DOSAGE AND ADMINISTRATION. Diuretics constitute a large family of medications that increase urine flow and induce urinary sodium loss and are widely used for therapy of hypertension, congestive heart failure, and edematous states. This could result in serotonin syndrome. Glucosamine: May enhance the antiplatelet effect of Agents with Antiplatelet Properties.Haloperidol: CYP2D6 Inhibitors (Moderate) may increase the serum concentration of Haloperidol. Propranolol: CYP2D6 Inhibitors (Moderate) may increase the serum concentration of Propranolol. If combined, monitor patients closely for the development of hypertension, including hypertensive crises.Peginterferon Alfa-2b: May decrease the serum concentration of CYP2D6 Substrates (High risk with Inhibitors). Subgroup analyses suggest efficacy may be greater for oxaliplatin-induced neuropathy as opposed to paclitaxel-induced neuropathy Data from a single-blind randomized study and 2 small open-label studies support the use of duloxetine in the treatment of stress urinary incontinence postprostatectomy in patients unresponsive to nonpharmacologic interventions Data from controlled trials of low and high quality, systematic reviews, and meta-analyses are conflicting.Use of monoamine oxidase (MAO) inhibitors intended to treat psychiatric disorders (concurrently or within 14 days of discontinuing the MAO inhibitor); initiation of MAO inhibitor intended to treat psychiatric disorders within 5 days of discontinuing duloxetine; initiation of duloxetine in a patient receiving linezolid or intravenous methylene blue.Oral: Initial: 30 mg once daily for 1 to 2 weeks, then increase to 60 mg once daily as tolerated; maximum dose: 60 mg/day (Isaac 2019; manufacturer's labeling).Oral: Initial: 30 mg once daily for 1 week, then 60 mg once daily. Use of a single agent is preferred. Ondansetron heeft geen invloed op de rijvaardigheid en het vermogen om machines te bedienen. Management: Monitor for signs and symptoms of serotonin syndrome/serotonin toxicity (eg, hyperreflexia, clonus, hyperthermia, diaphoresis, tremor, autonomic instability, mental status changes) and increased TCA concentrations and effects if these agents are combined.Urokinase: Agents with Antiplatelet Properties may enhance the anticoagulant effect of Urokinase. This could result in serotonin syndrome. Prostacyclin Analogues: May enhance the antiplatelet effect of Agents with Antiplatelet Properties.Ramosetron: May enhance the serotonergic effect of Serotonergic Agents (High Risk). Management: Monitor for signs and symptoms of serotonin syndrome/serotonin toxicity (eg, hyperreflexia, clonus, hyperthermia, diaphoresis, tremor, autonomic instability, mental status changes) when these agents are combined.CYP1A2 Inducers (Moderate): May decrease the serum concentration of DULoxetine.CYP1A2 Inhibitors (Moderate): May increase the serum concentration of DULoxetine.CYP2D6 Inhibitors (Strong): May increase the serum concentration of DULoxetine.Dabigatran Etexilate: Agents with Antiplatelet Properties may enhance the anticoagulant effect of Dabigatran Etexilate. Do not start, stop, or change the dosage of any medicine before checking with them first.Selected from data included with permission and copyrighted by First Databank, Inc. Volume depletion and/or concurrent use of diuretics likely increases risk.• Urinary hesitancy: May cause increased urinary resistance; advise patient to report symptoms of urinary hesitation/difficulty.• Cardiovascular disease: Use caution in patients with cardiovascular conditions or cerebrovascular disease.• Gastroparesis: Use caution in patients with impaired gastric motility (eg, some diabetics); may affect stability of the capsule's enteric coating.• Hepatic impairment: Avoid use in patients with chronic liver disease or cirrhosis.• Hypertension: Use caution in patients with hypertension; preexisting hypertension should be treated prior to initiating therapy. DULoxetine may enhance the serotonergic effect of Selective Serotonin Reuptake Inhibitors (Strong CYP2D6 Inhibitors). Use is contraindicated (COI) when also combined with strong CYP3A4 inhibitors. These medicines may interact and cause very harmful effects. Aprepitant is an orally available antiemetic agent that is used to prevent postoperative or cancer chemotherapy related nausea and vomiting. AtoMOXetine: CYP2D6 Inhibitors (Moderate) may increase the serum concentration of AtoMOXetine. This could result in serotonin syndrome. Lower initial doses have been used in women to reduce adverse effects: 20 mg twice daily for 2 weeks then 40 mg twice daily (Castro-Diaz 2007; Schagen van Leeuwen 2008).Allow 14 days to elapse between discontinuing an MAOI and initiation of duloxetine.Allow ≥5 days to elapse between discontinuing duloxetine and initiation of an MAOI according to manufacturer labeling; however, some experts recommend a 14-day washout period (APA 2010).Allow at least 14 days to elapse between discontinuing a MAO inhibitor intended to treat psychiatric disorders and initiation of duloxetine.Allow at least 5 days to elapse between discontinuing duloxetine and initiation of a MAO inhibitor intended to treat psychiatric disorders.Oral: Administer without regard to meals.