Andepra

Andepra - Dosage | Interactions | Side effects

Andepra is a drug that contains duloxetine as an active ingredient. Andepra increases plasma levels of serotonin and noradrenaline and belongs to the family of drugs called serotonin and noradrenaline reuptake inhibitors (SNRIs).

It is used to treat:

  • Diabetic peripheral neuropathy
  • Episodes of major depression
  • Fibromyalgia
  • Generalized anxiety disorder
  • Chronic pain in the muscles and bones

Precautions

Andepra is absolutely contraindicated in patients who have hepatic disease because studies have shown that the active substance - duloxetine, can cause an increase of the ALT levels (ALT is a liver enzyme) that is 10 times higher than recommended levels. Use with other hepatotoxic drugs is also absolutely contraindicated.

Due to the potential risk of hypertensive crises, use of this drug is contraindicated in patients suffering from moderate or severe hypertension.

Use of this medication in patients who have severe renal failure (creatinine clearance less than 30 mL / min), may result in a clinically significant increase in the plasma concentration of this drug, which increases the risk of toxic side effects.

Concomitant administration with drugs known as monoamine oxidase inhibitors (MAOI) is absolutely contraindicated because it may lead to a serotonin syndrome.

Co-administration with potent CYP1A2 enzyme inhibitors (CYP1A2 is an enzyme responsible for the metabolism of the Andepra) can increase the plasma concentration of this drug, and therefore concomitant administration must be avoided. Drugs known to act as inhibitors of CYP1A2 enzyme include ciprofloxacin (an antibiotic) and fluvoxamine (a selective serotonin reuptake inhibitor - SSRIs).

This drug can cause you having thoughts of harming yourself as well as suicidal thoughts, and you must inform your physician immediately if you notice these symptoms.

Considering that there are reported cases of bleeding disorders in patients who are treated with this drug, it must be used with great caution in patients receiving anticoagulant therapy.

Andepra may cause a lack of sodium in the blood (hyponatremia), and this side effect occurs more frequently in elderly patients and in patients receiving water pills.

Andepra, pregnancy and breastfeeding

According to the FDA, Andepra belongs to the group C, since studies in animals have shown that the use of this drug in the last trimester of pregnancy may cause growth retardation and behavioral disorders in newborns. This drug should be used during pregnancy only if necessary.

Avoid breastfeeding while taking Andepra.

Dosage

Andepra exists in the form of capsules at a dose of 30 and 60 mg.

The recommended dosage is in the table below:

Indication Dosage instructions
Diabetic peripheral neuropathic pain 60 mg once a day
Episodes of severe depression 60 mg once a day
Generalized anxiety disorder

Initial dose: 30 mg once a day

Maintenance dose: 60-120 mg once a day.

Fibromyalgia

Initial dose: 30 mg once a day

Maintenance dose: 30-60 mg once a day.

The duration of treatment depends on the severity of the condition.

Capsules can be taken independently of meal times.

Interactions

Andepra should not be administered concurrently with the following drugs:

  • Monoamine oxidase inhibitors (e.g. ssocarboxazid, selegiline and linezolid)
  • SSRIs (e.g. Zoloft)
  • Tricyclic antidepressants (amitriptyline, nortriptyline, imipramine, desipramine, etc)
  • Benzodiazepines (lorazepam, bromazepam, midazolam, nitrazepam, etc)
  • Antibiotics (e.g. ciprofloxacin)
  • Oral anticoagulants
  • Antipsychotics
  • Narcotic analgesics
  • Sedative H1 antihistamines
  • Triptans

Side effects

Very common side effects of Andepra are:

  • Nausea
  • Drowsiness
  • Headache
  • Dizziness

Common side effects are:

  • Palpitation
  • Tinnitus
  • Blurred vision
  • Decreased libido
  • Vomiting
  • Decreased appetite
  • Weight loss
  • Abdominal pain
  • Constipation
  • Pain in the muscles or muscle cramps
  • Heartburn

Uncommon side effects are

  • Liver inflammation
  • Restless legs syndrome
  • Gastroenteritis
  • Sore throat
  • Hypertension
  • Hyperglycemia
  • Insomnia
  • Arrhythmia
  • Disruption of taste
  • Difficulty urinating
  • Weight gain
  • Abnormal ejaculation
  • Abnormal menstruation
  • Feeling of inner restlessness

Rare side effects are

  • Hypothyroidism
  • Convulsions
  • Elevated intraocular pressure
  • Hyponatremia
  • Hypercholesterolemia
  • Allergy
  • Aggressiveness

Side effects with unknown frequency

  • Eye pain
  • Difficulty swallowing
  • Tightness in the chest
  • Increased thirst
  • Dark-colored urine
  • General malaise

References

  1. NCBI link 1
  2. NCBI link 2