- Major Depressive Disorder (MDD)
- Generalized Anxiety Disorder (GAD)
- Diabetic Peripheral Neuropathic Pain (DPNP)
- Fibromyalgia and
- Chronic Musculoskeletal Pain.
Stresin
Capsule (Delayed Release)
Generic Name
Duloxetine Hydrochloride
Strength
20 mg
Manufacturer
UniMed UniHealth Pharmaceuticals Ltd.
Unit Price
Unit Price: ৳ 8.00 (3 x 10: ৳ 240.00) Strip Price: ৳ 80.00
🔹 Indications
Stresin is a serotonin and norepinephrine reuptake inhibitor (SNRI) indicated for-
🔹 Pharmacology
Duloxetine Hydrochloride is a selective serotonin and norepinephrine reuptake inhibitor (SSNRI) for oral administration. Duloxetine is a less potent inhibitor of dopamine reuptake. Duloxetine has no significant affinity for dopaminergic, adrenergic, cholinergic, histaminergic, opioid, glutamate, and GABA receptors in vitro. Duloxetine does not inhibit monoamine oxidase (MAO). Orally administered Duloxetine hydrochloride is well absorbed. Elimination of Duloxetine is mainly through hepatic metabolism.
🔹 Dosage & Administration
Major Depressive Disorder (MDD)-
- Starting Dose: 40 mg/day to 60 mg/day
- Target Dose: Acute: 40 mg/day (20 mg twice daily) to 60 mg/day (once daily or as 30 mg twice daily); Maintenance: 60 mg/day
- Maximum Dose: 120 mg/day
- Starting Dose: 60 mg/day
- Target Dose: 60 mg/day (once daily)
- Maximum Dose: 120 mg/day
- Starting Dose: 60 mg/day
- Target Dose: 60 mg/day (once daily)
- Maximum Dose: 60 mg/day
- Starting Dose: 30 mg/day
- Target Dose: 60 mg/day (once daily)
- Maximum Dose: 60 mg/day
- Starting Dose: 30 mg/day
- Target Dose: 60 mg/day (once daily)
- Maximum Dose: 60 mg/day
🔹 Interaction
Both CYP1A2 and CYP2D6 isozymes are responsible for Stresin metabolism. When Stresin was co-administered with fluvoxamine, a potent CYP1A2 inhibitor, the AUC, Cmax and t of Stresin was increased. Other drugs that inhibit CYP1A2 metabolism include cimetidine and quinolone antimicrobials such as ciprofloxacin and enoxacin would be expected to have similar effects and these combinations should be avoided. Because CYP2D6 is involved in Stresin metabolism, concomitant use of Stresin with potent inhibitors of CYP2D6 may result in higher concentrations of Stresin.
🔹 Contraindications
Duloxetine is contraindicated in patients with a known hypersensitivity to this drug or any of the inactive ingredients. Duloxetine is not approved for use in treating bipolar depression. Duloxetine should not be prescribed to patients with substantial alcohol use or evidence of chronic liver disease. In clinical trials, Duloxetine was associated with an increased risk of mydriasis; therefore, it should be used cautiously in patients with controlled narrow-angle glaucoma.
🔹 Side Effects
The most commonly observed adverse events in Stresin treated patients were nausea, dizziness, dry mouth, constipation, decreased appetite, fatigue, somnolence, increased sweating, hyperhidrosis and asthenia. It may slightly increase blood pressure. No clinically significant differences were observed for QT, PR, and QRS intervals between Stresin-treated and placebo-treated patients.
🔹 Pregnancy & Lactation
Pregnancy: Pregnancy Category C. There are no adequate and well-controlled studies in pregnant women; therefore, Duloxetine should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
Labor and Delivery: The effect of Duloxetine on labor and delivery in humans is unknown. Duloxetine should be used during labor and delivery only if the potential benefit justifies the potential risk to the fetus.
Lactation: It is unknown whether or not Duloxetine and/or it's metabolites are excreted into human milk, but nursing while on Duloxetine is not recommended
Labor and Delivery: The effect of Duloxetine on labor and delivery in humans is unknown. Duloxetine should be used during labor and delivery only if the potential benefit justifies the potential risk to the fetus.
Lactation: It is unknown whether or not Duloxetine and/or it's metabolites are excreted into human milk, but nursing while on Duloxetine is not recommended
🔹 Precautions & Warnings
All patients being treated with antidepressants for any indication should be monitored appropriately and observed closely for clinical worsening, suicidality and unusual changes in behavior, especially during the initial few months of a course of drug therapy, or at times of dose changes. Blood pressure should be measured prior to initiating treatment and periodically measured throughout treatment. Patients should be cautioned about the risk of bleeding associated with the concomitant use of Stresin and NSAIDs, aspirin, or other drugs that affect coagulation. Stresin should be used cautiously in patients with a history of mania. Stresin should be prescribed with care in patients with a history of a seizure disorder.
🔹 Pediatric Usage
Use in the pediatric population: Safety and efficacy in pediatric patients have not been established
🔹 Storage Conditions
Do not store above 30°C. Keep away from light and out of the reach of children.
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💡 Frequently Asked Questions
Stresin is a serotonin and norepinephrine reuptake inhibitor (SNRI) indicated for-
Major Depressive Disorder (MDD)
Generalized Anxiety Disorder (GAD)
Diabetic Peripheral Neuropathic Pain (DPNP)
Fibromyalgia and
Chronic Musculoskeletal Pain....
Major Depressive Disorder (MDD)-
Starting Dose: 40 mg/day to 60 mg/day
Target Dose: Acute: 40 mg/day (20 mg twice daily) to 60 mg/day (once daily or as 30 mg twice daily); Maintenance: 60 mg/day
Maximum Dose: 120 mg/day
Generalized Anxiety D...
The most commonly observed adverse events in Stresin treated patients were nausea, dizziness, dry mouth, constipation, decreased appetite, fatigue, somnolence, increased sweating, hyperhidrosis and asthenia. It may slightly increase blood pressure. N...
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