Which of the following is NOT a duloxetine counseling point?

• A. Must be tapered
• B. Increased risk of bleeding when used with anticoagulants and antiplatelet agents
• C. Avoid alcohol
• D. Take with meals

Answer: (D)

Key counseling about duloxetine centers on avoiding withdrawal symptoms, watching for bleeding risks with certain drugs, and limiting alcohol use. Stopping duloxetine should be done by tapering gradually to prevent discontinuation symptoms and potential relapse. There is an increased bleeding risk when duloxetine is used with anticoagulants or antiplatelet agents because serotonin reuptake inhibition in platelets can impair clotting. Alcohol can amplify liver-related toxicity and CNS effects, so avoiding or limiting alcohol is advised.

Taking with meals is not a standard or required counseling point for duloxetine; it can be taken with or without food based on tolerance, so it’s not something you’d routinely emphasize.