All the Drug Class Drugs
SNRI. Duloxetine HCl 30 mg, 60 mg. CAPS: 7,14,28 x 30 mg, 60 mg.
intial: 30 mg dly. maint: 60 mg dly.
Ther. response: 2-4 wks aft. tmt. To
discont: Taper by 1/2 dose (30 mg) dly
or on alt. days. See lit.
Major depress. episodes., Generalized
anxiety dis., Neuropath. pain assoc.
with diabet. periph. neuropathy.,
fibromyalg., chron. muscoskeletal pain.
C/I: Concom. use with MAOI,
uncontrolled narrow-angle glaucoma.
SNRI. Duloxetine 30 , 60 mg. CAPS.:30. For diabet. peripher. neuropath. pain: The usual dose is 60 mg ×1/d.
For chron. musculoskel. pain and general. anxiety disord.: For most pts.
60 mg ×1/d. Some pts. require an init. dose of Dulox Teva 30 mg ×1/d for one wk., and then the usual dose of
60 mg ×1/d.
For depression: Most pts. will receive 60 mg ×1/d. Some pts. require an init. dose of Dulox Teva 30 mg ×1/d for one wk., and then the usual dose of 60 mg ×1/d
Elderly – The init. dose of 30 mg ×1/d for two wks., and only then consider incr. the dose to 60 mg ×1/d.
Fibromyalgia: The init. dose of Dulox Teva is 30 mg ×1/d for one wk., and then the usual dose of 60 mg ×1/d. In most cases, the effect of medication ther. with Dulox Teva is noticeab. after 2-4 wks. of tmt.
Tmt. of major depressive episodes.
Managem. of neuropath.pain associat. with diabet. peripher. neuropathy.
Tmt. of generaliz. anxiety disord. (GAD).
Manag. of fibromyalgia.
Manag. of chron. muscoskel. pain when other therapies have failed or are
contraindic. This has been establish. in studies in pts. with chron. low back pain (CLBP) and chron. pain due to osteoarthritis.
Pts. with hep. dis.
Pts. with severe ren. dis..
Concom. use with MAOI includ. IV methylene blue and the antibiot.linezolid. MAOI should be discount. 14 d. before init.of the tmt. with duloxetine.
Initiat. of MAOI should be start. at least 5 d. after discount. of the tmt. with duloxetine.
Concom. use with thioridazine
SNRI. Duloxetine (as HCl) 20, 30, 60 mg. DR CAPS: 30 ×20mg, 30mg, 60mg.
Major depres.disor. 60 mg/d.
GAD: init. reccom. dose 30 mg ×1/d for
1 week, may be incr. to 60 mg ×1/d.
Max until: 120mg x 1/d.
Diab. periph. neurop. pain: 60 mg x
1/d; lower init., dose, grad. incr. in pts.
with ren. impair.
Fibromyal.: init. 30 mg x 1/d; for 1
week, may be incr. to 60 mg ×1/d.
Chron. musculoskel. pain: init. 30 mg
start at 30 mg ×1/d for 1 week, may be
incr. to 60 mg ×1/d.
Tmt. of Major. depress. epis.; manag. of
neurop. pain assoc. with diab. periph.
neurop. Tmt. of GAD; Fibromyal.; Manag.
of chron. muscoskel. pain when other ther.
have fail.or are contra-ind.
C/I: Hypersens. , Liver dis. result. in hep.
impair., Sev. ren. impair., Pts. und. other
medic. contain. duloxetine.
Concom. use with MAOIs or within 14 d.
after use MAOIs Init. of tmt. with MAOIs
should be start. only on a 5th day elapse
from stop. tmt. with Duloxetine.
Concom. use with fluvoxamine,
thioridazine, cimetidine, quinolone.
Concom. use with ciprofloxacin or
enoxacin Pts. with uncontr. narr.-ang.
SNRI. Venlafaxine (HCl) 75 mg, 150 mg. E.R CAPS.: 28. Major depress. Episodes: The recomm. starting dose for prolong. release venlafaxine is 75 mg×1/d. Pts. not respond. to the init. 75 mg/d dose may benefit from dose incr. up to a max. dose of 375 mg/d. Dosage incr. can be made at interv. of 2 wks. or more. If clinic. warranted due to sympt. sever., dose incr. can be made at more freq. interv., but not less than 4 d. Contin. for at least 6 mnths. follow. remiss.
GAD: The recomm. starting dose for prolong. rel. venlafaxine is 75mg×1/d. Pts. not respond. to the init. 75 mg/d dose may benefit from dose incr. up to a max. dose of 225 mg/d. Dosage incr. can be made at interv. of 2 wks. or more.
SAD: The recomm. dose for prolong. rel. venlafaxine is 75mg×1/d. There is no evidence that higher doses confer any addit. benefit.
However, in individ. pts. not respond. to the init. 75 mg×1/d, incr. up to a max. dose of 225 mg/d may be consid. Dosage incr. can be made at interv. of 2 wks. or more.
For the tmt. of depress. Mainten. of recur. depress. Generalized anxiety Disord. (GAD) - short term & long-term. Social anxiety Disord. (SAD).
C/I: Hypersens. Concom. tmt. with irrevers. MAOIs. Venlafaxine must not be initiat. for at least 14 d after discont. of tmt. with an irrevers. MAOI. Venlafaxine must be discont. for at least 7 d before starting tmt. with an irrevers. MAOI.
SNRI. Milnacipran (HCl) 25 mg,. CAPS: 56. 100 mg in 2 div. doses.
Tmt. of major depress. epis. in adult.over
18 yrs. old.
C/I: Hypersens. Concom. use with nonselec.
MAOIs , B selec. MAOIs, digitalis , 5 HT1D agon. Sev. card. impair., arrhythmia (e.g. sign. left ventr. dysfunc., NYHA Class III/IV), uncontr. hypertens., sev., unst. coron. heart dis., lact. General. shouldn’t be use concom. with epinephrine, norepinephrine by parent. route, clonidine , related comp. and A selec. MAOIs.Prost.hypertrop., other gen.urin. disor. Preg.