The brand of duloxetine called Yentreve® is prescribed for women with stress incontinence. Take one capsule twice daily, in the morning and late afternoon. You may be given generic duloxetine capsules; 20 mg and 40 mg capsules are prescribed for stress incontinence.
Remember to do the exercises you have been given to strengthen your pelvic floor muscles.
Each time you collect a new supply of capsules, make sure the strength (20 mg or 40 mg) is the same as you have taken previously. If not, please speak with your pharmacist who will advise you.
About duloxetine for urinary symptoms
|Type of medicine||A serotonin and noradrenaline reuptake inhibitor|
|Used for||Symptoms of stress incontinence in women|
Stress incontinence is the most common form of incontinence. It means you pass urine with things like coughing, sneezing or exercise. It happens when the pelvic floor muscles that support your bladder are weakened. Childbirth is a common reason for a weak pelvic floor. The main treatment for stress incontinence is pelvic floor exercises. Surgery to tighten or support your bladder outlet can also help.
Duloxetine may be advised if pelvic floor exercises alone are not helping to treat your stress incontinence. It is usually advised in women who do not want to undergo surgery, or in women who have health problems that may mean that surgery is unsuitable.
Duloxetine is thought to work by interfering with certain chemicals (called serotonin and noradrenaline) that are used within the nerves that send messages to your pelvic floor muscles. This helps the muscles around the bladder outlet to contract more strongly, and this in turn controls the flow of urine and helps to prevent any leakage.
Duloxetine is also prescribed for the treatment of some mood and nerve disorders, although a different brand and strength of capsule are used. There is a separate medicine leaflet called Duloxetine for mood and nerve disorders which gives more information about duloxetine when it is used for this type of condition.
Before taking duloxetine
Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking duloxetine it is important that your doctor knows:
- If you are pregnant, trying for a baby or breastfeeding.
- If you have any problems with the way your liver works, or any problems with the way your kidneys work.
- If you have a heart condition.
- If you have increased eye pressure (called glaucoma).
- If you have high blood pressure.
- If you have ever had 'high' moods, such as mania in bipolar disorder.
- If you have ever had a fit (seizure).
- If you have a blood disorder that increases your risk of bleeding.
- If you are taking or using any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines.
- If you have ever had an allergic reaction to a medicine.
How to take duloxetine
- Before you start the treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about duloxetine and will provide you with a full list of the side-effects which you may experience from taking it.
- Take duloxetine exactly as your doctor tells you to. The usual dose is one 40 mg capsule twice daily (in the morning and late afternoon). If you are taking duloxetine for the first time, your doctor may give you the lower 20 mg strength capsule for a couple of weeks - this is to help avoid any unwanted symptoms when you first take duloxetine.
- Try to take your doses at the same times of day each day, as this will help you to remember to take your doses regularly. You can take duloxetine either before or after meals. Take the capsules with a drink of water to help you to swallow.
- If you forget to take a dose at your usual time, take it when you remember. However, if it is nearly time to take your next dose when you remember then leave out the forgotten dose and take your next dose when it is due. Do not take two doses together to make up for a missed dose.
Getting the most from your treatment
- Try to keep your regular appointments with your doctor. This is so your doctor can check on your progress and review your treatment.
- Remember to do the exercises you have been given to strengthen your pelvic floor muscles. This is important because the majority of people with stress incontinence are much improved with these exercises.
- If you have been advised to reduce your weight, try to stick to the advice you have been given about your diet. Losing even a modest amount of weight can help to improve your symptoms.
- Smoking can cause coughing which can aggravate your symptoms. It would help to not smoke. If you are a smoker and you need help to quit, ask your doctor or pharmacist for advice.
- Drinking alcohol can increase the risk of unwanted effects from duloxetine, such as dizziness and blurred vision.
- If you buy any medicines, check with a pharmacist that they are suitable to take with duloxetine. This is because some herbal medicines (such as St John's wort) can increase the chance that you will experience unwanted effects.
- If you are having an operation or dental treatment, tell the person carrying out the treatment that you are taking duloxetine.
- Keep taking duloxetine until your doctor tells you otherwise. Stopping suddenly can cause problems and your doctor may want you to reduce your dose gradually when this becomes necessary.
Can duloxetine cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the common ones associated with duloxetine. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.
|Very common duloxetine side-effects (these affect more than 1 in 10 people)||What can I do if I experience this?|
|Feeling sick (nausea)||Eat simple meals - avoid rich or spicy foods|
|Dry mouth||Try chewing sugar-free gum or sucking sugar-free sweets|
|Constipation||Try to eat a well-balanced diet and drink several glasses of water each day|
|Common duloxetine side-effects (these affect less than 1 in 10 people)||What can I do if I experience this?|
|Blurred vision, feeling tired, dizzy or sleepy||Do not drive and do not use tools or machines while affected. Avoid alcohol|
|Diarrhoea||Drink plenty of water to replace lost fluids|
|Headache||Ensure you are drinking the recommended amount of fluids each day. Ask your pharmacist to recommend a suitable painkiller. If the headaches continue, let your doctor know|
|Lack of appetite, indigestion, stomach pain, flushing, increased blood pressure, difficulty sleeping, feeling anxious, skin tinglings, feeling shaky, reduced interest in sex, increased sweating||Discuss these with your doctor if any become troublesome|
Important: if you develop any depressing or distressing thoughts or ideas, you should let your doctor know about this as soon as possible. When duloxetine is prescribed for people with depression, it can increase the risk of suicidal thoughts, particularly when the treatment is first started. Duloxetine taken for urinary symptoms is not thought to cause this, but it cannot be ruled out.
If you experience any other symptoms which you think may be due to the capsules, please speak with your doctor or pharmacist for further advice.
How to store duloxetine
- Keep all medicines out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
Important information about all medicines
Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
If you have any questions about this medicine ask your pharmacist.
Further reading and references
Manufacturer's PIL, Yentreve® 20 mg and 40 mg hard gastro-resistant capsules; Eli Lilly and Company Ltd, The electronic Medicines Compendium. Dated January 2016.
British National Formulary, 75th Edition (Mar 2018); British Medical Association and Royal Pharmaceutical Society of Great Britain, London.