duloxetine (Cymbalta, Yentreve, Drizalma Sprinkle)

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Tradenames: Cymbalta, Yentreve. Generic approved Dec 2103.


* on list of drugs to avoid for treatment of depression[9]

* no significant benefit for hip osteoarthritis or knee osteoarthritis


pregnancy category = c


Tabs: 20,30,60 mg

Drizalma Sprinkle:

  • sprinkle formulation of delayed-release duloxetine capsules
  • 20, 30, 40, 60 mg



blood pressure

Adverse effects

Drug interactions


Mechanism of action

More general terms


  1. Prescriber's Letter 11(9): 2004 Comparison of Commonly Used Antidepressants Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=200901&pb=PRL (subscription needed) http://www.prescribersletter.com
  2. 2.0 2.1 Prescriber's Letter 11(9): 2004 Duloxetine (Cymbalta) for Diabetic Peripheral Neuropathy Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=201004&pb=PRL (subscription needed) http://www.prescribersletter.com
  3. 3.0 3.1 Medwatch http://www.fda.gov/medwatch/safety/2005/safety05.htm#Cymbalta
    Prescriber's Letter 12(12): 2005 Liver function test scheduling Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=211210&pb=PRL (subscription needed) http://www.prescribersletter.com
  4. 4.0 4.1 4.2 4.3 4.4 4.5 FDA News release, Nov. 4, 2010 FDA clears Cymbalta to treat chronic musculoskeletal pain http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm232708.htm
  5. Prescriber's Letter 17(12): 2010 Cymbalta (Duloxetine) for Chronic Pain Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=261202&pb=PRL (subscription needed) http://www.prescribersletter.com
  6. 6.0 6.1 Smith EM et al Effect of Duloxetine on Pain, Function, and Quality of Life Among Patients With Chemotherapy-Induced Painful Peripheral Neuropathy. A Randomized Clinical Trial. JAMA. 2013;309(13):1359-1367 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/23549581 <Internet> http://jama.jamanetwork.com/article.aspx?articleid=1674238
  7. 7.0 7.1 Deprecated Reference
  8. FDA News Release: Dec. 11, 2013 FDA approves first generic versions of antidepressant drug Cymbalta. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm378282.htm
  9. 9.0 9.1 9.2 Therapeutics Letter #108. Therapeutics Initiative Drugs to Avoid. http://www.ti.ubc.ca/2018/01/04/108-drugs-avoid/
  10. A Pocket Guide to the 2019 Beer's Criteria. American Geriatrics Society.
  11. http://www.Cymbalta.com
  12. 12.0 12.1 Drugc.com: Duloxetine https://www.drugs.com/ppa/duloxetine.html
  13. Lunn MP, Hughes RA, Wiffen PJ. Duloxetine for treating painful neuropathy, chronic pain or fibromyalgia. Cochrane Database Syst Rev. 2014;(1):CD007115 PMID: https://www.ncbi.nlm.nih.gov/pubmed/24385423 Review. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD007115.pub3/full
  14. 14.0 14.1 Sofat N, Harrison A, Russell M, et al. The effect of pregabalin or duloxetine on arthritis pain: a clinical and mechanistic study in people with hand osteoarthritis. J Pain Res. 2017;10:2437-2449 https://www.dovepress.com/the-effect-of-pregabalin-or-duloxetine-on-arthritis-pain-a-clinical-an-peer-reviewed-fulltext-article-JPR
  15. 15.0 15.1 Uchio Y, Enomoto H, Alev L, et al. A randomized, double-blind, placebo-controlled phase III trial of duloxetine in Japanese patients with knee pain due to osteoarthritis. J Pain Res. 2018;11:809-821 https://www.dovepress.com/a-randomized-double-blind-placebo-controlled-phase-iii-trial-of-duloxe-peer-reviewed-fulltext-article-JPR
  16. 16.0 16.1 Geriatric Review Syllabus, 11th edition (GRS11) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2022
  17. van den Driest JJ et al. No added value of duloxetine in patients with chronic pain due to hip or knee osteoarthritis: A cluster-randomized trial. Arthritis Rheumatol 2022 May; 74:818 PMID: https://www.ncbi.nlm.nih.gov/pubmed/34989159 https://onlinelibrary.wiley.com/doi/10.1002/acr.24519
    Lenhard NK et al. Does screening for depressive symptoms help optimize duloxetine use in knee osteoarthritis patients with moderate pain? A cost-effectiveness analysis. Arthritis Rheumatol 2022 May; 74:776 PMID: https://www.ncbi.nlm.nih.gov/pubmed/33253496 PMCID: PMC8164641 (available on 2023-05-01) https://onlinelibrary.wiley.com/doi/10.1002/acr.24519
  18. Highlights of Prescribing Information Cymbalta (duloxetine) delayed release capsules for oral use https://www.accessdata.fda.gov/drugsatfda_docs/label/2010/022516lbl.pdf