Last update April 18, 2018

Duloxetine

Very Low Risk

Safe. Compatible. Minimal risk for breastfeeding and infant.

It is a reuptake-inhibitor of Serotonin and Norepinephrine.
Oral administration once a day.

Excreted into breast milk in clinically non-significant amount (Collin 2018, Andrade 2014, Rowe 2013, Boyce 2011, Berle 2011, Briggs 2009, EMA 2009, Lanza 2009, Lobo 2008) with no side-effects being observed in breastfed infants from treated mothers (Briggs 2009). Plasma level in those infants was very low or undetectable (Boyce 2011, Briggs 2009).

Because there is less experience published than with other antidepressants of the same pharmacological group, it should be preferred the use of an alternative drug that is known to be safer in the neonatal period or prematurity.

Galactorrhea has been observed with or without an increase in prolactin (Demirci 2015, Belli 2013, Korkmaz 2011), but less frequently than with other antidepressants (Trenque 2011).

Women who use antidepressant medication during pregnancy are in need of more support for breastfeeding since they are at risk for early weaning (Leggett 2017).

Alternatives

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

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Other names

Duloxetine is also known as


Duloxetine in other languages or writings:

Group

Duloxetine belongs to this group or family:

Tradenames

Main tradenames from several countries containing Duloxetine in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 50 (32 - 80) %
Molecular weight 334 daltons
Protein Binding 96 %
VD 23.4 l/Kg
pKa 9.5 -
Tmax 6 hours
T½ 12 (8- 17) hours
M/P ratio 0.27 - 1.3 -
Theoretical Dose 0.004 - 0.01 mg/Kg/d
Relative Dose 0.3 - 1 %

References

  1. Collin-Lévesque L, El-Ghaddaf Y, Genest M, Jutras M, Leclair G, Weisskopf E, Panchaud A, Ferreira E. Infant Exposure to Methylphenidate and Duloxetine During Lactation. Breastfeed Med. 2018 Abstract
  2. Leggett C, Costi L, Morrison JL, Clifton VL, Grzeskowiak LE. Antidepressant Use in Late Gestation and Breastfeeding Rates at Discharge from Hospital. J Hum Lact. 2017 Nov;33(4):701-709. Abstract
  3. Demirci S, Unubol M, Demirci K. Galactorrhea With Normal Prolactin Levels Associated With Duloxetine. J Clin Psychopharmacol. 2015 Abstract
  4. Larsen ER, Damkier P, Pedersen LH, Fenger-Gron J, Mikkelsen RL, Nielsen RE, Linde VJ, Knudsen HE, Skaarup L, Videbech P. Use of psychotropic drugs during pregnancy and breast-feeding. Acta Psychiatr Scand Suppl. 2015 Abstract
  5. Andrade C. The safety of duloxetine during pregnancy and lactation. J Clin Psychiatry. 2014 Abstract Full text (link to original source) Full text (in our servers)
  6. Belli H, Akbudak M, Ural C. Duloxetine-related galactorrhea and restless legs syndrome: a case report. Psychiatr Danub. 2013 Abstract Full text (link to original source) Full text (in our servers)
  7. Rowe H, Baker T, Hale TW. Maternal medication, drug use, and breastfeeding. Pediatr Clin North Am. 2013 Feb;60(1):275-94. Abstract
  8. Boyce PM, Hackett LP, Ilett KF. Duloxetine transfer across the placenta during pregnancy and into milk during lactation. Arch Womens Ment Health. 2011 Abstract
  9. Korkmaz S, Kuloğlu M, Işık U, Sağlam S, Atmaca M. Galactorrhea during duloxetine treatment: a case report. Turk Psikiyatri Derg. 2011 Abstract
  10. Berle JO, Spigset O. Antidepressant Use During Breastfeeding. Curr Womens Health Rev. 2011 Abstract Full text (link to original source) Full text (in our servers)
  11. Trenque T, Herlem E, Auriche P, Dramé M. Serotonin reuptake inhibitors and hyperprolactinaemia: a case/non-case study in the French pharmacovigilance database. Drug Saf. 2011 Abstract
  12. Lanza di Scalea T, Wisner KL. Antidepressant medication use during breastfeeding. Clin Obstet Gynecol. 2009 Abstract Full text (link to original source) Full text (in our servers)
  13. Briggs GG, Ambrose PJ, Ilett KF, Hackett LP, Nageotte MP, Padilla G. Use of duloxetine in pregnancy and lactation. Ann Pharmacother. 2009 Abstract
  14. EMA. Duloxetine. Drug Summary. 2009 Full text (in our servers)
  15. EMA. Duloxetina. Ficha técnica. 2009 Full text (in our servers)
  16. Lobo ED, Loghin C, Knadler MP, Quinlan T, Zhang L, Chappell J, Lucas R, Bergstrom RF. Pharmacokinetics of duloxetine in breast milk and plasma of healthy postpartum women. Clin Pharmacokinet. 2008 Abstract

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