Cymbalta

Cymbalta (duloxetine) helps balance your mood by targeting two chemicals in the brain, serotonin and norepinephrineneurotransmitters.  Cymbalta does not affect other neurotransmitters, which reduces the side effects when compared to some other antidepressants. Taking this drug on a regular basis should help make you feel better, reduce your symptoms or provide the results you and your doctor discussed.

Cymbalta is used for the following:

  • Diabetic neuropathy (nerve pain related to diabetes)
  • Generalized anxiety disorder
  • Major depressive disorder

Doctors may prescribe for you a medication to treat a disease or disorder that is not an FDA-approved use. If you have any questions about your prescription, please discuss them with your doctor or pharmacist.
 

How Do I Take Cymbalta?
Try to take your Cymbalta at the same time every day. Swallow the capsule whole. Don't break it open or chew it.
You can take your Cymbalta with or without food.
You may not feel any different for a few weeks. Don't stop taking Cymbalta without talking to your doctor first, even if you do start feeling better. If you stop taking it suddenly, you could have severe side effects.
Your doctor will prescribe the dose that he or she thinks is best for you. Do not take more or less than your doctor tells you to.
 

How Does Cymbalta Work?
Cymbalta works by increasing the effect of the neurotransmitters serotonin and norepinephrine in the brain. 
Serotonin is important for a person’s mood (helping to regulate anger, aggression, body temperature, sleep, vomiting, sexuality and appetite). 
Norepinephrine is important in regulating the effects on the heart and blood pressure. By blocking these neurotransmitters from being reabsorbed, Cymbalta can help stabilize your mood.
 

How Is Cymbalta Available?
Cymbalta (duloxetine hydrochloride) is available in delayed-release capsules in the following strengths:

  • 20 mg (olive green)
  • 30 mg (blue and white)
  • 60 mg (olive green and blue)

A generic version of Cymbalta is not available.
Cymbalta is only available by prescription.
The dose you will take depends on your condition. Your doctor will discuss the best dosage for your situation.
 

General Information on Cymbalta
Cymbalta treats major depressive disorder (MDD), pain related to diabetes and general anxiety disorder.
Tell your doctor about any other medicines you are taking before you begin this drug or any new medicine. Follow the directions on your prescription bottle carefully.
Pregnancy/breast-feeding precautions: Inform your doctor if you are or intend to become pregnant. Consult with your doctor before you start this medicine if you are breast-feeding.
You are encouraged to keep a Personal Medication Record (PMR), a list of all your medications, doses, doctors, and emergency contact, with you at all times. This will help you and your health care providers keep track of the medicines you are taking so potential side effects and interactions can be reduced or eliminated.
 

What Are the Possible Side Effects?
Common side effects of Cymbalta include the following:

  • Constipation
  • Headache
  • Dizziness
  • Trouble sleeping
  • Drowsiness
  • Nausea
  • Dry mouth
  • Sexual side effects
  • Increased sweating
  • Decreased appetite

Serious but rare side effects include the following:

  • Liver toxicity (when the liver is damaged by drugs)
  • Increased thoughts of suicide
  • Increased risk of bleeding especially in people taking warfarin (Coumadin®)
  • Low sodium (also known as hyponatremia
  • Retaining urine (not being able to urinate as easily; also known as urinary retention

Serotonin syndrome occurs when too much serotonin is in the body and can have toxic or fatal effects. These increased levels of serotonin can happen when a patient mixes some medications such as an MAO inhibitor, a type of antidepressant, with an SSRI (selective serotonin reuptake inhibitor), another type of antidepressant.
This list of the more common side effects is not complete. Talk with your doctor or health care provider if you feel you are experiencing a side effect from this drug.

Report a Side Effect Here



 

What Are the Warnings and Cautions I Should Know About?
Antidepressants can increase the risk of suicidal thinking and behavior in children and teens with major depressive disorder and other psychotic disorders. Patients who have a high tendency for suicide should not take Cymbalta.
You should not take Cymbalta if you are also taking an MAO inhibitor (MAOI) due to the increased risk of serotonin syndrome.
If you have uncontrolled narrow-angle glaucoma, you should not use Cymbalta.
You should not use Cymbalta if you have liver problems or severe kidney disease.
You shouldn't use Cymbalta in the third trimester of your pregnancy.
Cymbalta can make you tired and may affect your judgment or motor skills (such a balance and coordination). You should not drive or operate machinery until you know how Cymbalta affects you.
Use with caution and speak to your doctor if you have any of the following conditions:

  • Bleeding problems, especially in people taking warfarin (Coumadin®)
  • Low sodium (also known as hyponatremia
  • Retaining urine (not being able to urinate as easily; also known as urinary retention

 

What Are the Possible Interactions With Cymbalta?
Cymbalta may interact with the following medications and should not be used with the following:

  • Do not take --- if you have taken an MAOI (monoamine oxidase inhibitor) within the last two weeks. Medications in this group include:
    • Isocarboxazid (Marplan®)
    • Tranylcypromine (Parnate®)
    • Rasagiline (Azilect®)
    • Selegiline (Eldepryl®, Emsam®)
    • Phenelzine (Nardil®)
  • Migraine drugs including the following:
    • Almotriptan (Axert®)
    • Eletriptan (Relpax®)
    • Frovatriptan (Frova®)
    • Naratriptan (Amerge®)
    • Sumatriptan (Imitrex®)
    • Zolmitriptan (Zomig®)
    • Methysergide (Sansert®)
    • Ergotamine (Ergomar®, Ergostat®, Cafergot®, Ercaf®, Wigraine®)
    • Dihydroergotamine (D.H.E. 45®, Migranal® Nasal Spray)
    • Ergonovine (Ergotrate®)
    • Methylergonovine (Methergine®)
  • Antidepressants known as selective serotonin reuptake inhibitors or SSRIs. Brand names include:
    • Citalopram (Celexa®)
    • Escitalopram (Lexapro®)
    • Fluoxetine (Prozac®, Sarafem®)
    • Fluvoxamine (Luvox®)
    • Paroxetine (Paxil®)
    • Sertraline (Zoloft®)
  • Antidepressants know as the tricyclic antidepressants (TCAs), such as:
    • Amitriptyline (Elavil®)
    • Amoxapine
    • Clomipramine (Anafranil®)
    • Desipramine (Norpramine®)
    • Doxepin (Sinequan®)
    • Imipramine (Tofranil®)
    • Nortriptyline (Pamelor®)
    • Protriptyline (Vivactil®)
    • Trimipramine (Surmontil®)
  • Certain antiseizure medications such as:
    • phenytoin (Dilantin®)
    • carbamazepine (Tegretol®
    • phenobarbital (Luminal®)
    • lamotrigine (Lamictal®)
    • topiramate (Topamax®)
    • valproic acid (Depakote®, Depakene®, others)
  • Other drugs may interact with Cymbalta such as:
    • Amiodarone (Cordarone®)
    • blood thinners such as Coumadin®/warfarin
    • Cymbalta may interfere with other antidepressants (not listed above) and should not be used at the same time.
    • Patients being treated for disordered thoughts or moods should not take Cymbalta because these conditions may worsen
    • Rifabutin (Mycobutin®)
    • Rifampin (Rifadin®, Rifamate®, Rimactane®)
    • Rifapentine (Priftin®)
    • Sibutramine (Meridia®)

The list of possible interactions above may not include every drug that could interact with Cymbalta. You should speak with your health care provider before starting any new drug to be sure all possible interactions are reviewed in advance. Certain drugs may not mix well together.


What Should I Do If I Take Too Much Cymbalta?
If the person who took too much DRUG is having a serious reaction, call 911 immediately.
If you have questions about a possible overdose, call your local Poison Control center (1.800.222.1822), go to their website for information ([1]) or call your doctor as soon as possible.
Not very much information is available from clinical studies about Cymbalta overdose. 

What Should I Discuss With My Health Care Provider?
Talk to your doctor and pharmacist about all the medications you are taking, including prescription and over-the-counter medications, vitamins and herbal supplements.
This drug and other medicines may affect or interact with each other, sometimes causing serious side effects.
Tell your doctor if you are pregnant or plan to become pregnant or are breastfeeding.
If you have diabetes, glaucoma, high blood pressure or a seizure disorder, make sure you tell your doctor before taking Cymbalta.
This information may not cover all possible uses, directions, precautions, drug interactions or adverse effects. Talk to your doctor, pharmacist or other health care provider for more information.
 

More Information on Cymbalta