What Is Cymbalta?
Cymbalta (duloxetine) is a prescription medicine that treats a number of temper and ache circumstances, together with anxiousness and melancholy. It might additionally relieve diabetic peripheral neuropathic ache, fibromyalgia (muscle ache and stiffness), and long-lasting (persistent) muscle and bone ache.
Duloxetine is a serotonin and norepinephrine reuptake inhibitor (SNRI). These neurotransmitters have an effect on many features of the physique’s capabilities, together with temper, ache, coronary heart charge, and extra. Cymbalta will increase the consequences of serotonin and norepinephrine by maintaining them of their lively nerve areas.
Like different antidepressants, Cymbalta carries a boxed warning concerning the elevated threat of suicidal pondering and conduct in younger folks taking these drugs. A boxed warning is the strictest warning that may be given by the Meals and Drug Administration (FDA).
This medicine comes as a capsule in several strengths, taken orally (by mouth).
Drug Info
Generic Identify: Duloxetine
Model Identify: Cymbalta, Drizalma Sprinkle, Irenka
Drug Availability: Prescription
Therapeutic Classification: Antidepressant
Out there Generically: Sure
Managed Substance: N/A
Administration Route: Oral
Energetic Ingredient: Duloxetine
Dosage Type: Delayed-release capsule
What Is Cymbalta Used For?
The FDA accepted Cymbalta to deal with adults, however it may additionally deal with sure circumstances in each kids and adults.
Cymbalta is accepted for treating the next circumstances for adults:
Cymbalta is accepted for treating the next circumstances for youngsters and adults:
Cymbalta helps stop signs associated to those circumstances. It shouldn’t be used as a treatment or as an emergency therapy.
Tips on how to Take Cymbalta
Cymbalta is prescribed to be taken as soon as a day, normally on the similar time day-after-day. You possibly can take it with or with out meals.
To work correctly, it’s essential to swallow the capsules complete. You shouldn’t crush, chew, or open the capsule.
Make sure you inform your healthcare supplier straight away in case you have worsening melancholy, uncommon conduct adjustments, or different temper adjustments. You’ll want to look ahead to these indicators, significantly when beginning a brand new antidepressant or when your dose is modified.
Storage
You need to preserve this medicine in its authentic container and out of the attain of kids or pets. Hold it at room temperature (77 Fahrenheit [F]). You possibly can briefly expose it to temperatures of 59 F and 86 F.
Off-Label Makes use of
Healthcare suppliers generally prescribe this medicine off-label to deal with completely different circumstances, each in medical therapy and analysis.
Off label makes use of embody:
- Osteoarthritis ache
- Publish-operative ache after orthopedic (bone) surgical procedure
- Stress urinary incontinence after pelvic surgical procedure
- Chemotherapy-induced peripheral neuropathy in adults
How Lengthy Does Cymbalta Take to Work?
Cymbalta can start to have some results inside a couple of days. It could take three weeks or longer to start to expertise a therapeutic impact in your signs.
What Are the Aspect Results of Cymbalta?
Cymbalta can have gentle or extreme uncomfortable side effects. You is probably not bothered by uncomfortable side effects, or they are often very problematic. Inform your healthcare supplier about any uncomfortable side effects you expertise, particularly in the event that they worsen or don’t go away.
This isn’t an entire record of uncomfortable side effects, and others might happen. A healthcare supplier can advise you on uncomfortable side effects. If you happen to expertise different results, contact your pharmacist or a healthcare supplier. Chances are you’ll report uncomfortable side effects to the FDA at fda.gov/medwatch or 1-800-FDA-1088.
Widespread Aspect Results
The frequent uncomfortable side effects of Cymbalta will be completely different for youngsters and adults.
Widespread uncomfortable side effects for adults:
Widespread uncomfortable side effects for youngsters:
- Weight reduction or insufficient weight achieve
- Decreased urge for food
- Nausea, vomiting
- Tiredness
- Diarrhea
Let your healthcare supplier find out about any of those uncomfortable side effects. Typically you possibly can handle sure uncomfortable side effects—comparable to dry mouth, diarrhea, or constipation—with way of life changes or medicine. In case your uncomfortable side effects intervene together with your high quality of life, your healthcare supplier might change your Cymbalta prescription.
Extreme Aspect Results
Cymbalta may cause dangerous antagonistic results for some folks. These would necessitate a big change in your prescription.
Extreme uncomfortable side effects can embody:
- Suicidal ideas or actions, particularly in kids, adolescents, and younger adults
- Liver harm, which might trigger a generalized feeling of being sick and yellow discoloration of the pores and skin and eyes
- Low blood pressure with signs comparable to dizziness, falling, or passing out
- Serotonin Syndrome, which causes agitation, blood strain adjustments, and muscle stiffness
- Bleeding threat
- Extreme pores and skin reactions, which might trigger a rash, peeling of the pores and skin, and an infection threat
- Mania or hypomania with signs comparable to insomnia, hyperactivity, and reckless conduct
- Angle-closure glaucoma might trigger imaginative and prescient adjustments
- Seizures manifesting with adjustments in consciousness and involuntary actions
- Hypertension which may trigger chest ache, complications, or may not trigger any signs
- Low blood sodium levels, which might trigger dizziness or adjustments in consciousness
- Issue urinating
The intense uncomfortable side effects of Cymbalta can worsen quickly and trigger long-term well being issues or could also be life-threatening. Get medical consideration straight away when you develop extreme uncomfortable side effects of Cymbalta—therapy may help stop the dangerous penalties from occurring.
Don’t instantly cease taking Cymbalta—comply with your healthcare supplier’s directions for discontinuing.
Stopping too quickly may cause withdrawal signs that will embody:
- Dizziness
- Complications
- Nausea, vomiting
- Diarrhea
- Tingling sensations
- Irritability, anxiousness
- Bother sleeping, tiredness
- Sweating
Even in case you are following a tapering schedule, inform your healthcare supplier when you develop any signs of discontinuation.
Antidepressant use may cause suicidal ideas or actions in kids, adolescents, and younger adults. Individuals who have or have a household historical past of bipolar sickness or suicidal conduct are at an elevated threat. If you happen to or somebody you might be caring for is taking Cymbalta, make sure that to concentrate to any sudden adjustments in temper, behaviors, ideas, or emotions.
Name a healthcare supplier instantly if any of those signs happen:
- Ideas about suicide or dying
- Makes an attempt to commit suicide
- New or worse melancholy
- New or worse anxiousness
- Agitation or restlessness
- Bother sleeping
- New or worse irritability
- Aggressive, indignant, or violent actions
- Harmful and impulsive actions
- An excessive improve in exercise and speaking
- Different uncommon temper or conduct adjustments
Lengthy-Time period Aspect Results
The results of Cymbalta are anticipated to put on off inside a couple of days. Nevertheless, extreme uncomfortable side effects might trigger long-term well being harm.
Report Aspect Results
Cymbalta might trigger different uncomfortable side effects. Name your healthcare supplier in case you have any uncommon issues whereas taking this medicine.
If you happen to expertise a severe facet impact, you or your healthcare supplier might ship a report back to the FDA’s MedWatch Adverse Event Reporting Program or by telephone (800-332-1088).
Dosage: How A lot Cymbalta Ought to I Take?
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The dose of this drugs will likely be completely different for various sufferers. Comply with your physician’s orders or the instructions on the label. The next data contains solely the typical doses of this drugs. In case your dose is completely different, don’t change it until your physician tells you to take action.
The quantity of drugs that you simply take is determined by the energy of the drugs. Additionally, the variety of doses you’re taking every day, the time allowed between doses, and the size of time you’re taking the drugs rely upon the medical drawback for which you might be utilizing the drugs.
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For oral dosage kind (delayed-release capsules):
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For therapy of tension:
- Adults—At first, 60 milligrams (mg) as soon as a day. Some sufferers might begin at 30 mg as soon as a day for 1 week earlier than growing the dose to 60 mg as soon as a day. Your physician might improve your dose as wanted. Nevertheless, the dose is normally no more than 120 mg per day.
- Older adults—At first, 30 mg as soon as a day for two weeks earlier than growing the dose to 60 mg as soon as a day. Your physician might improve your dose as wanted. Nevertheless, the dose is normally no more than 120 mg per day.
- Youngsters 7 years of age and older—At first, 30 mg as soon as a day for two weeks earlier than growing the dose to 60 mg as soon as a day. Your physician might improve your dose as wanted. Nevertheless, the dose is normally no more than 120 mg per day.
- Youngsters youthful than 7 years of age—Use and dose should be decided by your physician.
-
For therapy of persistent muscle ache:
- Adults—60 milligrams (mg) as soon as a day. Some sufferers might begin at 30 mg as soon as a day for 1 week earlier than growing the dose to 60 mg as soon as a day.
- Youngsters—Use and dose should be decided by your physician.
-
For therapy of melancholy:
- Adults—40 milligrams (mg) per day (given as 20 mg two occasions per day) to 60 mg per day (given both as soon as a day or as 30 mg two occasions per day). Your physician might improve your dose as wanted. Nevertheless, the dose is normally no more than 120 mg per day.
- Youngsters—Use and dose should be decided by your physician.
-
For therapy of diabetic peripheral neuropathy:
- Adults—60 milligrams (mg) as soon as a day.
- Youngsters—Use and dose should be decided by your physician.
-
For therapy of fibromyalgia:
- Adults—60 milligrams (mg) as soon as a day. Some sufferers might begin at 30 mg as soon as a day for 1 week earlier than growing the dose to 60 mg as soon as a day.
- Youngsters 13 years of age and older—At first, 30 mg as soon as a day. Your physician might improve your dose as wanted. Nevertheless, the dose is normally no more than 60 mg per day.
- Youngsters youthful than 13 years of age—Use and dose should be decided by your physician.
-
For therapy of tension:
Modifications
Cymbalta could also be much less efficient in case you are a smoker as a result of lowered bioavailability.
If you must cease taking Cymbalta, your dose could also be steadily lowered (tapered) by your healthcare supplier to forestall withdrawal signs.
Missed Dose
If you happen to miss your scheduled dose, take it as quickly as you possibly can. Whether it is nearly time to take your subsequent dose, take your subsequent scheduled dose with out doubling up after which resume your common dosing schedule.
Overdose: What Occurs If I Take Too A lot Cymbalta?
Taking an excessive amount of Cymbalta will be very harmful, and it might end in demise.
Results of Cymbalta overdose can embody:
- Excessive tiredness
- Fainting
- Vomiting
- Diminished degree of consciousness
- Speedy coronary heart charge
- Low or hypertension
- Seizures
- Serotonin syndrome
- Coma
If in case you have taken an excessive amount of Cymbalta, get immediate medical consideration. Chances are you’ll must be noticed for indicators of an overdose. Your therapy would rely upon the overdose results that you simply develop and will embody interventions to help your respiratory and blood strain administration.
In some conditions, your healthcare supplier might try to cut back the extent of the drug in your physique with gastric lavage or activated charcoal.
Precautions
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It is crucial that your physician test your progress at common visits to permit for adjustments in your dose and to assist stop any negative effects.
Don’t take duloxetine with a monoamine oxidase (MAO) inhibitor (eg, isocarboxazid [Marplan®], phenelzine [Nardil®], selegiline [Eldepryl®], or tranylcypromine [Parnate®]) previously 2 weeks. Don’t begin taking an MAO inhibitor inside 5 days of stopping duloxetine. If you happen to do, chances are you’ll develop confusion, agitation, restlessness, abdomen or intestinal signs, sudden excessive physique temperature, extraordinarily hypertension, or extreme convulsions. Ask your physician in case you are undecided when you take an MAOI, together with linezolid (Zyvox®) or methylene blue injection.
Duloxetine might trigger some youngsters and younger adults to be agitated, irritable, or show different irregular behaviors. It could additionally trigger some folks to have suicidal ideas and tendencies or to change into extra depressed. Some folks might have hassle sleeping, get upset simply, have an enormous improve in vitality, or begin to act reckless. If you happen to or your caregiver discover any of those negative effects, inform your physician straight away. Let the physician know when you or anybody in your loved ones has bipolar dysfunction (manic-depressive) or has tried to commit suicide.
Examine together with your physician straight away in case you have ache or tenderness within the higher abdomen, pale stools, darkish urine, lack of urge for food, nausea, vomiting, or yellow eyes or pores and skin. These may very well be signs of a severe liver drawback.
Make certain your physician is aware of about all the opposite medicines you might be utilizing. Duloxetine might trigger severe circumstances known as serotonin syndrome or neuroleptic malignant syndrome (NMS)-like reactions if taken with sure medicines comparable to buspirone (Buspar®), fentanyl (Abstral®, Duragesic®), lithium (Eskalith®, Lithobid®), tryptophan, St. John’s wort, amphetamines, or some ache medicines (eg, tramadol [Ultram®], sumatriptan [Imitrex®], zolmitriptan [Zomig®], or rizatriptan [Maxalt®]). Examine together with your physician first earlier than taking some other medicines.
This drugs might improve your threat for bleeding issues. Make certain your physician is aware of in case you are additionally taking different medicines that skinny the blood, comparable to aspirin, NSAID ache medicines (eg, ibuprofen, naproxen, Advil®, Aleve®, Celebrex®, or Motrin®) or warfarin (Coumadin®).
Severe pores and skin reactions (eg, erythema multiforme, Stevens-Johnson syndrome) can happen throughout therapy with this drugs. Examine together with your physician straight away in case you have blistering, peeling, or loosening of the pores and skin, chills, cough, diarrhea, itching, joint or muscle ache, crimson irritated eyes, crimson pores and skin lesions, usually with a purple middle, sore throat, sores, ulcers, or white spots within the mouth or on the lips, or uncommon tiredness or weak spot while you’re utilizing this drugs.
Don’t instantly cease taking this drugs with out checking first together with your physician. If in case you have been instructed to cease taking duloxetine, ask your physician the right way to slowly lower the dose. It will lower your probability of getting withdrawal signs comparable to dizziness, nausea, complications, vomiting, elevated sweating, irritability, nightmares, hassle with sleeping, or prickling or tingling emotions.
This drugs might have an effect on blood sugar ranges. If you’re diabetic and spot a change within the outcomes of your blood or urine sugar exams, test together with your physician.
This drugs might trigger blurred imaginative and prescient, dizziness, drowsiness, hassle with pondering, or hassle with controlling physique actions, which can result in falls, fractures, or different accidents. Ensure you understand how you react to this drugs earlier than you drive, use machines, or do anything that may very well be harmful in case you are not alert or capable of see clearly. You may additionally really feel lightheaded or chances are you’ll fall or faint when getting up instantly from a mendacity or sitting place, so stand up slowly. If these signs are bothering you or maintaining you from doing all your day by day actions, inform your physician straight away..
You will want to measure your blood strain earlier than beginning this drugs and while you’re utilizing it. If you happen to discover any change to your advisable blood strain, name your physician straight away. If in case you have questions on this, speak to your physician.
Hyponatremia (low sodium within the blood) might happen with this drugs. Examine together with your physician straight away in case you have confusion, decreased urine output, problem concentrating, quick or irregular heartbeat, complications, reminiscence issues, nausea or vomiting, swelling of the face, ankles, or palms, hassle respiratory, or uncommon tiredness or weak spot.
This drugs might trigger sexual issues. Examine together with your physician straight away in case you have decreased curiosity in sexual activity, incapacity to have or preserve an erection, or loss in sexual capability, need, drive, or efficiency.
Keep away from smoking while you’re utilizing this drugs. If in case you have any questions on this, test together with your physician.
What Are Causes I Shouldn’t Take Cymbalta?
This medicine is probably not secure for individuals who have extreme liver or kidney illness or who’re within the final trimester of being pregnant. Your healthcare supplier might talk about the professionals and cons of this medicine or keep away from prescribing it for you in case you have any of those circumstances.
What Different Medicines Work together With Cymbalta?
Cymbalta has many drug interactions, a few of which might trigger severe antagonistic occasions. Don’t use alcohol when you find yourself taking Cymbalta—the mix may cause extreme liver harm.
Medicines that may work together with Cymbalta embody:
- Triptans, comparable to Reyvow (lasmiditan), Zolmitriptan (Zomg), and others
- Medicines that work together with serotonin, comparable to monoamine oxidase inhibitors (MAOIs), serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants, tryptophan, or St. John’s Wort
- Eskalith, Lithobid (lithium)
- Buspar, Vanspar (buspirone)
- Tramadol
- Fentanyl
- Amphetamines
- Cimetidine
- Sure antibiotics, comparable to ciprofloxacin or enoxacin
- Blood thinners and non-steroidal anti-inflammatory medication (NSAIDs)
- Zyvox (linezolid)
- Intravenous methylene blue
- Medicines which are potent inhibitors of CYP1A2
- Medicines which are potent inhibitors of CYP2D6
- Some drugs used for therapy of irregular coronary heart charge
- Theo-24, Elixophylline, Theochron, amongst others (theophylline)
- Mellaril (thioridazine)
Additionally, Cymbalta shouldn’t be used inside 14 days of an MAOI inhibitor. As a result of Cymbalta has so many drug interactions, it’s essential to inform your healthcare supplier and pharmacist about some other prescription or over-the-counter (OTC) drugs, dietary supplements, or herbs that you simply use or plan to make use of.
What Medicines Are Comparable?
There are lots of different drugs used to deal with melancholy, anxiousness, ache, and fibromyalgia. Different SNRIs are accepted for related indications as Cymbalta.
Different SNRIs embody:
- Pristiq (desvenlafaxine)
- Fetzima (levomilnacipran)
- Effexor XR (venlafaxine)
How Can I Keep Wholesome Whereas Taking Cymbalta?
When utilizing Cymbalta, you must preserve a number of concerns in thoughts. Make certain to take the medicine precisely as directed.
Talk together with your healthcare supplier about:
- New adjustments in your well being that develop whereas taking Cymbalta
- Any prescription, OTC drugs, dietary supplements, or herbs you might be planning to take
- Any severe uncomfortable side effects you might be experiencing, particularly when you discover adjustments in your temper, ideas, and conduct
Whereas taking Cymbalta, make sure that to proceed with the opposite components of your therapy plan, comparable to attending remedy or counseling.
Medical Disclaimer
Verywell Well being’s drug data is supposed for instructional functions solely and never meant as a alternative for medical recommendation, prognosis, or therapy from a healthcare supplier. Seek the advice of your healthcare supplier earlier than taking any new medicine(s). IBM Watson Micromedex supplies a number of the drug content material, as indicated on the web page.
