From the FDA Drug Label
Duloxetine delayed-release capsules are in a class of drugs known to affect urethral resistance. If symptoms of urinary hesitation develop during treatment with duloxetine delayed-release capsules, consideration should be given to the possibility that they might be drug-related. In post marketing experience, cases of urinary retention have been observed In some instances of urinary retention associated with duloxetine delayed-release capsules use, hospitalization and/or catheterization has been needed. Urinary Hesitation and Retention — Duloxetine delayed-release capsules are in a class of medicines that may affect urination. Instruct patients to consult with their healthcare provider if they develop any problems with urine flow [see WARNINGS AND PRECAUTIONS (5. 15)] .
Yes, duloxetine can cause urinary retention.
- The drug label warns that duloxetine delayed-release capsules may affect urethral resistance, leading to symptoms of urinary hesitation and retention.
- Cases of urinary retention have been observed in post-marketing experience, with some instances requiring hospitalization and/or catheterization 1, 1.
From the Research
Duloxetine is unlikely to cause urinary retention, with no cases of objective acute urinary retention reported in clinical studies. The risk of urinary retention associated with duloxetine therapy is low, as evidenced by a study published in 2004 2, which found that only 0.4% of patients treated with duloxetine reported subjective urinary retention, compared to none in the placebo group. Another study published in 2016 3 found that duloxetine was not associated with urinary retention in any of the 1,139 patients treated with the medication.
The mechanism of action of duloxetine, which inhibits serotonin and norepinephrine reuptake, can affect bladder and urethral function by altering autonomic nervous system activity. However, the overall risk of urinary retention is low, and patients with pre-existing bladder outlet obstruction, prostatic hyperplasia, or those taking other medications with anticholinergic properties may be at increased risk.
Some key points to consider when prescribing duloxetine include:
- Monitoring patients for symptoms of urinary retention, especially during the initial weeks of treatment or after dose increases
- Obtaining a thorough urological history before prescribing duloxetine
- Considering alternative treatments for patients with significant risk factors for urinary retention
- Being aware of the potential for duloxetine to cause other adverse effects, such as nausea and cognitive impairment, as reported in a study published in 2024 4
It is essential to weigh the benefits and risks of duloxetine therapy and to closely monitor patients for any adverse effects, particularly in older adults with pre-existing cardiovascular conditions. Overall, the available evidence suggests that duloxetine is a safe and effective treatment option for patients with depression, anxiety, and other conditions, with a low risk of urinary retention.