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2018 | 18 | 1 | 74–80
Article title

Duloksetyna – profil farmakologiczny i kliniczny leku z grupy inhibitorów zwrotnego wychwytu serotoniny i noradrenaliny

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Title variants
EN
Duloxetine: the pharmacological and clinical profile of a drug from the group of serotonin and noradrenaline reuptake inhibitors
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PL
Abstracts
EN
Duloxetine, a serotonin and noradrenaline reuptake inhibitor, is registered in Poland for treatment of depressive disorders, generalized anxiety disorder and peripheral diabetic neuropathy. However, research has also confirmed its efficacy in other disorders associated with neuropathic pain, fibromyalgia, urinary incontinence and for relieving menopause symptoms. Duloxetine is an oral drug in the form of gastro-resistant capsules (30, 60, 90 and 120 mg). Its serum concentrations show high individual variability. Absolute bioavailability averages 50%, but may range from 32 to 80%. In humans, duloxetine binds with plasma proteins in 96%; it is intensively metabolised by CYP1A2 and CYP2D6. Due to the intensive metabolism by CYP1A2, substances that inhibit this enzyme (such as fluvoxamine, ciprofloxacin and enoxacin) increase duloxetine concentration significantly and may result in toxicity. In registered indications, duloxetine has at least equivalent efficacy to other drugs used in first-line therapy. It is both well-tolerated and safe, also in terms of cardiovascular effects. The most common adverse effects include: nausea, dry mouth, constipation, insomnia, dizziness, fatigue and drowsiness, excessive sweating and lower appetite. Patients treated with duloxetine develop sexual dysfunctions, similar to those associated with serotonin drugs. As with venlafaxine or paroxetine, withdrawal symptoms do develop after abrupt discontinuation of duloxetine therapy. This article presents basic pharmacological properties and the clinical profile of duloxetine.
PL
Duloksetyna, inhibitor zwrotnego wychwytu serotoniny i noradrenaliny, jest zarejestrowana w Polsce w leczeniu zaburzeń depresyjnych, zaburzenia lękowego uogólnionego i obwodowej neuropatii cukrzycowej. Badania potwierdziły też skuteczność leku w innych zaburzeniach związanych z obecnością bólu neuropatycznego, w fibromialgii, nietrzymaniu moczu oraz łagodzeniu objawów towarzyszących menopauzie. Duloksetyna podawana jest doustnie w formie kapsułek dojelitowych (30, 60, 90 i 120 mg). Stężenie leku w osoczu wykazuje dużą zmienność osobniczą. Bezwzględna dostępność biologiczna wynosi średnio 50%, może się jednak wahać od 32 do 80%. Duloksetyna wiąże się u ludzi z białkami osocza w 96%, jest intensywnie metabolizowana przez CYP1A2 i CYP2D6. Z uwagi na intensywny metabolizm przez CYP1A2 substancje hamujące ten enzym – fluwoksamina, ciprofloksacyna czy enoksacyna – zdecydowanie zwiększają stężenie duloksetyny i mogą spowodować wystąpienie objawów toksycznych. W zarejestrowanych wskazaniach duloksetyna wykazuje co najmniej taką samą skuteczność jak inne leki zalecane w terapii pierwszego rzutu. Jest dobrze tolerowana i bezpieczna – również pod względem wpływu na układ krążenia. Wśród najczęstszych działań niepożądanych należy wymienić nudności, suchość w ustach, zaparcia, bezsenność, zawroty głowy, uczucie zmęczenia i nadmiernej senności, wzmożone pocenie się i obniżony apetyt. U osób przyjmujących duloksetynę obserwuje się dysfunkcje seksualne podobne do tych związanych z przyjmowaniem leków serotoninowych. W razie nagłego przerwania leczenia duloksetyną, tak jak w przypadku wenlafaksyny czy paroksetyny, pojawiają się objawy dyskontynuacyjne. W artykule przedstawiono podstawowe właściwości farmakologiczne i profil kliniczny duloksetyny.
Discipline
Publisher

Year
Volume
18
Issue
1
Pages
74–80
Physical description
Contributors
  • Oddział Psychiatrii Wieku Podeszłego, Centralny Szpital Kliniczny Uniwersytetu Medycznego w Łodzi, Łódź, Polska, mwojtera@medycynamilorzab.pl
author
  • Zakład Psychologii Lekarskiej, Uniwersytet Medyczny w Łodzi, Łódź, Polska
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Document Type
article
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YADDA identifier
bwmeta1.element.psjd-93801d9a-530e-46d5-b20c-0cc52d950d81
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