Canadian Pharmacist Qualifying Exam Practice · Question
A patient presents a prescription for 'duloxetine 60 mg PO daily for neuropathic pain'. The patient's profile shows they are currently taking venlafaxine XR 150 mg PO daily for depression. What is the most appropriate action for the pharmacist?
Both duloxetine and venlafaxine are serotonin-norepinephrine reuptake inhibitors (SNRIs). Prescribing both concurrently represents duplicate therapy and signifi
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Question: A patient presents a prescription for 'duloxetine 60 mg PO daily for neuropathic pain'. The patient's profile shows they are currently taking venlafaxine XR 150 mg PO daily for depression. What is the most appropriate action for the pharmacist?
Answer options: ✅ Contact the prescriber to clarify the intent of adding duloxetine given the patient is already on venlafaxine.
- Dispense duloxetine as prescribed, as it has a different mechanism of action than venlafaxine.
- Dispense duloxetine and instruct the patient to take it on alternate days with their venlafaxine.
- Advise the patient to stop venlafaxine and start duloxetine immediately.
Correct answer: Contact the prescriber to clarify the intent of adding duloxetine given the patient is already on venlafaxine.
Explanation: Both duloxetine and venlafaxine are serotonin-norepinephrine reuptake inhibitors (SNRIs). Prescribing both concurrently represents duplicate therapy and significantly increases the risk of serotonin syndrome and other adverse effects without offering additional benefit. The pharmacist should contact the prescriber to clarify the therapeutic plan.
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