Duloxetine
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Hypertensive urgency: case report A 62-year-old woman developed hypertensive urgency during treatment with duloxetine for diabetic neuropathy [route not stated]. The woman, who had a history of renal calculus, type 2 diabetes mellites and hypertension, presented to the hospital with the complaints of burning pain and numbness on both the legs and feet, in June 2019. She had been receiving antidiabetic treatment with insulin glargine and gliclazide for diabetes, amlodipine for hypertension, rosuvastatin for hyperlipidaemia and aspirin for cardiovascular diseases management. Her blood pressure was under control. She was diagnosed with painful diabetic neuropathy and started receiving duloxetine 30mg twice daily for 1.5 months. Two days later, she presented to the emergency department with the complaints of severe headache, anxiety and nausea. She did not mention any history related to shortness of breath, palpitations, chest pain and abdominal or urinary complications. On examination, she was afebrile, conscious and oriented. Her pulse rate was 105 beats per min, blood pressure was found 210/120 mmHg in the supine position and oxygen saturation of 93% on 2 L/min of oxygen flow. Based on the examination, she was suspected as hypertensive urgency secondary to duloxetine. Immediately she transferred to the ICU for blood pressure management. Duloxetine‑induced hypertensive urgency was confirmed. Duloxetine was discontinued. She started treatment with labetalol. After that, her blood pressure reduced to 170/110 mmHg, and after the repeated doses it further dropped to 154/88 mmHg, and her headache was resolved. A clinical and symptomatical improvement was noted. She discharged on the next day, with telmisartan and metoprolol to control her blood pressure and pantoprazole and domperidone for acid reflux. The reaction was reported to the World Health Organization Uppsala Monitoring Centre (WHO‑UMC). Shukla R, et al. Duloxetine-induced hypertensive urgency in type 2 diabetes mellitus with diabetic neuropathy. Indian Journal of Pharmacology 52: 213-215, No. 3, May-Jun 803517245 2020. Available from: URL: http://doi.org/10.4103/ijp.IJP_370_19
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Reactions 28 Nov 2020 No. 1832
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