|Type of medicine||Serotonin and noradrenaline reuptake inhibitor|
|Used for||Symptoms of stress incontinence in women|
Stress incontinence is the most common form of incontinence. It means you pass urine with things like coughing, sneezing or exercise. It happens when the pelvic floor muscles that support your bladder are weakened. Childbirth is a common reason for a weak pelvic floor. The main treatment for stress incontinence is pelvic floor exercises. Surgery to tighten or support your bladder outlet can also help. Medication like duloxetine may be used in addition to exercises if you do not want, or are not suitable for, surgery.
Duloxetine works by increasing the amount of chemical transmitters (called serotonin and noradrenaline) within the nerves that send messages to your pelvic floor muscles. This increases the strength of these muscles, and this in turn controls the flow of urine and helps to prevent any leakage.
Duloxetine is also used for mood and nerve disorders. There is a separate leaflet called Duloxetine for mood and nerve disorders which gives more information about it when it is used for this.
Before taking duloxetine
Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking duloxetine it is important that your doctor or pharmacist knows:
- If you are pregnant, trying for a baby or breast-feeding.
- If you have liver, kidney or heart problems.
- If you have high blood pressure.
- If you have glaucoma (an increased pressure in your eyes).
- If you have ever had mania ('high' moods) such as in bipolar disorder.
- If you have ever had seizures (fits).
- If you have a blood disorder that has increased your risk of bleeding.
- If you are taking or using any other medicines. This includes any medicines you are taking which are available to buy without a prescription, such as herbal and complementary medicines.
- If you have ever had an allergic reaction to a medicine.
How to take duloxetine
- Before you start this treatment, read the manufacturer's printed information leaflet from inside your pack. The leaflet will give you more information about duloxetine, and a full list of possible side-effects from taking it.
- Take duloxetine exactly as your doctor has told you. The usual dose is one capsule twice daily. Your dose will be on the label of the pack to remind you. When starting duloxetine, your doctor may give you the 20 mg strength of capsules to begin with, and then increase them to 40 mg after a couple of weeks. This is to help avoid any unwanted symptoms when you first take duloxetine.
- Try to take your doses at the same times of day each day, as this will help you to remember to take them. You can take them before, during or after your meals. Swallow the capsules whole with a drink of water to help you to swallow them.
- If you forget to take a capsule, take it as soon as you remember. If it is almost time to take your next dose, skip the missed capsule and take your next dose when it is due. Do not take two doses together to make up for a forgotten one.
Getting the most from your treatment
- Try to keep your regular appointments with your doctor. This is so your doctor can check on your progress and review your treatment.
- Keep taking these capsules until your doctor tells you otherwise. Stopping suddenly can cause problems and your doctor may want you to reduce your dose gradually when this is necessary.
- Remember to do the exercises you have been given to strengthen your pelvic floor muscles. This is important because the majority of people with stress incontinence are much improved with these exercises.
- If you have been advised to reduce your weight, try to stick to the advice you have been given about your diet. It has been shown that losing even a modest amount of weight can help improve your symptoms.
- Smoking can cause coughing which can aggravate your symptoms. It will help to not smoke. If you are a smoker and you need help to quit, ask your doctor or pharmacist for advice.
- If you drink alcohol, ask your doctor for advice about drinking while you are on duloxetine. Your doctor may recommend you do not drink alcohol while you are on this medicine as it may increase the risk of unwanted effects such as dizziness and blurred vision.
- If you buy any medicines, check with a pharmacist that they are suitable to take with duloxetine. This is because some herbal medicines (such as St John's wort) can increase the chance that you will experience unwanted effects.
- If you are having an operation or dental treatment, tell the person carrying out the treatment that you are taking duloxetine.
Can duloxetine cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. These usually improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following side-effects continue or become troublesome.
|Common duloxetine side-effects - these affect around 1 in 10 people who take this medicine||What can I do if I experience this?|
|Feeling or being sick, indigestion, abdomen pain||Eat simple meals - avoid rich or spicy foods|
|Dry mouth||Try chewing sugar-free gum or sucking sugar-free sweets|
|Blurred vision, feeling tired, dizzy or sleepy||If any of these happen, do not drive or use tools or machines|
|Constipation||Try to eat a well-balanced diet containing plenty of fibre, and drink several glasses of water each day|
|Diarrhoea||Drink plenty of water to replace lost fluids|
|Headache||Ask your pharmacist to recommend a suitable painkiller|
|Lack of appetite, flushes, increased blood pressure, vertigo (a spinning sensation), difficulty sleeping, feeling anxious, skin tinglings, feeling shaky, reduced interest in sex, increased sweating||Discuss these with your doctor if any become troublesome|
Important: if you develop any depressing or distressing thoughts or ideas, you should let your doctor know about this as soon as possible. When duloxetine is used for depression, it may increase the risk of suicidal thoughts, particularly at the start of treatment. Although duloxetine when it is taken for urinary symptoms is not thought to cause this, it cannot be ruled out.
If you experience any other symptoms which you think may be due to this medicine, speak with your doctor or pharmacist.
How to store duloxetine
- Keep all medicines out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
Important information about all medicines
Further reading & references
- British National Formulary; 63rd Edition (Mar 2012) British Medical Association and Royal Pharmaceutical Society of Great Britain, London
- Manufacturer's PIL, Yentreve® 20 mg and 40 mg hard gastro-resistant capsules; Eli Lilly and Company Ltd, The electronic Medicines Compendium. Dated July 2011.
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.
Dr Hannah Gronow