Symbiia - Antidepressants Intestinal Soluble Capsules

Duloxetine is a combined serotonin and norepinephrine reuptake inhibitor. It insignificantly inhibits dopamine uptake, has no significant affinity for histamine and dopamine, cholinergic and adrenergic receptors. The mechanism of action of duloxetine in the treatment of depression is due to inhibition of serotonin and norepinephrine reuptake and, as a result, increased serotonergic and noradrenergic neurotransmission in the central nervous system. Duloxetine also has an analgesic effect, which is probably the result of slowing the transmission of pain impulses in the central nervous system.

Major depressive disorder. The initial and recommended maintenance dose is 60 mg 1 time per day, used regardless of food intake. Dosage more than 60 mg 1 time per day to the maximum 120 mg per day were estimated in terms of safety. However, there is no clinical data on the fact that increasing the dose will be effective for patients who do not respond to the initial recommended dose.

The therapeutic response is usually observed after 2-4 weeks of treatment.

After a persistent antidepressant effect, it is recommended to continue treatment for several months to avoid recurrence. In patients who respond to duloxetine and have a history of recurrent episodes of major depression, further long-term treatment at a dose 60-120 mg per day should be considered.

Diabetic peripheral neuropathic pain. The recommended initial dose is 60 mg 1 time per day, used regardless of food intake. Some patients can be prescribed a daily dose above 60 mg up to a maximum dose of 120 mg per day, divided into 2 doses.

The therapeutic treatment effect is manifested within 2 months. In patients with an inadequate initial response, an additional response after this period is unlikely. Therapeutic benefits should be evaluated regularly (at least every 3 months).

Generalized anxiety disorder. The recommended initial dose is 30 mg 1 time per day, used regardless of food intake. In case of insufficient effect of the treatment, the dose should be increased to 60 mg per day. In case of insufficient effect of treatment in a dose of 60 mg it is possible to consider an increase in a dose to 90 or 120 mg per day.

The therapeutic effect of treatment is manifested within 2-4 weeks. Once the response has been established, it is recommended to continue treatment for several months to avoid recurrence.

Patients with renal impairment. No dose adjustment is required for patients with mild to moderate renal impairment (creatinine clearance 30-80 ml/min). Symbiia® is not used to treat patients with terminal stage renal disease (creatinine clearance <30 ml/min).

Patients with hepatic impairment. The medicinal product cannot be prescribed to patients with liver disease or liver failure.

Elderly patients. For elderly patients, it is not recommended to adjust doses based on age. As with any medicinal products, caution should be taken in the treatment of elderly patients, especially when using Symbiia® at a dose of 120 mg per day for major depressive disorder or generalized anxiety disorder.

Treatment cessation. Sudden cessation of treatment should be avoided. The dose must be gradually reduced for a period of at least one to two weeks to reduce the risk of withdrawal reactions. If intolerable symptoms occur after dose reduction or after discontinuation of treatment, the medicinal product can be resumed at the previously set dose. Over time, the doctor may continue to reduce the dose, but more gradually.

Children.

Clinical studies on the use of duloxetine in children (under 18 years of age) have not been performed, so it is not used in pediatric practice.