Safety and tolerability of duloxetine in women with stress urinary incontinence

Background  The serotonin/noradrenaline uptake inhibitor duloxetine has been shown to be effective in the medical treatment of stress urinary incontinence (SUI) in women.
Aim  To review the safety and tolerability of duloxetine with SUI.
Methods  A systematic Medline search for the key word 'duloxetine' was performed, and abstracts from recent international gynaecological and urological meetings were also considered.
Results  Various unpleasant adverse effects exist, among which nausea is the most frequent, but is mild to moderate and transient in most cases. Dose escalation upon initiation of treatment improves the tolerability of duloxetine. The use of duloxetine appears safe as it lacks the cardiovascular adverse effects of older amine reuptake inhibitors.
Conclusions  Duloxetine has an acceptable safety profile. Dose escalation combined with patient counselling on the intensity and transient nature of adverse effects may help to further improve the benefit/tolerability ratio of duloxetine in the treatment of SUI.