Duvanta 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 Duvanta 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 Duvanta 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 Duvanta 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 Duvanta?
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 Duvanta?
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.
Mitä teen, jos unohdan ottaa annoksen?
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 Duvanta 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 Duvanta 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.
Muut mielenterveyslääkkeet
- Flunil (Fluoxetine SSRI)
- Lexaheal (Escitalopram SSRI)
- Mirtaz (Mirtazapine NaSSA)
- Bupron XL (Bupropion XL — NDRI)
- Agoprex (Agomelatine — melatonergic)
Lisää vaihtoehtoja mielenterveys- ja psykiatrisissa lääkkeissä
Luokiteltu MedsBase-tilausmäärän mukaan — mitä muut asiakkaat tässä kategoriassa valitsevat.
| Vahvuus | 20 mg, 30 mg |
|---|---|
| Määrä | 30 tablettia, 60 tablettia, 90 tablettia, 180 tablettia |
Duvanta
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