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Duloxetine is a generic drug sold under the brand name Cymbalta.
Cymbalta is a serotonin and norepinephrine reuptake inhibitor (SNRI). Doctors prescribe it to treat mood disorders like depression and anxiety, but it can also be used to treat pain and muscle problems.
SNRIs work by increasing serotonin and norepinephrine activity in the brain, which helps regulate mood.
Cymbalta can be prescribed to people with depression or anxiety. It can also help people with diabetes, fibromyalgia, or other conditions that cause musculoskeletal problems or neuropathy (numbness or tingling in the extremities).
Cymbalta is prescribed as an oral capsule. The capsules are available in 20mg, 30mg, and 60mg doses. Your doctor will prescribe a dose¹ based on your health condition.
For musculoskeletal pain and fibromyalgia, the normal starting daily dose is 30mg increased to 60mg depending on how you respond to treatment.
For people aged 13 years and older, the recommended dosage is 30mg once a day. If there are no adverse effects, your doctor can increase the dosage to 60mg.
People with diabetes and neuropathy may need to start with a lower dose because of possible renal complications. Doses higher than 60mg are not advisable for this condition.
A starting dose of 40–60mg is recommended for people with depression. Your doctor may put you on a dosing schedule of 20mg or 30mg twice daily, or 60mg once per day. Your doctor can raise your dose to 120mg if necessary.
If you need to take Cymbalta twice a day, you should take it in the morning and in the evening.
Your doctor may prescribe 60mg once per day to treat generalized anxiety disorder (GAD) if you’re under 65. If you’re older than 65, a daily dose of 30mg for at least 14 days is recommended. If there are no side effects, your dose could be increased to 60mg per day.
Doctors recommend 30–60mg daily for children aged seven and above. They can take 30mg for the first two weeks, to be increased to 60mg if they have no side effects.
You might notice improvements in your sleep, energy levels, and appetite within the first two weeks.² It could take three months to experience Cymbalta’s full effects on your mood.
Cymbalta may cause side effects, including:
Loss of appetite
Nausea
Diarrhea
Sexual dysfunction (including erectile dysfunction)
Flu-like symptoms
Serious physical side effects of Cymbalta may include:
Liver damage with complications
Hypotension (low blood pressure)
Severe bleeding
Severe skin allergies
Swelling in the face or extremities
Serious psychological side effects of Cymbalta may include:
Increased thoughts of suicide among people aged up to 24
Hallucinations
Agitation
Restlessness
Confusion
Delusions
Seek medical help if you develop serious side effects when taking Cymbalta. Less serious side effects may go away unaided, but see your doctor about long-lasting or worsening adverse effects.
Cymbalta is suitable for long-term use. Although taking this drug may cause side effects, there are no proven long-term, harmful effects of using the drug.
Missing doses of Cymbalta may reduce its effectiveness and cause your symptoms to return.
If you forget to take a dose, take it as soon as possible. Don’t take a missed dose if it’s almost time for your next dose. Never take two doses at once.
Taking more than the recommended dose could lead to overdose, increasing your risk of side effects and serious, long-lasting complications.
Overdose symptoms may include hypotension, hypertension, vomiting, serotonin syndrome, and even coma. To ensure that you do not overdose, carefully follow your doctor’s instructions.
If you think you or someone else has taken too much Cymbalta, seek medical attention urgently.
Before taking Cymbalta, talk to your doctor about the following things:
Allergies: Tell your doctor if you are allergic to any medications, including Cymbalta or any of its ingredients.
Other medications: Your doctor needs to know if you are taking any other medications, prescription or nonprescription. Some medications can interact with Cymbalta, reducing its effectiveness or causing complications.
Supplements and herbal remedies: Tell your doctor if you take or plan to take any nutritional supplements or herbal remedies as they may interact with Cymbalta.
Drugs and alcohol: Tell your doctor if you regularly consume alcohol or drugs.
Pregnancy: If you are pregnant, breastfeeding, or planning to get pregnant, tell your doctor before taking Cymbalta.
You must also tell your doctor if you will be undergoing surgery, including dental surgery. Be sure to make medical and dental professionals aware that you’re taking Cymbalta before having surgery.
Tell your doctor if you have thoughts of suicide or have suicidal tendencies, as Cymbalta may be unsuitable for you.
Stopping Cymbalta suddenly without first talking to your doctor may cause withdrawal symptoms. Only stop taking Cymbalta if your doctor tells you to.
If you want to stop taking this medication, discuss it with your doctor. They can help you stop taking Cymbalta safely.
Taking Cymbalta after 13 weeks of pregnancy may increase your risk of delivering preterm.² Discuss the potential benefits and risks of taking this medication with your doctor.
Duloxetine (Cymbalta) can be passed to the child in small quantities in breastmilk. Tell your doctor if you are breastfeeding before taking Cymbalta.
Cymbalta can interact with other drugs, so you must tell your doctor about all medications you currently take or plan to take. Drugs that may interact with Cymbalta include:
Other antidepressant drugs, including monoamine oxidase inhibitors (MAOIs), tricyclic antidepressants, and other SNRIs
Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen
Triptans (a class of drugs used to treat migraines and other symptoms)
Stimulant drugs
Some types of antibiotics
Blood thinners, such as aspirin and warfarin
Other drugs that cause gastric acidity
These drugs may interact with Cymbalta, changing the way it affects your body and potentially causing complications, such as increased side effects.
Skin allergies are one of the more common side effects of Cymbalta. Other allergic reactions may include difficulty breathing and swelling.
If you experience any signs of an allergic reaction to Cymbalta (like hives or difficult breathing), or a severe skin reaction (like fever, sore throat, burning eyes, painful skin rashes with blisters and peeling), seek immediate medical attention.
The United States Food and Drug Administration (FDA) approved Cymbalta based on four randomized, double-blind, placebo-controlled studies³ in patients with major depressive disorder aged 18 to 83 years.
In two of these studies, participants were randomized to take a placebo or 60mg of Cymbalta once daily. The trial lasted nine weeks.
In a third study that took place over eight weeks, participants were randomized to take 20 or 40mg of Cymbalta twice daily, or a placebo.
In a fourth study that lasted eight weeks, participants were randomized to take 40 or 60mg of Cymbalta twice daily, or a placebo.
Using the Hamilton Depression Rating Scale, participants were rated after the studies had ended to assess the effectiveness of Cymbalta. In all four studies, Cymbalta was found to improve depression symptoms more than the placebo.
Keep these tips in mind when taking Cymbalta to improve your experience and keep you safe:
Take Cymbalta before or after eating, with or without food. It should be swallowed whole, not chewed or crushed.
Follow your doctor’s instructions carefully to increase your chance of seeing results and avoid side effects.
Avoid consuming alcohol when taking Cymbalta as it could increase your risk of liver damage.
Cymbalta may impair your reactions, so avoid activities like driving or operating heavy machinery until you know how the drug affects you.
Inform your doctor immediately if you have any serious side effects when taking Cymbalta, including hallucinations or suicidal thoughts.
Sources
Cymbalta dosage | Medical News Today
Duloxetine (Cymbalta) | National Alliance of Mental Illness
Cymbalta (duloxetine delayed-release capsules) | Center Watch
Other sources:
Cymbalta | Drugs.com
Duloxetine | MedlinePlus
Cymbalta | Rx List
Cymbalta (duloxetine) | Good Rx
Cymbalta side effects & withdrawal symptoms | Drug Watch
Cymbalta (Duloxetine) | Everyday Health
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Here at HealthMatch, we’ve done our best to ensure that the information provided in this article is helpful, up to date, and, most importantly, accurate.
However, we can’t replace the one-to-one advice of a qualified medical practitioner or outline all of the possible risks associated with this particular drug and your circumstances.
It is therefore important for you to note that the information contained in this article does not constitute professional medical or healthcare advice, diagnosis or recommendation of treatment and is not intended to, nor should be used to, replace professional medical advice. This article may not always be up to date and is not exhaustive of all of the risks and considerations relevant to this particular drug. In no circumstances should this article be relied upon without independent consideration and confirmation by a qualified medical practitioner.
Your doctor will be able to explain all possible uses, dosages, precautions, interactions with other drugs, and other potential adverse effects, and you should always talk to them about any kind of medication you are taking, thinking about taking or wanting to stop taking.
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