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    Duloxetine is a selective serotonin and norepinephrine reuptake inhibitor antidepressant (SSNRI). Duloxetine affects chemicals in the brain that may be unbalanced in people with depression. Duloxetine is used to treat major depressive disorder in adults. It is also used to treat general anxiety disorder in adults and children who are at least 7 years old. Duloxetine is also used in adults to treat fibromyalgia (a chronic pain disorder), or chronic muscle or joint pain (such as low back pain and osteoarthritis pain). Duloxetine is also used to treat pain caused by nerve damage in adults with diabetes (diabetic neuropathy). Do not take duloxetine within 5 days before or 14 days after you have used an MAO inhibitor, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine. Some young people have thoughts about suicide when first taking an antidepressant. Report any new or worsening symptoms to your doctor. Fibromyalgia is a lifelong condition that affects about 5 million Americans. People with it have sore, stiff muscles, but nothing odd shows up on X-rays or most lab tests. Doctors diagnose it based on your symptoms and an exam. While fibromyalgia doesn't damage joints or organs, the constant aches and fatigue can really impact daily life. Because traditionally no lab tests or X-rays could confirm a diagnosis of fibromyalgia, people may have been led to believe this feeling was "all in their heads." But the medical community now accepts that the intense pain of fibromyalgia is real. One of the unique things about fibromyalgia is specific locations on the body that, when pressed, hurt. Research suggests it's caused by a glitch in the way the body perceives pain. Women between 25 and 60 have the highest chances of developing fibromyalgia. Doctors aren't sure why, but women are 10 times more likely to have it than men.

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    50 mg PO q Day initially for 5 days If no ovulation, treatment can be repeated as early as 30 days after previous therapy Dosage can be increased to 100 mg only in patients who do not respond to first course Body as a whole: Fever, tinnitus, weakness Cardiovascular: Arrhythmia, chest pain, edema, hypertension, palpitation, phlebitis, pulmonary embolism, shortness of breath, tachycardia, thrombophlebitis Central nervous system: Migraine headache, paresthesia, seizure, stroke, syncope Dermatologic: Acne, allergic reaction, erythema, erythema multiforme, erythema nodosum, hypertrichosis, pruritus, urticaria Genitourinary: Endometriosis, ovarian cyst (ovarian enlargement or cysts could, as such, be complicated by adnexal torsion), ovarian hemorrhage, tubal pregnancy, uterine hemorrhage; reduced endometrial thickness Hepatic: Transaminases increased, hepatitis, pancreatitis Musculoskeletal: Arthralgia, back pain, myalgia Neoplasms: Liver (hepatic hemangiosarcoma, liver cell adenoma, hepatocellular carcinoma); breast (fibrocystic disease, breast carcinoma); endometrium (endometrial carcinoma); nervous system (astrocytoma, pituitary tumor, prolactinoma, neurofibromatosis, glioblastoma multiforme, brain abscess); ovary (luteoma of pregnancy, dermoid cyst of the ovary, ovarian carcinoma); trophoblastic (hydatiform mole, choriocarcinoma); miscellaneous (melanoma, myeloma, perianal cysts, renal cell carcinoma, Hodgkin’s lymphoma, tongue carcinoma, bladder carcinoma) Psychiatric: Anxiety, irritability, mood changes, psychosis Visual disorders: Abnormal accommodation, cataract, eye pain, macular edema, optic neuritis, photopsia, posterior vitreous detachment, retinal hemorrhage, retinal thrombosis, retinal vascular spasm, temporary or prolonged loss of vision, possibly irreversible Metabolism disorders: Hypertriglyceridemia Other: Leukocytosis, thyroid disorder Careful attention should be given to selection of candidates for therapy; pelvic examination is necessary prior to treatment and before each subsequent course Uterine fibroids, pituitary or ovarian failure may occur Risk of ovarian enlargement & ovarian hyperstimulation syndrome (OHSS); transient liver function test abnormalities suggestive of hepatic dysfunction, which may be accompanied by morphologic changes on liver biopsy, reported in association with OHSS, which is a medical event distinct from uncomplicated ovarian enlargement; death due to hypovolemic shock, hemoconcentration, or thromboembolism has occurred; if enlargement of ovary occurs, additional therapy should not be given until ovaries have returned to pretreatment size, and dosage or duration of next course should be reduced; ovarian enlargement and cyst formation associated with therapy usually regresses spontaneously within a few days or weeks after discontinuing treatment; potential benefit of subsequent therapy in these cases should exceed risk Potential for multiple births, especially at 100 mg dosage Risk of visual disturbance (like scotoma & photopsia); patients should be warned that visual symptoms may render activities such as driving a car or operating machinery more hazardous than usual, particularly under conditions of variable lighting; while etiology of visual symptoms is not yet understood, patients with any visual symptoms should discontinue treatment and have complete ophthalmological evaluation carried out promptly Cases of hypertriglyceridemia reported; preexisting or family history of hyperlipidemia and use of higher than recommended dose and/or longer duration of treatment are associated with risk of hypertriglyceridemia; periodic monitoring of plasma triglycerides is recommended in patients with preexisting or family history of hyperlipidemia; pretreatment screening of triglyceride levels is recommended in patients initiating therapy Cases of pancreatitis reported Prolonged use of clomiphene citrate tablets USP may increase risk of a borderline or invasive ovarian tumor Use in pregnant women is contraindicated, as treatment does not offer benefit in this population; to avoid inadvertent administration during early pregnancy, appropriate tests should be utilized during each treatment cycle to determine whether ovulation and/or pregnancy occurs; patients should be evaluated carefully to exclude ovarian enlargement or ovarian cyst formation between each treatment cycle; the next course of therapy should be delayed until these conditions have been excluded Available human data from epidemiologic studies do not show apparent cause and effect relationship between clomiphene citrate periconceptual exposure and an increased risk of overall birth defects, or any specific anomaly It is not known whether drug is excreted in human milk; because many drugs are excreted in human milk, caution should be exercised if drug is administered to a nursing woman; in some patients, therapy may reduce lactation Half-Life elimination: 5-7 days Onset: Within 5-10 days Peak plasma time 6.5 hours Bioavailability: Readily absorbed from GI tract Metabolism: Enterohepatically circulated Excretion: feces 37-51%; small amount in urine The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information. Ejemplos de Indigenismos - Clomiphene Citrate - Fact Sheet Uses, Side Effects, Interactions Clomiphene Citrate Drug Information, Professional -
     
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