Duloxetine

GREEN:

2nd line to amitriptyline for neuropathic pain. (Decision date - January 2020). See neuropathic pain guideline (and NICE CG173). 120mg daily dose not recommended. (Decision date - January 2014).
3rd line for stress urinary incontinence after pelvic floor exercises and surgery have been tried/considered. (Decision date - January 2014).
1st line off-label option for the treatment of chronic primary pain. Antidepressants can help with quality of life, pain, sleep and psychological distress, even in the absence of a diagnosis of depression. Review the efficacy and side-effects after 4-6 weeks. See Management of Non-malignant Chronic Pain in Primary Care for further details. (Decision date - Oct 2021).

GREY: For depression as alternative to venlafaxine for patients with previous history of antidepressant benefit. (Decision date - October 2022).

DO NOT PRESCRIBE (DNP): Not to be prescribed by brand - Cymbalta. (Decision date - August 2019).

Cost effective to prescribe generically.

Derbyshire Medicines Management and Clinical Policies