Open Angle glaucoma and Duloxetine medication

[Karjade]

I have open angle glaucoma and my Neurologist wants me to go on Duloxetine as I have peripheral neuropathy. I have read the leaflet and it says do not take if you have glaucoma as it can raise eye pressure. I have asked my neurologist, GP and Ophthalmologist if it okay to take and they really do not know. Is there anybody taking this medication and has it increased your eye pressure?

[muddledme]

Hello Karjade,

It is quite surprising how different specialists do not always consider the interaction of medicines with other conditions.

Have you looked on google ? Duloxitine does not seem to be recommended if you have glaucoma, could you contact your neurologist and ask if there is an alternative ?

I have had several incidences where drugs have been advised but contra -indicated for another problem. So , like you, I always double check with the patient leaflet or look on line. Pharmacists are often very helpful to discuss problems and perhaps suggest alternative medications.

Best wishes

[Karjade in reply to muddledme]

I have looked on Google and some say do not take if you have glaucoma and some say do not take if you have narrow or closed angle glaucoma. I am not going back to the Neurologist until 31st July and I have left a message with her secretary to phone me and I have not heard anything. All medication for neuropathy works on the central nervous system and raises eye pressure. I am in so much pain and after a lot of consideration I need to go on something. I have also been in touch with the Glaucoma Association and they said it should be okay to take it but still not sure. I just cannot risk further damage to my eyes.

[muddledme in reply to Karjade]

I quite understand your concern about the Duloxetine.

It may be worth phoning your consultant's secretary again, in fact you could try both the neurologist and opthalmologist.

Sometimes Glaucoma UK will ask a specialist on your behalf, or the RNIB are also usually very helpful. If you stress the fact that you are in pain without a suitable medication then perhaps that would help. Have you tried the hospital pharmacy ?

Sadly these days I find things are sometimes quite a battle , but someone must know , just a case of finding them. Have you a Glaucoma nurse or Eye Liason Officer at your eye clinic ? They may be able to contact the right person on your behalf.

I contacted Moorfields for something and found them very helpful.

I can imagine if you are in pain then it is much more difficult, but I do hope you get an answer.

Best wishes

[Karjade in reply to muddledme]

thank you so much. I phoned my Ophthalmologist again and she said to take them and I can go in once a week to have my pressure checked which I thought was very helpful. I need to take something as I just cannot live with this pain for much longer. Thank you for your reply xx

[muddledme in reply to Karjade]

So pleased to hear you were able to contact your opthalmologist and have a weekly pressure test. Do hope the medication helps.

A while ago my GP advised that I took Amytriptyline for a very painful trapped nerve. The G.P and the pharmacist seemed unsure if the medication could interfere with eye pressure, so I did neck exercises instead , luckily this was successful.

Interested to hear that Amytriptyline did raise your pressure with Open Angle glaucoma, as the literature does seem to be vague.

Best wishes

[Nonswimmer]

Hello, Diagnosed with normal tension glaucoma in 2003, having lost a lot of sight in my left eye and recently passed the DVLA test due to the good sight in the right eye I too am reluctant to take more medication.

Unfortunately I developed neuropathy in 2011, in October 2023 I was diagnosed with small fibre peripheral neuropathy the pain increased so much in January 2022 I began to take Pregabalin 25mg twice daily in June 2022 the pressure in my good right eye was 11.

The cold weather and stress increase the pain, because of the difficulty obtaining Azopt Trish's lastest post stating the supply issue should be resolved soon is very good to hear, the receptionist at my health center told me to go to the opticians to ask for an alternative drop.

Having had five surgicial procedures on both eyes I doubt if an opthalmologist would approve of this advice because I fell sure if I changed drops I would need pessure checked at the eye clinic.

[Karjade in reply to Nonswimmer]

It is good that Pregabalin did not raise your eye pressure. Are you still on them and have you had any side effects? Do they help with your neuropathy? I went on Amitriptyline and this definitely raised my eye pressure and I had to come off it. At the moment I am in so much pain that I have to go on something. Thank you for your reply.

[Hidden]

I think it may only apply to closed angle glaucoma

[Karjade in reply to Hidden]

thank you so much for your reply.

[Nonswimmer in reply to Karjade]

Hello, I'm still taking 50 mg pregabalin daily so far I have not had any side effects, the pain never stops but it is easier. I believe gabapentin is more affective. The fact that you can have regular pressure checks is good.

I find a soak in a warm bath with a few drops of lavender oil relaxing, anything that distracts from the pain like a funny film also helps me to relax.

[Karjade in reply to Nonswimmer]

I took one Duloxetine and I was so ill so I was too scared to take another one. I have gone back on a low dose of Gabapentin and will have to discuss Increasing it with my doctor. I was on this before and it did not raise my eye pressure. It was the Neurologist who said that Duloxetine worked the best with peripheral neuropathy and how wrong was she! If I lay in the bath to soak then my feet flare up and burn even after a shower because of the neuropathy.

[Nonswimmer in reply to Karjade]

Everyone is different, I tried Duloxetine which made absolutely no difference, one 25mg pregabalin last March eased the pain in an hour now by taking two per day I'm still have a lot of pain which never stops. I find warmth helps and that the cold closes the nerves making it worse, I waited 9 months to see a neurologist and see my opthalmologist at 6 month intervals. The condition has changed my life by restricting where I can go and what I'm able to do. How much gabapentin are you taking and does it stop the pain please?

[Karjade in reply to Nonswimmer]

I am only on 3 x 100 mg and have only been on them a few days so not working as yet. I have not had any side effects and it is supposed to help with anxiety as well which I have! I have had peripheral neuropathy for about six years and it has got much worse lately. I asked my GP to refer me to another Neurologist which he did and this Neurologist did lots of specialised blood tests and nerve conduction tests. I had all the results a couple of weeks ago by letter and I have been diagnosed with Anti-MAG peripheral neuropathy which is a rare disease to do with the antibodies fighting each other! I was then sent an appointment with this Neurologist for August to discuss treatment so I have to wait until then to understand exactly what this is. Nobody has heard of it including my doctor, Rheumatologist and Pain Clinic consultant so I have to worry until August without knowing what I am dealing with. I have always been anti medication but now I have to go on anything that will help with the pain without raising eye pressure. I know what you mean about neuropathy restricting your life as I was so active but now I cannot go out if it involves walking. I am hoping Gabapentin will improve the quality of my life x

[Nonswimmer in reply to Karjade]

I was diagnosed in 2011 with neuropathy and had learnt to live with the pain until 2021 being difficult to speak to any doctor it was August 2022 before I saw a neurologist who sent me for a nerve conduction test which was normal, small fibre peripheral neuropathy was diagnosed.

Every one has a different reaction to medication and I hesitate to say this but in my case I believe the 3rd phizer vaccination increased my problem, this did not stop me having a 3rd and 5th covid jab because I believe it to be the correct thing to do, but think I am paying a price for the protection.

You seem to have a lot of medical attention, I sincerely hope the gabapentin works.

[Karjade in reply to Nonswimmer]

Thank you so much and I hope any treatment you have works for you too xx

[Helen_GlaucomaUK Administrator]

Hi Karjade. It is good to hear that you will be having weekly eye pressure measurements, to help ease your mind. I am sorry to hear from everyone, how painful peripheral neuropathy is for you all. Thank you everyone for coming forward and being so supportive.

I note in the patient leaflet for Duloxetine that it is contraindicated for certain types of glaucoma. This could be referring to primary angle closure glaucoma or narrow angles, but doesn't state exactly. Also medications can react differently in different people but I am aware that you are no longer on Duloxetine. I hope the new medication will work for you.

[Karjade in reply to Helen_GlaucomaUK]

thank you so much for your reply. The side effects of Duloxetine after just one capsule were so awful that I was too scared to take any more! I am now on Gabapentin 3 x 100mg and have not had any side effects and nothing seems to indicate on the leaflet that it raises eye pressure. I am really hoping that they will help with the pain so I can have some sort of quality of life. The group have been very supportive and I am so grateful to everyone especially Nonswimmer. Thank you again for your support as it certainly helps me x

[Nonswimmer]

Hello, Reading previous replies I can see we have discussed this problem in the past, I have acute glaucoma and peripheral neuropathy in 2023 I took Pregabalin reading Gabapentin was more effective and did not have so many side effects after weaning off pregabalin and taking gabapentin I developed a very rare skin desease Bullous Pemphigold which is not contagious or hereditary.

My reason for this reply is because in an effort to find some relief for the nerve pain and reading advertisements for hand held Orthoback massagers I purchased the device at a cost of £99.00. Having received the massager and reseaching further reading of the reviews I am beginning to believe I have been scammed.

The hand held device does become warm and there is a vibration button but no clear instructions for use. Does anyone else have experience of Orthoback please? It seems they make shoes socks etc;