Drizalma Sprinkle
Drizalma Sprinkle (duloxetine) is a selective serotonin and norepinephrine reuptake inhibitor (SNRI). It's taken by adults to treat depression and certain types of pain, such as fibromyalgia and nerve pain. It can taken by both adults and children for anxiety. Drizalma Sprinkle (duloxetine) comes as a capsule that's taken by mouth, typically once to twice daily. The capsule can also be opened up and the pellets sprinkled over and eaten with applesauce. Some of the more common side effects of Drizalma Sprinkle (duloxetine) include nausea, dry mouth, and headache. Drizalma Sprinkle (duloxetine) is only available as a brand-name medication.
What is Drizalma Sprinkle (duloxetine)?
What is Drizalma Sprinkle (duloxetine) used for?
- Depression (adults)
- Anxiety (adults and children age 7 years or older)
- Nerve pain caused by diabetes (adults)
- Fibromyalgia (adults)
- Long-term pain in muscles, bones, and joints (adults)
How Drizalma Sprinkle (duloxetine) works
Drizalma Sprinkle (duloxetine) is a selective serotonin and norepinephrine reuptake inhibitor (SNRI). The exact way it works to ease pain and improve mood isn't well-understood. But Drizalma Sprinkle (duloxetine) is thought to help regulate mood, behavior, and pain by raising the levels of serotonin and norepinephrine in the brain.
Drug facts
Side effects of Drizalma Sprinkle (duloxetine)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Nausea (18-23%)
- Headache (14-18%)
- Weight loss (14% in children)
- Dry mouth (6-14%)
- Stomach pain (5-13%)
- Sleepiness (9-11%)
- Tiredness (7-11%)
- Lower appetite (6-10%)
- Constipation (9% in adults)
- Dizziness (8-9%)
- Hard to sleep (7-10%)
- Diarrhea (6-9%)
- Vomiting (3-9%)
- Excessive sweating (6% in adults)
Less Common Side Effects
- Blurred vision
- Agitation
- Tremor
- Anxiety
- Erectile dysfunction
- Low sex drive
- Upper respiratory tract infections
- Muscle pain
- Flushing
- Throat pain
- Cough
Drizalma Sprinkle (duloxetine) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Suicidal thoughts and behavior
- Liver failure: itchy skin, feeling bloated, nausea, right upper stomach pain, dark urine, yellow skin or eyes, feeling tired, feeling confused, not wanting to eat
- Serotonin syndrome: agitation, hallucinations, confusion, coma, fast heart rate, sudden changes in blood pressure, dizziness, sweating, blushing, high body temperature, tremor, stiffness, muscle jerks, or seizures
- Severe skin reactions: skin blisters, peeling rash, sores in the mouth, or hives
- Withdrawal symptoms: nausea, diarrhea, sweating, anxiety, agitation, dizziness, confusion, headache, trouble sleeping, and seizures
- Severe bleeding or bruising: bruising that doesn't improve, black-colored stools, pink or red-colored urine, coughing up or vomiting blood, unusual bleeding from the nose or gums
- Low sodium levels: headaches, trouble concentrating, memory problems, weakness, confusion, hallucinations
- Seizures
The following Drizalma Sprinkle (duloxetine) side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Incidence not known
Abdominal or stomach pain
area rash
blindness
blistering, peeling, or loosening of the skin
blurred vision
change in consciousness
chills
clay-colored stools
cold sweats
confusion
convulsions
dark urine
decreased urine output
decreased vision
difficulty with swallowing
dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
fainting
fast or irregular heartbeat
general tiredness or weakness
hives or welts, itching, or skin rash
hives, itching, puffiness, or swelling of the eyelids or around the eyes, face, lips, or tongue
increased thirst
joint or muscle pain
large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
light-colored stools
loss of consciousness
red skin lesions, often with a purple center
red, irritated eyes
redness of the skin
sores, ulcers, or white spots in the mouth or on the lips
swelling of the face, ankles, or hands
tearing
tightness in the chest
unpleasant breath odor
upper right stomach pain
vomiting of blood
yellow eyes and skin
Get emergency help immediately if any of the following symptoms of overdose occur:
Symptoms of overdose
Agitation
loss of bladder control
muscle spasm or jerking of all extremities
overactive reflexes
poor coordination
restlessness
shivering
sleepiness or unusual drowsiness
sudden loss of consciousness
sweating
talking or acting with excitement you cannot control
trembling or shaking
twitching
unusual tiredness or weakness
vomiting
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Body aches or pain
difficulty having a bowel movement (stool)
ear congestion
headache
lack or loss of strength
loss of appetite
loss of voice
muscle aches
sleepiness or unusual drowsiness
stuffy or runny nose
sweating increased
trouble sleeping
Less common
Abnormal orgasm
acid or sour stomach
belching
burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
change in taste
change or problem with discharge of semen
decreased interest in sexual intercourse
difficulty with moving
feeling of warmth or redness of the face, neck, arms, and occasionally, upper chest
inability to have or keep an erection
indigestion
longer than usual time to ejaculation of semen
loose stools
loss in sexual ability, desire, drive, or performance
loss of taste
muscle cramps, pains, or stiffness
shakiness in the legs, arms, hands, or feet
stomach discomfort or upset
sudden sweating
swollen joints
trembling or shaking of the hands or feet
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of Drizalma Sprinkle (duloxetine)
Pros
- Capsules can be opened and its contents sprinkled onto applesauce, so good for people who have a hard time swallowing pills
- Can be taken once or twice daily
- Can be taken with or without food
- Can help with several different conditions, so good for people who have multiple symptoms
Cons
- Only available as a brand-name medication
- Not recommended for people with serious liver or kidney problems or certain types of glaucoma
- Risk of suicidal thoughts and behavior for children and young adults
- Can't use Drizalma Sprinkle (duloxetine) within 14 days of also taking a MAOI medication because of risk for serotonin syndrome
Pharmacist tips for Drizalma Sprinkle (duloxetine)
- Don't crush or chew Drizalma Sprinkle (duloxetine) capsules because doing so will damage the pellets inside and affect how the medication works. Swallow the capsule whole.
- If you can't swallow Drizalma Sprinkle (duloxetine) whole, you can open the capsule and sprinkle the pellets inside over applesauce. You can also mix the pellets with water and give the mixture through a nasogastric tube (NG).
- To take Drizalma Sprinkle (duloxetine) with applesauce, open the capsule and sprinkle the pellets onto a small amount of applesauce (about one tablespoonful). It's important to take this mixture right away. Don't try to save it for later because having the pellets sit too long on top of food might affect how they work in your body.
- To take Drizalma Sprinkle (duloxetine) through a nasogastric tube (NG), open the capsule and add the pellets to an all plastic catheter tip syringe. Then, add 50 mL of water and gently shake the syringe for about 10 seconds. Give the mixture through a 12 French or larger NG tube. If there are still pellets left in the syringe, add a little extra water (about 15 mL) to rinse out the syringe.
- Let your healthcare team know if you notice any unusual or sudden changes in your mood, behavior, or thoughts. This can be a sign of a rare, but serious side effect of Drizalma Sprinkle (duloxetine) that can lead to suicidal thoughts or behaviors, especially in children and young adults.
- Drizalma Sprinkle (duloxetine) might cause dizziness or sleepiness, so don't drive or do anything that needs a lot of focus and attention until you know how this medication affects you.
- Let your prescriber know if you have a hard time urinating or emptying your bladder because it might be caused by Drizalma Sprinkle (duloxetine).
- Don't drink alcohol while taking Drizalma Sprinkle (duloxetine). This medication can cause side effects such as sleepiness and liver damage. Drinking alcohol at the same time can worsen these side effects and raise your risk for falls or liver failure. If you drink alcohol regularly or have liver problems, let your prescriber know.
- Drizalma Sprinkle (duloxetine) can cause sexual side effects, including problems with ejaculation and low sexual desire. Let your healthcare team know if you experience these side effects and they can talk with you about your options, such as lower the dose of Drizalma Sprinkle (duloxetine) or considering other medications.
- Your healthcare team might ask you to check your blood pressure regularly while you're taking Drizalma Sprinkle (duloxetine). Some people have noticed their blood pressure rising after starting this medication. If your blood pressure becomes too high, your care team might lower your dose of Drizalma Sprinkle (duloxetine) or ask you to consider other options.
- If you have diabetes, make sure to check your blood sugar regularly while taking Drizalma Sprinkle (duloxetine). Some people have reported higher blood sugar levels after starting Drizalma Sprinkle (duloxetine).
- Stopping Drizalma Sprinkle (duloxetine) too suddenly can cause withdrawal symptoms such as nausea, agitation, and dizziness. If you want to stop Drizalma Sprinkle (duloxetine), speak to your prescriber about how to do so safely by lowering your dosage slowly over time.
Common questions about Drizalma Sprinkle (duloxetine)
Continue to take Drizalma Sprinkle (duloxetine) as prescribed by your healthcare team. Current guidelines for nerve pain related to diabetes doesn't recommend a set duration of treatment. Your healthcare team will typically ask you to take this medication as long as it's working well to treat your nerve pain and you're not experiencing any serious side effects. Keep in mind that when you first start Drizalma Sprinkle (duloxetine), it can take up to 3 months before you experience more noticeable relief from nerve pain. So your healthcare team might ask to you to try Drizalma Sprinkle (duloxetine) for 3 months to understand whether this medication works well for you.
Both Drizalma Sprinkle (duloxetine) and duloxetine (Cymbalta) are delayed-release forms of duloxetine that are approved to treat the same medical conditions. The main difference is how they're taken. While both Drizalma Sprinkle (duloxetine) and duloxetine (Cymbalta) capsules can be swallowed whole, only Drizalma Sprinkle (duloxetine) capsules can be opened up and the pellets sprinkled over foods like applesauce. So Drizalma Sprinkle (duloxetine) might be a better option for people who have a hard time swallowing a regular pill. Talk with your healthcare team if you have more questions about either of these medications.
Drizalma Sprinkle (duloxetine) is typically taken by mouth once or twice daily, which will depend on your prescriber's instructions. If you take this medication once daily, you can take it either in the morning or at night, but you're recommended to take it around the same time each day. If you take Drizalma Sprinkle (duloxetine) in the morning and it makes you very drowsy, ask your prescriber about taking it in the evening instead.
Only take Drizalma Sprinkle (duloxetine) with gabapentin (Neurontin) if both medications are prescribed by your healthcare team. Also, ask your care team to go over the possible risks of taking both medications together. While Drizalma Sprinkle (duloxetine) and gabapentin (Neurontin) aren't known to have serious interactions, these medications can cause similar side effects, including dizziness, dry mouth, and sexual problems. Ask your healthcare team if you have specific questions about Drizalma Sprinkle (duloxetine) and gabapentin (Neurontin).
Acetaminophen (Tylenol) and Drizalma Sprinkle (duloxetine) aren't known to have serious medication interactions. But this combination might not be safe to take for certain people. For example, both medications have a risk of causing or worsening liver problems. If you're not sure whether it's appropriate for you to take acetaminophen (Tylenol) with Drizalma Sprinkle (duloxetine), talk with your healthcare team.
Ask your healthcare team if you can take ibuprofen (Advil) with Drizalma Sprinkle (duloxetine). Taking these medications together can raise your risk of bleeding and bruising. But your prescriber might suggest this combination as an option if they think the benefit is greater than the risk for harm. If you're taking ibuprofen (Advil) with Drizalma Sprinkle (duloxetine), tell your care team right away if you notice bruises that won't go away or bleeding that's difficult to stop.
No, Drizalma Sprinkle (duloxetine) isn't a monoamine oxidase inhibitor (MAOI); it's a selective serotonin and norepinephrine reuptake inhibitor (SNRI). While Drizalma Sprinkle (duloxetine) isn't a MAOI, it can interact with MAOI medications. Never take Drizalma Sprinkle (duloxetine) with MAOI medications at the same time, or within 2 weeks of each other. you must wait 14 days before starting Drizalma Sprinkle (duloxetine). Taking them too close together can lead to a dangerous side effect called serotonin syndrome.
Yes, selective serotonin and norepinephrine reuptake inhibitors (SNRI) like Drizalma Sprinkle (duloxetine) are first-choice medications for depression. Drizalma Sprinkle (duloxetine) has other uses too, like treating anxiety, nerve pain, and fibromyalgia. Speak with your HCP to see if Drizalma Sprinkle (duloxetine) is right for you.
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Risks and warnings for Drizalma Sprinkle (duloxetine)
Drizalma Sprinkle (duloxetine) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Suicidal thoughts and behaviors
- Risk factors: People ages 24 years and younger
Medications for depression, including Drizalma Sprinkle (duloxetine), can raise the risk of suicidal thoughts and behavior in children and young adults. Make sure your family members or loved ones are aware of this risk so they can let you know if they notice any changes in your mood, especially during your first few months of treatment or when the dose changes. Let your prescriber know if your depression gets worse or if you experience new or worsening suicidal thoughts because you might need to change to a different medication
Blood pressure changes and risk of falls
- Risk factors: Taking other medications that lower blood pressure or affect balance | Taking more than 60 mg per day of Drizalma Sprinkle (duloxetine) | Older adults
Drizalma Sprinkle (duloxetine) can suddenly lower your blood pressure, especially when you change from a lying or sitting position to a standing position. This can put you at risk for falling and fainting. Your risk might be higher when you first start Drizalma Sprinkle (duloxetine) or when there's a dosage change. Let your prescriber if you feel dizzy or faint while taking this medication because you might need a lower dose or change to a different medication.
Bleeding risk
- Risk factors: Taking aspirin, NSAIDs, warfarin, or other blood thinners | Taking other medications that affect serotonin
Drizalma Sprinkle (duloxetine) can raise the risk of bleeding, especially if you take it with other medications that can cause bleeding, such as non-steroidal anti-inflammatory drugs (NSAIDs) and warfarin (Coumadin). Let your prescriber know your full medication history before starting Drizalma Sprinkle (duloxetine) to see if this medication is safe for you. Get medical help right away if you notice bruises that won't go away, bleeding that's difficult to stop, blood in your urine, or dark-colored stool.
Serious liver problems
- Risk factors: Liver problems | Drinking alcohol Rarely, Drizalma Sprinkle (duloxetine) can cause liver failure, which can be life-threatening. If you experience signs of liver problems, you might need to stop this medication. Let your prescriber know right away if you experience fever, tiredness, loss of appetite, nausea, vomiting, stomach pain, dark urine, or yellowing of the skin or eyes. They might ask you to stop taking Drizalma Sprinkle (duloxetine) and talk with you about other options.
Serotonin syndrome
- Risk factors: Taking medications that raise serotonin levels | Taking medications that prevent the breakdown of serotonin
Drizalma Sprinkle (duloxetine) can cause a life-threatening condition called serotonin syndrome, where too much serotonin builds up in your body. The risk is higher when you take other medications that also raise serotonin levels. Get emergency medical help if you experience symptoms of serotonin syndrome, like agitation, sweating, muscle spasms.
Severe skin reactions
In some rare cases, Drizalma Sprinkle (duloxetine) can cause potentially life-threatening skin reactions, called Stevens-Johnson Syndrome. Stop taking Drizalma Sprinkle (duloxetine) and let your care team know right away if you get any blisters, peeling rash, painful skin ulcers, or other skin reactions.
Withdrawal
- Risk factors: Stopping Drizalma Sprinkle (duloxetine) suddenly
Stopping Drizalma Sprinkle (duloxetine) too suddenly can cause withdrawal symptoms such as nausea, diarrhea, sweating, anxiety, agitation, and dizziness. If you want to stop Drizalma Sprinkle (duloxetine), speak to your prescriber about how to do so safely by lowering your dosage slowly over time.
Low sodium levels
- Risk factors: Older adults | Taking water pills | Not enough fluids
Drizalma Sprinkle (duloxetine) can cause very low sodium levels in your blood. Your risk is higher if you've lost a lot of fluids from your body from things such as taking water pills or not drinking enough water. Let your prescriber know if you have symptoms of low sodium levels, such as headache, difficulty concentrating, memory problems, confusion, weakness, or unsteadiness.
Sexual problems
Some adults who took Drizalma Sprinkle (duloxetine) experienced sexual problems, such as erectile dysfunction and low sex drive. Contact your HCP if you notice any bothersome sexual problems while you're taking Drizalma Sprinkle (duloxetine).
Mania
- Risk factors: Personal or family history of bipolar disorder
Let your healthcare team know if you or someone in your family have bipolar disorder because Drizalma Sprinkle (duloxetine) might not be appropriate for you. Treating someone with bipolar disorder with an antidepressant alone can cause a manic episode (great excitement, euphoria, delusions, and overactivity). Talk to your prescriber right away if you notice unusual changes in your behavior after you take Drizalma Sprinkle (duloxetine). This medication isn't approved for treating bipolar depression.
Drizalma Sprinkle (duloxetine) dosage
Capsule| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 20mg | 30 capsules | $221.11 | $7.37 |
| 30mg | 30 capsules | $221.11 | $7.37 |
| 40mg | 30 capsules | $221.11 | $7.37 |
| 60mg | 30 capsules | $221.11 | $7.37 |
Typical dosage for Drizalma Sprinkle (duloxetine)
- Depression: The typical starting dose is 30 mg by mouth once a day, 20 mg twice daily, or 30 mg twice daily. The usual dose is 60 mg by mouth daily.
- Anxiety: The typical starting dose and dosing range is 30 mg to 60 mg by mouth once daily.
- Diabetic neuropathy: The typical dose is 60 mg by mouth once daily.
- Fibromyalgia and long-term pain in muscles, bones, and joints: The typical starting dose is 30 mg by mouth once daily. The maximum dose is 60 mg by mouth daily.
Interactions between Drizalma Sprinkle (duloxetine) and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Bromopride
- Eliglustat
- Furazolidone
- Iproniazid
- Isocarboxazid
- Linezolid
- Methylene Blue
- Metoclopramide
- Moclobemide
- Nialamide
- Phenelzine
- Procarbazine
- Rasagiline
- Safinamide
- Selegiline
- Thioridazine
- Tranylcypromine
- Viloxazine
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Abciximab
- Aceclofenac
- Acemetacin
- Alfentanil
- Almotriptan
- Amphetamine
- Amtolmetin Guacil
- Anagrelide
- Anileridine
- Apixaban
- Asenapine
- Aspirin
- Benzhydrocodone
- Benzphetamine
- Brexpiprazole
- Bromfenac
- Brompheniramine
- Bufexamac
- Buprenorphine
- Bupropion
- Buspirone
- Butorphanol
- Capmatinib
- Carbamazepine
- Celecoxib
- Chlorpheniramine
- Choline Salicylate
- Cifenline
- Cilostazol
- Cimetidine
- Ciprofloxacin
- Citalopram
- Clonixin
- Clopidogrel
- Clozapine
- Cocaine
- Codeine
- Cyclobenzaprine
- Darunavir
- Deferasirox
- Desvenlafaxine
- Dexibuprofen
- Dexketoprofen
- Dextroamphetamine
- Dextromethorphan
- Diclofenac
- Difenoxin
- Diflunisal
- Dihydrocodeine
- Diphenoxylate
- Dipyridamole
- Dipyrone
- Dolasetron
- Donepezil
- Doxorubicin
- Doxorubicin Hydrochloride Liposome
- Droxicam
- Edoxaban
- Eletriptan
- Encainide
- Enoxacin
- Epoprostenol
- Eptifibatide
- Escitalopram
- Ethylmorphine
- Etodolac
- Etofenamate
- Etoricoxib
- Felbinac
- Fenfluramine
- Fenoprofen
- Fentanyl
- Fepradinol
- Feprazone
- Flecainide
- Floctafenine
- Flufenamic Acid
- Fluoxetine
- Flurbiprofen
- Fluvoxamine
- Frovatriptan
- Givosiran
- Granisetron
- Hydrocodone
- Hydromorphone
- Hydroxytryptophan
- Ibuprofen
- Iloprost
- Indecainide
- Indomethacin
- Iobenguane I 123
- Iobenguane I 131
- Ketobemidone
- Ketoprofen
- Ketorolac
- Lamifiban
- Lasmiditan
- Levomilnacipran
- Levorphanol
- Lexipafant
- Lisdexamfetamine
- Lithium
- Lorcainide
- Lorcaserin
- Lornoxicam
- Loxoprofen
- Lumiracoxib
- Meclofenamate
- Mefenamic Acid
- Meloxicam
- Meperidine
- Metaxalone
- Methadone
- Methamphetamine
- Milnacipran
- Mirtazapine
- Morniflumate
- Morphine
- Morphine Sulfate Liposome
- Nabumetone
- Nalbuphine
- Naproxen
- Naratriptan
- Nebivolol
- Nefazodone
- Nepafenac
- Nicomorphine
- Niflumic Acid
- Nimesulide
- Nimesulide Beta Cyclodextrin
- Ondansetron
- Opium
- Opium Alkaloids
- Oxaprozin
- Oxycodone
- Oxymorphone
- Oxyphenbutazone
- Ozanimod
- Palonosetron
- Papaveretum
- Parecoxib
- Paregoric
- Paroxetine
- Pentazocine
- Phenylbutazone
- Piketoprofen
- Piritramide
- Piroxicam
- Pixantrone
- Pranoprofen
- Proglumetacin
- Propafenone
- Propyphenazone
- Proquazone
- Recainam
- Remifentanil
- Rivaroxaban
- Rizatriptan
- Rofecoxib
- Salicylic Acid
- Salsalate
- Sertraline
- Sibrafiban
- Sibutramine
- Sodium Salicylate
- St John's Wort
- Sufentanil
- Sulfinpyrazone
- Sulindac
- Sulodexide
- Sumatriptan
- Tapentadol
- Tenoxicam
- Tianeptine
- Tiaprofenic Acid
- Ticlopidine
- Tilidine
- Tirofiban
- Tolfenamic Acid
- Tolmetin
- Tramadol
- Trazodone
- Tryptophan
- Valdecoxib
- Venlafaxine
- Vilazodone
- Vortioxetine
- Xemilofiban
- Ziprasidone
- Zolmitriptan
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Acenocoumarol
- Phenprocoumon
- Warfarin
How much does Drizalma Sprinkle (duloxetine) cost?
$221.11
Drizalma Sprinkle (duloxetine) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Drizalma Sprinkle (duloxetine) will not be safe for you to take.
- Taking monoamine oxidase inhibitors (MAOIs) together with Drizalma Sprinkle (duloxetine) or within 5 days of stopping Drizalma Sprinkle (duloxetine)
- Taking Drizalma Sprinkle (duloxetine) within 14 days of stopping an MAOI
- Taking linezolid or intravenous methylene blue
What are alternatives to Drizalma Sprinkle (duloxetine)?
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