Duloxetine

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Also known as DuloxetinaLY-248686LY248686(S)-DuloxetineS-DuloxetineSID26719725SID26757978SID49681583SID124893161DULOXETINE HYDROCHLORIDE

Summary

Duloxetine (CHEMBL1175) is an approved small molecule (ATC N06AX21) targeting HTR6, ZC3H14, and HTR2A; indicated across 37 conditions including osteoarthritis, knee and anxiety.

At a glance

  • Status: Approved (max clinical phase 4)
  • Modality: Small molecule
  • ATC class: N06AX21
  • Targets: 6 (HTR6, ZC3H14, HTR2A…)
  • Indications: 37 conditions
  • Clinical trials: 331
  • Chemistry: 297.4 Da · C18H19NOS

Identifiers

Drug identity and classification

FieldValue
ChEMBL IDCHEMBL1175
NameDuloxetine
TypeSmall molecule
Max phase4
FDA approvedyes
PubChem CID60835
ChEBICHEBI:36795
ATCN06AX21
Molecular formulaC18H19NOS
Molecular weight297.4
InChIKeyZEUITGRIYCTCEM-KRWDZBQOSA-N

SMILES: CNCC[C@@H](C1=CC=CS1)OC2=CC=CC3=CC=CC=C32

IUPAC name: (3S)-N-methyl-3-naphthalen-1-yloxy-3-thiophen-2-ylpropan-1-amine

Also known as: Duloxetina, Duloxetine, LY-248686, LY248686, (S)-Duloxetine, duloxetine, S-Duloxetine, SID26719725, SID26757978, SID49681583, SID124893161, DULOXETINE

Parent form; salt/anhydrous children: CHEMBL1200328

Patent coverage: 7,911 distinct patent families (28,527 SureChEMBL compound mentions), from 2 matched compound structure(s). One matched structure accounts for 28,258 (99%) of the total. Mentions count patents naming the compound (not distinct inventions), so promiscuous / reference molecules inflate the mention figure — families are the dedup metric.

Targets

Targets

Primary targets (GtoPdb curated mechanism): the Cancer dependency column is the DepMap CRISPR fitness signal (% of screened cell lines dependent on the target).

GeneTargetActionpAffinityCancer dependencyUniProt
HTR65-HT6 receptorAntagonist6.40.2%P50406
ZC3H14zinc finger CCCH-type containing 14Binding0%Q6PJT7
HTR2A5-HT2A receptorAntagonist6.30%P28223
HTR2C5-HT2C receptorAntagonist60%P28335
SLC6A2NETInhibition8.220.4%P23975
SLC6A4SERTInhibition8.30.7%P31645

Broader ChEMBL bioactivity targets: 43 (assay-derived). Sample: Histone-lysine N-methyltransferase 2A, 5-hydroxytryptamine receptor 2B, 5-hydroxytryptamine receptor 3A, Alpha-2C adrenergic receptor, Voltage-dependent L-type calcium channel subunit alpha-1C, Alpha-2B adrenergic receptor, A-type voltage-gated potassium channel KCND3, Sodium channel protein type 5 subunit alpha, Voltage-gated L-type calcium channel, P2X purinoceptor 4.

Bioactivity

ChEMBL activities: 107 potent at pChembl ≥ 5 of 127 total. Top 30 by potency (10 = 0.1 nM, 6 = 1 µM):

TargetpChemblTypeValueUnitActivity ID
P3165210.09Ki0.08nMCHEMBL_ACT_13325640
SLC6A49.62Ki0.24nMCHEMBL_ACT_13325672
SLC6A49.5IC500.32nMCHEMBL_ACT_12668699
SLC6A49.3Ki0.5nMCHEMBL_ACT_2714826
SLC6A49.1Ki0.8nMCHEMBL_ACT_652283
SLC6A49.1Ki0.79nMCHEMBL_ACT_662615
SLC6A48.85Ki1.4nMCHEMBL_ACT_655872
SLC6A28.8IC501.58nMCHEMBL_ACT_12668749
SLC6A48.64IC502.3nMCHEMBL_ACT_13325591
SLC6A48.52IC503nMCHEMBL_ACT_2483387
SLC6A48.52AC503nMCHEMBL_ACT_25149883
SLC6A48.52IC503nMCHEMBL_ACT_2522762
SLC6A48.52IC503nMCHEMBL_ACT_3285117
SLC6A28.4IC504nMCHEMBL_ACT_2483369
SLC6A28.4IC504nMCHEMBL_ACT_2522735
SLC6A48.4IC504nMCHEMBL_ACT_2674398
SLC6A28.4IC504nMCHEMBL_ACT_3285116
SLC6A48.34Ki4.6nMCHEMBL_ACT_1617662
P316528.34Ki4.6nMCHEMBL_ACT_2265484
SLC6A28.34Ki4.6nMCHEMBL_ACT_24987129
SLC6A48.3Ki5nMCHEMBL_ACT_2163924
SLC6A28.3IC505nMCHEMBL_ACT_2674440
SLC6A48.3Ki5nMCHEMBL_ACT_3226179
SLC6A48.3Ki5nMCHEMBL_ACT_3309571
SLC6A28.22Ki5.97nMCHEMBL_ACT_12169776
SLC6A48.22IC506nMCHEMBL_ACT_1753742
SLC6A48.22IC506nMCHEMBL_ACT_1755301
SLC6A48.22IC506nMCHEMBL_ACT_2020842
SLC6A48.18IC506.6nMCHEMBL_ACT_2100220
SLC6A48.18IC506.6nMCHEMBL_ACT_2397254

Target pathways

Aggregated over 6 target gene(s): HTR6, ZC3H14, HTR2A, HTR2C, SLC6A2, SLC6A4.

Top Reactome pathways

21 total, by targets touching each:

PathwayTargetsGenes
Signal Transduction3HTR2A, HTR2C, HTR6
Signaling by GPCR3HTR2A, HTR2C, HTR6
Class A/1 (Rhodopsin-like receptors)3HTR2A, HTR2C, HTR6
Amine ligand-binding receptors3HTR2A, HTR2C, HTR6
GPCR downstream signalling3HTR2A, HTR2C, HTR6
Serotonin receptors3HTR2A, HTR2C, HTR6
GPCR ligand binding3HTR2A, HTR2C, HTR6
G alpha (q) signalling events2HTR2A, HTR2C
SLC-mediated transport of neurotransmitters2SLC6A2, SLC6A4
Neurotransmitter clearance1SLC6A4
Transmission across Chemical Synapses1SLC6A4
Neuronal System1SLC6A4
Disease1SLC6A2
Serotonin clearance from the synaptic cleft1SLC6A4
Transport of small molecules1SLC6A2
G alpha (s) signalling events1HTR6
R-HSA-4253661SLC6A2
SLC-mediated transmembrane transport1SLC6A2
SLC transporter disorders1SLC6A2
Defective SLC6A2 causes orthostatic intolerance (OI)1SLC6A2
Disorders of transmembrane transporters1SLC6A2

Dominant GO biological processes

GO termTargets
chemical synaptic transmission4
G protein-coupled receptor signaling pathway, coupled to cyclic nucleotide second messenger3
signal transduction3
G protein-coupled receptor signaling pathway3
G protein-coupled serotonin receptor signaling pathway3
response to xenobiotic stimulus3
intracellular calcium ion homeostasis2
phospholipase C-activating serotonin receptor signaling pathway2
serotonin receptor signaling pathway2
memory2
positive regulation of phosphatidylinositol biosynthetic process2
positive regulation of fat cell differentiation2
behavioral response to cocaine2
release of sequestered calcium ion into cytosol2
positive regulation of ERK1 and ERK2 cascade2

Indications & clinical

Indications

37 indications (0 at ChEMBL trial phase 4). Phase below is the highest clinical-trial phase recorded for this drug against each disease — not the molecule’s overall approval status (that is in the Summary).

IndicationTrial phaseMONDOEFO
osteoarthritis, knee3MONDO:0005416EFO:0004616
anxiety3MONDO:0011918EFO:0005230
fibromyalgia3MONDO:0005546EFO:0005687
biliary dyskinesia3MONDO:0005667EFO:0007169
diabetic neuropathy3MONDO:0006626EFO:1000783
dementia3MONDO:0001627HP:0000726
peripheral neuropathy3MONDO:0005244EFO:0003100
major depressive disorder3MONDO:0002009MONDO:0002009
depressive disorder3MONDO:0002050MONDO:0002050
generalized anxiety disorder3MONDO:0001942EFO:1001892
osteoarthritis3MONDO:0005178MONDO:0005178
Parkinson disease3MONDO:0005180MONDO:0005180
burning mouth syndrome3MONDO:0006687EFO:1000850
diabetes mellitus2MONDO:0005015EFO:0000400
attention deficit-hyperactivity disorder2MONDO:0007743EFO:0003888
myalgic encephalomeyelitis/chronic fatigue syndrome2MONDO:0005404EFO:0004540
neuralgia2MONDO:0021667EFO:0005762
diabetic kidney disease2MONDO:0005016EFO:0000401
interstitial lung disease2MONDO:0015925EFO:0004244
multiple sclerosis2MONDO:0005301MONDO:0005301
alcohol abuse2MONDO:0002046MONDO:0007079
colorectal neoplasm2MONDO:0005335MONDO:0005575
methamphetamine dependence1MONDO:0005419EFO:0004701
stroke disorder0MONDO:0005098EFO:0000712
post-traumatic stress disorder0MONDO:0005146EFO:0001358

12 further indication records had no mapped disease name (EFO/MeSH-only) or were duplicates, and are omitted.

Clinical trials

Total trials: 331.

Phase distribution

PhaseTrials
PHASE499
PHASE396
Not specified66
PHASE242
PHASE114
PHASE2/PHASE37
EARLY_PHASE14
PHASE1/PHASE23

Top trials by phase / activity

NCTPhaseStatusTitle
NCT04245436PHASE4RECRUITINGAcute and Long-Term Antidepressant Treatment Success in Adolescents With Anxiety (AtLAS-A)
NCT04245748PHASE4RECRUITINGDetermining Optimal Treatment Sequences in Anxious Depression (DOTS-AD)
NCT05851898PHASE4RECRUITINGSerotonin-norepinephrine Reuptake Inhibitor in Prophylaxis of Depression Following Fragility Fractures
NCT05851976PHASE4RECRUITINGDuloxetine for LBP
NCT05976347PHASE4RECRUITINGIdentifying and Treating Depression in the Orthopaedic Trauma Population
NCT06232473PHASE4RECRUITINGPatient Education and Duloxetine, Alone and in Combination, for Patients With Multisystem Functional Somatic Disorder
NCT06245109PHASE4RECRUITINGBrain-Based and Clinical Phenotyping of Pain Pharmacotherapy in Knee Osteoarthritis
NCT06423716PHASE4RECRUITINGEffect of peRiopErative duLoxetIne Administration on Opioid Consumption Following Total kneE Arthroplasty (RELIFE)
NCT06807866PHASE4RECRUITINGDuloxetine for Perioperative Pain in Hip Arthroplasty: A RCT
NCT06968624PHASE4NOT_YET_RECRUITINGKetamine for Postherpetic Neuralgia With Depression
NCT00067912PHASE4COMPLETEDDuloxetine vs. Active Comparator for the Treatment of Depression
NCT00071695PHASE4COMPLETEDDuloxetine vs. Active Comparator in the Treatment of Patients With Depression
NCT00177671PHASE4COMPLETEDAntidepressant Medication Plus Donepezil for Treating Late-life Depression
NCT00191061PHASE4COMPLETEDA Comparison of Tolerability and Efficacy of Different Doses of Duloxetine for the Treatment of Major Depressive Disorder
NCT00191932PHASE4COMPLETEDSwitching to Duloxetine From Other Antidepressants
NCT00224302PHASE4COMPLETEDTreatment of MDEs During the Course of Psychotic Disorders With Duloxetine
NCT00244296PHASE4COMPLETEDTo Determine How Effective Duloxetine is in Treating Women 65 Years and Older With Symptoms of Stress Urinary Incontinence, or With a Combination of Stress Urinary Incontinence and Urge Urinary Incontinence Symptoms
NCT00266643PHASE4COMPLETEDTolerability of Switching to Duloxetine for the Management of Diabetic Nerve Pain
NCT00296699PHASE4COMPLETEDA Pilot Study Assessing Duloxetine’s Efficacy in Atypical Depression
NCT00322621PHASE4COMPLETEDMaintenance of Effect of Duloxetine in Patients With Diabetic Peripheral Neuropathic Pain (DPNP)
NCT00360724PHASE4COMPLETEDDuloxetine for Chronic Depression: a Double-blind Study
NCT00385671PHASE4COMPLETEDAn Open-Label Comparison of Duloxetine to Other Alternatives for the Management of Diabetic Peripheral Neuropathic Pain
NCT00398632PHASE4TERMINATEDSwitching to Duloxetine to Ameliorate SSRI-Induced Sexual Dysfunction
NCT00401258PHASE4COMPLETEDAn Open-Label Trial of Duloxetine for the Treatment of Irritable Bowel Syndrome
NCT00406848PHASE4COMPLETEDA Study Comparing the Efficacy and Safety of Duloxetine and Placebo for the Treatment of Depression in Elderly Patients
NCT00422162PHASE4COMPLETEDA Study Evaluating Duloxetine in Patients Hospitalized for Severe Depression
NCT00437125PHASE4COMPLETEDStudy on the Tolerability of Duloxetine in Depressed Patients With Parkinson’s Disease
NCT00438971PHASE4COMPLETEDThe Efficacy and Tolerability of Duloxetine for the Treatment of Panic Disorder
NCT00443352PHASE4COMPLETEDA Research Study Examining The Use Of Duloxetine In The Prevention Of Migraine Headache
NCT00464698PHASE4COMPLETEDDuloxetine for the Treatment of Obsessive Compulsive Disorder (OCD)
NCT00479726PHASE4COMPLETEDLilly’s Emotional and Physical Symptoms of Depression Study (LEAPS)
NCT00494377PHASE4COMPLETEDDuloxetine Versus Duloxetine Plus Non-Drug Therapy for Depression
NCT00517985PHASE4COMPLETEDDuloxetine for Perimenopausal Depression
NCT00531895PHASE4COMPLETEDAn Open Trial of Duloxetine on Comorbid Major Depression and Chronic Headache
NCT00532480PHASE4COMPLETEDStudy of Brain Response to Emotional Pictures Using a fMRI While on Duloxetine
NCT00536471PHASE4COMPLETEDA Study Comparing Duloxetine and Placebo in Assessing Energy and Vitality in Major Depressive Disorder (MDD) Patients
NCT00607789PHASE4COMPLETEDStudy of Duloxetine vs Placebo in Treatment of Binge Eating Disorder With Depression
NCT00609557PHASE4COMPLETEDA Single-Blind Placebo Run-in Study of Duloxetine for Activity-Limiting Osteoarthritis Pain
NCT00619983PHASE4TERMINATEDThree Way Interaction Between Gabapentin, Duloxetine, and Donepezil in Patients With Diabetic Neuropathy
NCT00666757PHASE4COMPLETEDA Study Comparing Duloxetine to Other Antidepressants in the Treatment of Severe Depression

Clinical evidence (CIViC)

No CIViC predictive evidence (expected for non-precision-medicine drugs).

Pharmacology

Pharmacogenomics

PharmGKB dosing guidelines (4) — CPIC / DPWG genotype-guided dosing for this drug (drug × pharmacogene):

GuidelineSourceGene(s)DosingRecommendation
Annotation of DPWG Guideline for duloxetine and CYP2D6DPWGCYP2D6
Annotation of CPIC Guideline for duloxetine and CYP2D6CPICCYP2D6
Annotation of CPIC Guideline for desvenlafaxine, duloxetine, fluoxetinCPICHTR2A
Annotation of CPIC Guideline for citalopram, desvenlafaxine, duloxetinCPICSLC6A4

PharmGKB also curates 73 clinical and 101 variant annotation(s) for this drug (gene-keyed; see PharmGKB).

Molecules sharing ≥1 of this drug’s curated primary targets, merged from two biobtree sources and ranked by shared-target count, then clinical phase: ChEMBL clinical-stage candidates (development phase ≥2) and PubChem drug-class bioactivity (approved / known drugs acting on the target). Deduplicated by drug name; the drug’s own salt forms are excluded. Note: for a drug with few primary targets a shared-target match can reflect off-target / promiscuous binding rather than the same therapeutic mechanism — the phase ordering surfaces bona-fide therapeutics first.

777 molecules share ≥1 primary target. Top 60 by shared-target count:

MoleculeSourceStatusShared targets
AMITRIPTYLINEChEMBL + PubChemPhase 4 (approved)HTR2A, HTR2C, HTR6, SLC6A2, SLC6A4
DIHYDROERGOTAMINEChEMBL + PubChemPhase 4 (approved)HTR2A, HTR2C, HTR6, SLC6A2, SLC6A4
AMIODARONEChEMBLPhase 4 (approved)HTR2A, HTR2C, HTR6, SLC6A2, SLC6A4
AMOXAPINEChEMBLPhase 4 (approved)HTR2A, HTR2C, HTR6, SLC6A2, SLC6A4
ARIPIPRAZOLEChEMBLPhase 4 (approved)HTR2A, HTR2C, HTR6, SLC6A2, SLC6A4
ASENAPINEChEMBLPhase 4 (approved)HTR2A, HTR2C, HTR6, SLC6A2, SLC6A4
ASTEMIZOLEChEMBLPhase 4 (approved)HTR2A, HTR2C, HTR6, SLC6A2, SLC6A4
AZELASTINEChEMBLPhase 4 (approved)HTR2A, HTR2C, HTR6, SLC6A2, SLC6A4
BENZTROPINEChEMBLPhase 4 (approved)HTR2A, HTR2C, HTR6, SLC6A2, SLC6A4
BREXPIPRAZOLEChEMBLPhase 4 (approved)HTR2A, HTR2C, HTR6, SLC6A2, SLC6A4
CARVEDILOLChEMBLPhase 4 (approved)HTR2A, HTR2C, HTR6, SLC6A2, SLC6A4
CHLORPROMAZINEChEMBLPhase 4 (approved)HTR2A, HTR2C, HTR6, SLC6A2, SLC6A4
CINACALCETChEMBLPhase 4 (approved)HTR2A, HTR2C, HTR6, SLC6A2, SLC6A4
CLEMASTINEChEMBLPhase 4 (approved)HTR2A, HTR2C, HTR6, SLC6A2, SLC6A4
CLOMIPRAMINEChEMBLPhase 4 (approved)HTR2A, HTR2C, HTR6, SLC6A2, SLC6A4
CLOTRIMAZOLEChEMBLPhase 4 (approved)HTR2A, HTR2C, HTR6, SLC6A2, SLC6A4
CLOZAPINEChEMBLPhase 4 (approved)HTR2A, HTR2C, HTR6, SLC6A2, SLC6A4
CYPROHEPTADINEChEMBLPhase 4 (approved)HTR2A, HTR2C, HTR6, SLC6A2, SLC6A4
DESLORATADINEChEMBLPhase 4 (approved)HTR2A, HTR2C, HTR6, SLC6A2, SLC6A4
DIETHYLSTILBESTROLChEMBLPhase 4 (approved)HTR2A, HTR2C, HTR6, SLC6A2, SLC6A4
DIPHENHYDRAMINEChEMBLPhase 4 (approved)HTR2A, HTR2C, HTR6, SLC6A2, SLC6A4
DOXEPINChEMBLPhase 4 (approved)HTR2A, HTR2C, HTR6, SLC6A2, SLC6A4
EBASTINEChEMBLPhase 4 (approved)HTR2A, HTR2C, HTR6, SLC6A2, SLC6A4
ECONAZOLEChEMBLPhase 4 (approved)HTR2A, HTR2C, HTR6, SLC6A2, SLC6A4
FLUOXETINEChEMBLPhase 4 (approved)HTR2A, HTR2C, HTR6, SLC6A2, SLC6A4
FLUPHENAZINEChEMBLPhase 4 (approved)HTR2A, HTR2C, HTR6, SLC6A2, SLC6A4
FLUSPIRILENEChEMBLPhase 4 (approved)HTR2A, HTR2C, HTR6, SLC6A2, SLC6A4
HALOPERIDOLChEMBLPhase 4 (approved)HTR2A, HTR2C, HTR6, SLC6A2, SLC6A4
HALOPROGINChEMBLPhase 4 (approved)HTR2A, HTR2C, HTR6, SLC6A2, SLC6A4
ILOPERIDONEChEMBLPhase 4 (approved)HTR2A, HTR2C, HTR6, SLC6A2, SLC6A4
IMIPRAMINEChEMBLPhase 4 (approved)HTR2A, HTR2C, HTR6, SLC6A2, SLC6A4
LOXAPINEChEMBLPhase 4 (approved)HTR2A, HTR2C, HTR6, SLC6A2, SLC6A4
MEPAZINEChEMBLPhase 4 (approved)HTR2A, HTR2C, HTR6, SLC6A2, SLC6A4
METHAPYRILENEChEMBLPhase 4 (approved)HTR2A, HTR2C, HTR6, SLC6A2, SLC6A4
MIANSERINChEMBLPhase 4 (approved)HTR2A, HTR2C, HTR6, SLC6A2, SLC6A4
MICONAZOLEChEMBLPhase 4 (approved)HTR2A, HTR2C, HTR6, SLC6A2, SLC6A4
NEFAZODONEChEMBLPhase 4 (approved)HTR2A, HTR2C, HTR6, SLC6A2, SLC6A4
NORTRIPTYLINEChEMBLPhase 4 (approved)HTR2A, HTR2C, HTR6, SLC6A2, SLC6A4
ORPHENADRINEChEMBLPhase 4 (approved)HTR2A, HTR2C, HTR6, SLC6A2, SLC6A4
PIMOZIDEChEMBLPhase 4 (approved)HTR2A, HTR2C, HTR6, SLC6A2, SLC6A4
PIPAMAZINEChEMBLPhase 4 (approved)HTR2A, HTR2C, HTR6, SLC6A2, SLC6A4
PROCHLORPERAZINEChEMBLPhase 4 (approved)HTR2A, HTR2C, HTR6, SLC6A2, SLC6A4
PROMAZINEChEMBLPhase 4 (approved)HTR2A, HTR2C, HTR6, SLC6A2, SLC6A4
PROMETHAZINEChEMBLPhase 4 (approved)HTR2A, HTR2C, HTR6, SLC6A2, SLC6A4
PROPAFENONEChEMBLPhase 4 (approved)HTR2A, HTR2C, HTR6, SLC6A2, SLC6A4
PROPRANOLOLChEMBLPhase 4 (approved)HTR2A, HTR2C, HTR6, SLC6A2, SLC6A4
RALOXIFENEChEMBLPhase 4 (approved)HTR2A, HTR2C, HTR6, SLC6A2, SLC6A4
RISPERIDONEChEMBLPhase 4 (approved)HTR2A, HTR2C, HTR6, SLC6A2, SLC6A4
SERTINDOLEChEMBLPhase 4 (approved)HTR2A, HTR2C, HTR6, SLC6A2, SLC6A4
SUNITINIBChEMBLPhase 4 (approved)HTR2A, HTR2C, HTR6, SLC6A2, SLC6A4
TAMOXIFENChEMBLPhase 4 (approved)HTR2A, HTR2C, HTR6, SLC6A2, SLC6A4
TEGASERODChEMBLPhase 4 (approved)HTR2A, HTR2C, HTR6, SLC6A2, SLC6A4
TERFENADINEChEMBLPhase 4 (approved)HTR2A, HTR2C, HTR6, SLC6A2, SLC6A4
THIORIDAZINEChEMBLPhase 4 (approved)HTR2A, HTR2C, HTR6, SLC6A2, SLC6A4
ZIPRASIDONEChEMBLPhase 4 (approved)HTR2A, HTR2C, HTR6, SLC6A2, SLC6A4
ENCLOMIPHENEChEMBLPhase 3HTR2A, HTR2C, HTR6, SLC6A2, SLC6A4
ZUCLOPENTHIXOLChEMBLPhase 3HTR2A, HTR2C, HTR6, SLC6A2, SLC6A4
METERGOLINEChEMBLPhase 2HTR2A, HTR2C, HTR6, SLC6A2, SLC6A4
PENFLURIDOLChEMBLPhase 2HTR2A, HTR2C, HTR6, SLC6A2, SLC6A4
RITANSERINChEMBLPhase 2HTR2A, HTR2C, HTR6, SLC6A2, SLC6A4