Does duloxetine cause constipation? (+5 factors)
By
Ivan Kahwa
Author bio
Mr Ivan Kahwa is a chemist and phytopharmaceutical scientist with expertise in chemistry, pharmacology, phytochemistry, and Nanobiotechnology. He writes and reviews content on these topics.
Mr Ivan Kahwa’s Highlights:
Guest Researcher at the University of Leipzig, Senior Research Fellow/Scientist, and Lecturer at the Department of Pharmacy, Faculty of Medicine, Mbarara University of Science and Technology.
Professional Experience:
Mr Ivan joined PHARMBIOTRAC as a research fellow/scientist during his master of science tenure. He contributed to the development of most of the phytopharmaceutical products in the project. Furthermore, he participated in carrying out the pharmacological activities of the developed products in laboratory animals such as mice and rats in order to develop proper doses hence leading to pre-clinical studies.
With the above relevant research experience, Ivan started to work with the University of Leipzig on collaborative projects with Mbarara University to develop the chemistry of Ugandan Medicinal plants and their pharmacological activities. This was coupled with several consultative positions by different German NGOs. Mr. Kahwa is also a supporting in the teaching and learning at the Departments of Pharmacy and Pharmaceutical Sciences, Faculty of Medicine, Mbarara University of Science and Technology.
With the increase in antimicrobial resistance globally, Ivan retooled his thinking towards developing new naturally derived antibiotic regimens from Ugandan propolis with the assistance of nanotechnology to improve their delivery to microbial cells. Kahwa has also published over 28 articles in peer-reviewed journals and he is currently reviewing for many journals.
Education:
2023-2027: PhD in Pharmaceutical Sciences (ongoing) with a focus on Pharmaceutical Microbiology and Nanobiology at Mbarara University of Science and Technology.
2022: 2Msc. in Pharmacognosy and Natural Medicine Science at Mbarara University of Science and Technology.
2018: Bachelor of Science (Chemistry) at Mbarara University of Science and Technology.
Publications:
▪ Iqbal, S., Jabeen, F., Kahwa, I., & Omara, T. 2023. Suberosin Alleviates Thiazolidinedione-Induced Cardiomyopathy in Diabetic Rats by Inhibiting Ferroptosis via Modulation of ACSL4-LPCAT3 and PI3K-AKT Signaling Pathways. Cardiovascular Toxicology. https://doi.org/10.1007/s12012-023-09804-7
▪ Gupta, A. K., Yadav, R., Sharma, S., Sawale, J., & Kahwa, I. 2023. Anti-ageing Activity and Antioxidant Activity of Methanol Extracts of Leaves and Flowers of Salvia officinalis and Rosmarinus officinalis. Journal of Young Pharmacists, 15(3), 448–455. https://doi.org/10.5530/jyp.2023.15.60
▪ Tolo, C.U., Kahwa, I., Nuwagira, U., Weisheit, A. and Ikiriza, H., 2023. Medicinal plants used in treatment of various diseases in the Rwenzori Region, Western Uganda. Ethnobotany Research and Applications, 25, pp.1-16.
https://ethnobotanyjournal.org/index.php/era/article/view/4683
▪ Kahwa, I., Ajayi, C.O., Yadav, R., Chauhan, N.S., Shah, K., Abdelgadir, A.A., Shegena, E.A., Daniel, S., Omara, T., Asiimwe, J.B. and Ikiriza, H., 2023. Pharmacognostic and phytochemical studies as an invaluable approach for correct identification of medicinal plants: The case of Artemisia vulgaris L. substituted for Artemisia annua L. in Western Uganda. TMR Integr Med, 7, p.e23004.
https://doi.org/10.53388/TMRIM202307004
▪ Nalimu, F., Oloro, J., Kahwa, I. and Ogwang, P.E., 2021. Review on the phytochemistry and toxicological profiles of Aloe vera and Aloe ferox. Future Journal of Pharmaceutical Sciences, 7, pp.1-21.
https://doi.org/10.1186/s43094-021-00296-2
▪ Elamin, O.H.S., Ali, M.A., Elgezuli, I.A.A., Bashir, M.A. and Kahwa, I., 2021. Diagnosis of pre-and post-treatment of echinococcus granulosus with counter current immune electrophoresis and bacterial co-agglutination. Journal of Microbiology and Infectious Diseases, 11(02), pp.88-94.
https://doi.org/10.5799/jmid.951600
Published book Chapter
▪ Kahwa, I., Ayesiga, I., Nakalema, S., Alinaiswe, R., Mbabazi, R. and Iqbal, S., 2023. Natural products in the management of onchocerciasis. In Natural Products in Vector-Borne Disease Management (pp. 63-80). Academic Press. Book Chapter.
https://doi.org/10.1016/B978-0-323-91942-5.00012-4
Submitted manuscripts Under Review:
▪ Comparison of the Wound Healing Activity of the Leaf and Leaf Ash Extracts of Vernonia amygdalina in Rats. Journal name: Clinical Phytoscience
▪ Ethnobotanical Survey of Medicinal plants used in the management of cancer in Uganda. Journal name: Journal of Herbal Medicine
▪ Ethnobotanical survey and phytochemical screening of medicinal plants used in treatment of epilepsy by PROMETRA-Uganda Traditional Health Practitioners in Mpigi District, Uganda. Journal name: Journal of Ethnopharmacology
Submitted book chapters under review
1.Book title: Algae as a Natural Solution for Water-Food-Energy Nexus, Section 4: Microalgae and cyanobacteria for food applications, Chapter 4.6: Safety, toxicological and allergenic aspects of using algae for food. Authors: Christine Kyarimpa, Tom Omute, Caroline K. Nakiguli, Alice V. Khanakwa4, Christopher Angiro, Ivan Kahwa, Fortunate Ahumuza, Timothy Omara*. Publisher: Springer Nature Singapore Pte Ltd. 152 Beach Road, #21-01/04 Gateway East, Singapore 189721, Singapore.
2.Book title: Nutraceuticals Inspiring the Contemporary Therapy for Lifestyle Diseases. Chapter: Nutraceutical applications of Seaweeds and their Phytocompounds in Nutrition and Treatment of Diseases. Authors: Ivan Kahwa, Timothy Omara , Innocent Ayesiga , Gael Noel Neh Neba Ambe , Zehbanaz Javidbhai Panwala , Rachel Mbabazi , Shabnoor Iqbal , Christine Kyarimpa , Christine Betty Nagawa , Kamal Shah ,Nagendra Singh Chauhan* Publisher: CRC Press
You can view my works on the following professional sites:
Research Gate: https://www.researchgate.net/profile/Ivan-Kahwa
Google Scholar: https://scholar.google.com/citations?user=tOwrvqoAAAAJ&hl=en
ORCID: https://orcid.org/0000-0002-6440-3437
Linkedin: https://de.linkedin.com/in/ivan-kahwa-865450159
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:
| Individual sensitivity | 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). |
| Concurrent medications | 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. |
| High dosage | 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:
- venlafaxine
- fluvoxamine
- vortioxetine
- sertraline
- fluoxetine
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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References
1.-
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/
2.-
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/
3.-
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/
4.-
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/
5.-
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/
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