Do not take this medicine with any of the following medications:

-desvenlafaxine
-levomilnacipran
-linezolid
-MAOIs like Carbex, Eldepryl, Emsam, Marplan, Nardil, and Parnate
-methylene blue (injected into a vein)
-milnacipran
-safinamide
-thioridazine
-venlafaxine
-viloxazine
This medicine may also interact with the following medications:

-alcohol
-amphetamines
-aspirin and aspirin-like medicines
-certain antibiotics like ciprofloxacin and enoxacin
-certain medicines for blood pressure, heart disease, irregular heart beat
-certain medicines for depression, anxiety, or psychotic disturbances
-certain medicines for migraine headache like almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, sumatriptan, zolmitriptan
-certain medicines that treat or prevent blood clots like warfarin, enoxaparin, and dalteparin
-cimetidine
-fentanyl
-lithium
-NSAIDS, medicines for pain and inflammation, like ibuprofen or naproxen
-phentermine
-procarbazine
-rasagiline
-sibutramine
-St. John''s wort
-theophylline
-tramadol
-tryptophan

They need to know if you have any of these conditions:

-bipolar disorder
-glaucoma
-high blood pressure
-kidney disease
-liver disease
-seizures
-suicidal thoughts, plans or attempt; a previous suicide attempt by you or a family member
-take medicines that treat or prevent blood clots
-taken medicines called MAOIs like Carbex, Eldepryl, Marplan, Nardil, and Parnate within 14 days
-trouble passing urine
-an unusual reaction to duloxetine, other medicines, foods, dyes, or preservatives
-pregnant or trying to get pregnant
-breast-feeding

Tell your doctor if your symptoms do not get better or if they get worse. Visit your doctor or healthcare provider for regular checks on your progress. Because it may take several weeks to see the full effects of this medicine, it is important to continue your treatment as prescribed by your doctor.

This medicine may cause serious skin reactions. They can happen weeks to months after starting the medicine. Contact your healthcare provider right away if you notice fevers or flu-like symptoms with a rash. The rash may be red or purple and then turn into blisters or peeling of the skin. Or, you might notice a red rash with swelling of the face, lips, or lymph nodes in your neck or under your arms.

Patients and their families should watch out for new or worsening thoughts of suicide or depression. Also watch out for sudden changes in feelings such as feeling anxious, agitated, panicky, irritable, hostile, aggressive, impulsive, severely restless, overly excited and hyperactive, or not being able to sleep. If this happens, especially at the beginning of treatment or after a change in dose, call your healthcare provider.

You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this medicine affects you. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells. Alcohol may interfere with the effect of this medicine. Avoid alcoholic drinks.

This medicine can cause an increase in blood pressure. This medicine can also cause a sudden drop in your blood pressure, which may make you feel faint and increase the chance of a fall. These effects are most common when you first start the medicine or when the dose is increased, or during use of other medicines that can cause a sudden drop in blood pressure. Check with your doctor for instructions on monitoring your blood pressure while taking this medicine.

Your mouth may get dry. Chewing sugarless gum or sucking hard candy, and drinking plenty of water, may help. Contact your doctor if the problem does not go away or is severe.

Keep out of the reach of children and pets.
Store at room temperature between 15 and 30 degrees C (59 to 86 degrees F). Get rid of any unused medicine after the expiration date.
To get rid of medicines that are no longer needed or have expired:

-Take the medicine to a medicine take-back program. Check with your pharmacy or law enforcement to find a location.
-If you cannot return the medicine, check the label or package insert to see if the medicine should be thrown out in the garbage or flushed down the toilet. If you are not sure, ask your health care provider. If it is safe to put it in the trash, take the medicine out of the container. Mix the medicine with cat litter, dirt, coffee grounds, or other unwanted substance. Seal the mixture in a bag or container. Put it in the trash.