Does duloxetine cause constipation? (+5 factors)
In this article, we will discuss whether duloxetine causes constipation. We will also discuss the research studies suggesting the link between duloxetine and constipation. Additionally, we will discuss the factors that may increase the risk of duloxetine-induced constipation as well as the management of constipation while taking duloxetine.
Does duloxetine cause constipation?
Yes, duloxetine can cause constipation. It is one of the frequently reported side effects associated with the use of duloxetine. However, it is important to note that, in some cases, individuals may report diarrhea after using duloxetine instead of constipation as a side effect.
Duloxetine is an antidepressant medication that is generally employed in the treatment of various mental health disorders such as depression and anxiety. Additionally, it is also recommended in the management of fibromyalgia, chronic pain, and muscle aches (1).
What does research suggest?
Research suggests that duloxetine is a safe medication with a lower incidence of serious side effects. The commonly reported side effects of duloxetine may include fatigue, dizziness, nausea, and constipation. However, it is important to acknowledge that research studies have also documented the occurrence of diarrhea associated with this medication (3).
A research study aimed to evaluate the effectiveness of duloxetine in the management of stress urinary incontinence and assess its tolerability among individuals. The study results indicated that duloxetine was successful in managing stress urinary incontinence, however, a notable proportion of individuals opted to discontinue the medication due to the occurrence of side effects, primarily constipation, reported by more than 10% of the patients.
Additionally, the study revealed that approximately 5% of the participants experienced diarrhea as an adverse event (2).
What factors can increase the risk of constipation while using duloxetine?
While duloxetine is commonly associated with causing constipation in individuals taking this medication, however, the risk is elevated in the presence of several risk factors. These factors may include:
|Sensitivity to duloxetine may vary from one individual to another. Elderly patients are generally more prone to constipation, and combining duloxetine with age-related factors may increase the likelihood of constipation.
|Underlying medical conditions
|Several underlying medical conditions or gastrointestinal disorders may increase the likelihood of constipation, while using duloxetine, such as inflammatory bowel disease, multiple sclerosis, and diabetes mellitus (4).
|Combining duloxetine with certain drugs can increase the likelihood of constipation. Some medications that are known to have a potential interaction leading to increased constipation when taken with duloxetine may include opioid analgesics and drugs with anticholinergic properties.
|According to research, a higher dosage of duloxetine is more likely to increase the incidence of constipation and other side effects as compared to a lower dosage (3).
|Start of treatment
|The occurrence of side effects in patients undergoing treatment with duloxetine is often higher during the initial period of treatment because the patient’s body is adjusting to the medication. As the body adapts to the drug, side effects may become less pronounced or diminish over time.
What to do if duloxetine causes constipation?
Side effects like constipation associated with duloxetine generally subside as the body adjusts to the medication. However, if you experience severe and persistent constipation after taking duloxetine, it is important to consult your healthcare provider.
They will assess your condition and determine the cause of your symptoms. If it is related to duloxetine, they may suggest dosage adjustment or discontinuation of the medication based on the severity of symptoms.
It is crucial to note that you should never change your treatment regimen without consulting your healthcare provider, as sudden discontinuation of duloxetine may cause withdrawal effects that can worsen your condition.
Your healthcare provider will determine the most appropriate option based on your specific needs and the severity of constipation.
What are the management tips for constipation?
There are some useful tips that your healthcare provider may suggest to help you manage your constipation. These management tips may include:
- Increase your fiber intake by incorporating whole grains into your diet. Similarly, figs are also a good source of dietary fiber that may contribute to improved digestive health
- A teaspoon of castor oil or olive oil may reduce friction in the large intestine and ease the passage of stool
- Increase water intake throughout the day to soften the stool and facilitate bowel movements
- Including prune juice in your diet may also help relieve constipation
- Short-term use of laxatives such as senna may provide relief
- In cases of severe constipation, suppositories or enemas may be used if other measures, including laxatives, are not effective
What are the alternatives to duloxetine if it causes constipation?
If you experience severe constipation due to duloxetine, which affects your quality of life, your healthcare provider may suggest alternative medications that are less likely to cause constipation. Some examples of such medications are:
However, it’s important to note that these medications may also cause constipation, but the incidence is lower as compared to duloxetine. When choosing a new medication, the risks and benefits associated with each medication should be considered along with your overall health.
In my opinion, if duloxetine is deemed effective in managing your symptoms and the benefits outweigh the risks, discontinuation of the medication should not be considered without consulting your healthcare provider. The decision to switch or continue medication should be a collaborative one, taking into account your individual health status and treatment goals.
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Dhaliwal JS, Spurling BC, Molla M. Duloxetine. 2023 May 29. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 31747213. https://pubmed.ncbi.nlm.nih.gov/31747213/
Hurley DJ, Turner CL, Yalcin I, Viktrup L, Baygani SK. Duloxetine for the treatment of stress urinary incontinence in women: an integrated analysis of safety. Eur J Obstet Gynecol Reprod Biol. 2006 Mar 1;125(1):120-8. doi: 10.1016/j.ejogrb.2005.08.006. Epub 2005 Sep 26. PMID: 16188367. https://pubmed.ncbi.nlm.nih.gov/16188367/
Detke MJ, Wiltse CG, Mallinckrodt CH, McNamara RK, Demitrack MA, Bitter I. Duloxetine in the acute and long-term treatment of major depressive disorder: a placebo- and paroxetine-controlled trial. Eur Neuropsychopharmacol. 2004 Dec;14(6):457-70. doi: 10.1016/j.euroneuro.2004.01.002. PMID: 15589385. https://pubmed.ncbi.nlm.nih.gov/15589385/
Diaz S, Bittar K, Hashmi MF, et al. Constipation. [Updated 2023 Nov 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK513291/
Oliva V, Lippi M, Paci R, Del Fabro L, Delvecchio G, Brambilla P, De Ronchi D, Fanelli G, Serretti A. Gastrointestinal side effects associated with antidepressant treatments in patients with major depressive disorder: A systematic review and meta-analysis. Prog Neuropsychopharmacol Biol Psychiatry. 2021 Jul 13;109:110266. doi: 10.1016/j.pnpbp.2021.110266. Epub 2021 Feb 5. PMID: 33549697. https://pubmed.ncbi.nlm.nih.gov/33549697/