Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Riva Duloxetine.
Bleeding: Riva Duloxetine may increase the risk of bleeding, especially if you are also taking medications such as acetylsalicylic acid (Asa), nonsteroidal anti-inflammatory drugs (NSAIDs; e.g., Ibuprofen, Naproxen, Ketoprofen), or Warfarin. If you experience easy bruising, pinpoint-sized red spots on the skin, or unusual bleeding while taking Riva Duloxetine, contact your doctor immediately.
Blood pressure and heart rate: Duloxetine may cause an increase in blood pressure or heart rate. Your doctor will monitor your blood pressure and heart rate before starting Riva Duloxetine and periodically while you are taking Riva Duloxetine. If you have high blood pressure or other types of heart disease, discuss with your doctor how Riva Duloxetine may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Riva Duloxetine, and whether any special monitoring is needed.
Bone fractures: Duloxetine may increase your risk of breaking a bone, especially if you are a senior, have Osteoporosis, or have other risk factors for bone fractures. Take extra care to avoid falling by sitting or lying down if you feel dizzy or lightheaded. Contact your doctor if you experience dizziness or lightheadedness frequently.
Diabetes: Riva Duloxetine may worsen blood sugar control in some people who have diabetes. If you have diabetes, monitor your blood sugar closely and report any changes to your doctor.
If you are at risk for developing diabetes, discuss with your doctor how Riva Duloxetine may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Riva Duloxetine, and whether any special monitoring is needed.
Drowsiness/reduced alertness: Riva Duloxetine may affect judgment, thinking, or physical abilities and may cause drowsiness or dizziness. Avoid driving, operating machinery, or performing other hazardous tasks until you have determined how Riva Duloxetine affects you.
Glaucoma: Riva Duloxetine may cause the symptoms of glaucoma (increased pressure in the eye) to become worse. If you have controlled narrow-angle glaucoma, discuss with your doctor how Riva Duloxetine may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Riva Duloxetine, and whether any special monitoring is needed. Report any changes in vision to your doctor as soon as possible while you are taking Riva Duloxetine.
Kidney function: Duloxetine is not recommended for people with severe kidney problems. If you have kidney problems, discuss with your doctor how Riva Duloxetine may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Riva Duloxetine, and whether any special monitoring is needed.
Liver function: Decreased liver function or liver disease can cause Riva Duloxetine to build up in the body, causing side effects. If you have liver problems or consume substantial amounts of alcohol, discuss with your doctor how Riva Duloxetine may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Riva Duloxetine, and whether any special monitoring is needed. Riva Duloxetine may also cause liver problems. If you experience nausea, abdominal pain, or yellowing of the skin or eyes while taking Riva Duloxetine, contact your doctor immediately.
Seizures: If you have a seizure disorder, discuss with your doctor how Riva Duloxetine may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Riva Duloxetine, and whether any special monitoring is needed.
Serotonin syndrome/neuroleptic malignant syndrome: Severe reactions are possible when duloxetine is combined with other medications that act on serotonin, such as tricyclic antidepressants and certain migraine medications. These combinations must be avoided. Symptoms of a reaction may include muscle rigidity and spasms, difficulty moving, and changes in mental state including delirium and agitation. Coma and death are possible.
If you are taking antidepressants, discuss with your doctor how Riva Duloxetine may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Riva Duloxetine, and whether any special monitoring is needed.
Slowed stomach emptying: If you have a condition that slows emptying from the stomach (e.g., diabetes), discuss with your doctor how Riva Duloxetine may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Riva Duloxetine, and whether any special monitoring is needed.
Stopping the medication: Stopping Riva Duloxetine suddenly may lead to side effects such as dizziness, abnormal dreams, difficulty sleeping, numbness or tingling sensations, irritability, anxiety, nausea, vomiting, diarrhea, sweating, muscle pain, or other symptoms. Stopping Riva Duloxetine gradually as directed by your doctor can minimize these effects. If you are thinking of stopping the medication, check with your doctor first.
Sucrose: Riva Duloxetine contains sucrose. If you have a rare hereditary problem of fructose intolerance, glucose-galactose malabsorption, or sucrose metabolism, you should not take Riva Duloxetine.
Suicidal or agitated behaviour: People taking Riva Duloxetine may feel agitated (restless, anxious, aggressive, emotional, and feeling not like themselves), or they may want to hurt themselves or others. If you experience these side effects or notice them in a family member who is taking Riva Duloxetine, contact your doctor immediately. Your doctor will monitor you closely for these side effects while you are taking Riva Duloxetine.
Urinary tract symptoms: Some people who take Riva Duloxetine experience difficulty starting urine flow or emptying the bladder. If you notice these changes, contact your doctor.
Pregnancy: It has been reported that babies born to women who took medications similar to duloxetine during the last trimester of their pregnancy may experience adverse effects (such as breathing problems, seizures, trouble feeding, jitteriness, irritability, and constant crying). Women who take duloxetine during pregnancy may be at increased risk of bleeding after childbirth. Riva Duloxetine should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking Riva Duloxetine, contact your doctor immediately.
Breast-feeding: Riva Duloxetine passes into breast milk. If you are a breast-feeding mother and are taking duloxetine, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.
Children and adolescents: The safety and effectiveness of Riva Duloxetine have not been established for children. Children under 18 years old are at an increased risk of suicidal thoughts or behaviour if they take duloxetine.
