The following provides information on contraindications to the use of duloxetine in general, pregnancy, breastfeeding and children. Please note that the contraindications may vary depending on the dosage form of a drug (eg tablet, syringe, ointment).
When should duloxetine not be used?
Duloxetine should not be used with
- Hypersensitivity to the active substance
- liver disease leading to hepatic impairment
- severe renal impairment (creatinine clearance below 30 milliliters / minute)
- uncontrolled hypertension.
Duloxetine should be used in
- only after careful evaluation of the benefit / risk by the physician and under his supervision
- Patients with mental disorders such as over-exertion (mania) or mania with depression
- epileptic seizures
- Increased intraocular pressure or risk of acute narrow-angle glaucoma (special case of the cataract), because duloxetine dilates the pupil
- High blood pressure and / or other heart disease because the drug can increase blood pressure
- mild or moderate renal impairment (creatinine clearance 30 to 80 milliliters / minute)
Bleeding tendency because it may increase with duloxetine
- older age, liver cirrhosis or dehydration, because all three conditions can lead to a sodium deficiency in the blood, which is intensified by duloxetine
- depression, because the drug can lead to increased suicidal thoughts.
- Liver damage or ingestion of other agents that may cause liver damage.
What should you watch out for during pregnancy and lactation?
Duloxetine should be taken during pregnancy only if the doctor considers the potential benefit and risk to the unborn baby to be reasonable. So tell your doctor if you become pregnant or if you intend to get pregnant during therapy. As with other drugs with a similar mechanism of action, neonatal withdrawal symptoms may occur if the mother has taken duloxetine shortly before the delivery date. These withdrawal signs may include low blood pressure, tremors, nervous restlessness, feeding difficulties, shortness of breath and brain cramps. In the majority of cases, these occurred either at birth or within a few days thereafter.
Duloxetine passes into breast milk only in very small proportions. However, as there is no information on the tolerability of duloxetine in infants and children, it is not recommended during breast-feeding.
What should be considered in children?
There have been no clinical trials of duloxetine in patients under the age of 18 years. Therefore, the drug should not be used in children and adolescents under 18 years. In addition, there is a lack of data from long-term safety studies in children and adolescents under the age of 18 in terms of growth, physical development, and the development of thinking and behavior.
Warnings and Precautions
- The therapy must not be stopped suddenly, but must be discontinued by the doctor for two weeks with a reduced dosage.
- Smoking and alcohol consumption should be avoided during therapy with the drug.
- The use of this medicine may be accompanied by fatigue and dizziness that make driving and machine operation dangerous.
Sometimes medications release allergic reactions.
If you notice signs of allergic reaction, tell your doctor or pharmacist immediately.