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Any psychiatrist locked into the biology has absolutely no idea what they re doing. Limited data are available on the effects of duloxetine in patients with end-stage renal disease ESRD. After a single 60 mg dose of duloxetine, Cmax and AUC values were approximately 100% greater in patients with end-stage renal disease receiving chronic intermittent hemodialysis than in subjects with normal renal function. The elimination half-life, however, was similar in both groups. The AUCs of the major circulating metabolites, 4-hydroxy duloxetine glucuronide and 5-hydroxy, 6-methoxy duloxetine sulfate, largely excreted in urine, were approximately 7- to 9-fold higher and would be expected to increase further with multiple dosing. Population PK analyses suggest that mild to moderate degrees of renal dysfunction estimated CrCl 30-80 mL/min have no significant effect on duloxetine apparent clearance see Dosage and Administration 2.3 and Warnings and Precautions 5.13.
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