What is Cymbalta?Cymbalta belongs to a class of drugs called serotonin-norepinephrine reuptake inhibitors (SNRIs). Cymbalta is used to treat major depression, diabetic neuropathy (a painful nerve disorder associated with diabetes that affects the hands, legs, and feet), generalized anxiety disorder, and fibromyalgia (a condition characterized by weakness and pain inthe muscles and tissues surrounding the joints).
What is the most important information I should know about Cymbalta?Cymbalta is not approved for use in children or adolescents.
Cymbalta may increase suicidal thoughts or actions in some children, teenagers, and young adults when the medicine is first started. Depression and other serious mental illnesses are the most important causes of suicidal thoughts and actions. People with bipolar disorder or who have a family history of this condition (also called manic-depressive illness) are at a greater risk. Contact your doctor immediately if you experience any changes, especially sudden ones, in mood, behavior, thoughts, or feelings. Signs to watch for include new or worsening depression, new or worsening anxiety, agitation, insomnia, hostility, panic attacks, restlessness, extreme hyperactivity, and suicidal thinking or behavior. This is very important when an antidepressant medicine is first started or when the dose is changed.
Cymbalta may cause liver damage. Contact your doctor immediately if you experience abdominal pain or yellowing of the whites of your eyes or skin (jaundice). Avoid alcohol while taking Cymbalta as this can contribute to liver damage.
Cymbalta may cause an increase or decrease in blood pressure especially if you are also taking medications for your blood pressure. Your doctor may measure your blood pressure before starting you on Cymbalta and throughout treatment.
Contact your doctor immediately if you experience any of the following symptoms: agitation, hallucinations, coma, fast heart beat, changes in blood pressure, increased body temperature, lack of coordination, overactive reflexes, nausea, vomiting, or diarrhea.
Cymbalta may increase your risk of bleeding. Consult your doctor before taking aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, or blood-thinners such as warfarin.
Do not stop taking Cymbalta without first talking with your doctor as this can cause serious side effects.
Cymbalta may cause low blood sodium levels. Contact your doctor immediately if you experience any of the following: headache, difficulty concentrating, confusion, weakness, unsteadiness, hallucinations, falls, or seizures.
Cymbalta may affect your blood sugar levels. If you are a diabetic, make sure you check your blood sugar levels regularly.
Cymbalta may make it difficult to urinate. If you experience this problem, contact your doctor.
Who should not take Cymbalta?Do not use Cymbalta if you are allergic to it; if you are taking a monoamine oxidase inhibitor (MAOI) a class of drugs used to treat depression; if you have a psychiatric or emotional disorder, Parkinson's disease; or if you are taking thioridazine. Do not take Cymbalta if you have uncontrolled increased pressure in your eyes (narrow-angle glaucoma), serious kidney or liver disease, or if you drink alcohol excessively.
What should I tell my doctor before I take the first dose of Cymbalta?Tell your doctor about all prescription, over-the-counter, and herbal medications you are taking before beginning treatment with Cymbalta. Also, talk to your doctor about your complete medical history, especially if you have liver problems, severe kidney disease, diabetes, glaucoma, high blood pressure, a seizure disorder, bipolar disorder, if you consume large amounts of alcohol, or if you have difficulty urinating. Also tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding.
What is the usual dosage?The information below is based on the dosage guidelines your doctor uses. Depending on your condition and medical history, your doctor may prescribe a different regimen. Do not change the dosage or stop taking your medication without your doctor's approval.
Diabetic Neuropathy, Generalized Anxiety Disorder, and Fibromyalgia
Adults: The recommended dose is 60 milligrams (mg) once a day. A lower starting dose of 30 mg once a day for 1 week may be desirable for some patients.
Adults: The total daily dose ranges from 40 mg (taken as 20 mg twice a day) to 60 mg (taken once a day or as 30 mg twice a day).
How should I take Cymbalta?Cymbalta can be taken with or without food. Do not crush, chew, or open the capsule; swallow whole.
What should I avoid while taking Cymbalta?Cymbalta may cause drowsiness and can affect judgment or motor skills. Avoid driving or operating heavy machinery until you know how Cymbalta affects you.
Cymbalta may increase your risk of bleeding. Avoid taking aspirin, nonsteroidal anti-inflammatory drugs, or blood-thinners (such as warfarin) while taking Cymbalta.
Cymbalta may cause liver damage. Avoid alcohol while taking Cymbalta as this can contribute to liver damage.
What are possible food and drug interactions associated with Cymbalta?Never take Cymbalta with the drug thioridazine.
Never combine Cymbalta with any drug classified as an MAOI. Cymbalta and MAOIs should not be taken together or within 14 days of each other.
If Cymbalta is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Cymbalta with the following: alcohol, aspirin, cimetidine, desipramine, fluoxetine, fluvoxamine, linezolid, lithium, narcotic painkillers, NSAIDs, paroxetine, phenothiazines, quinidine, quinolone antibiotics (such as ciprofloxacin), sleep inducers, other SNRIs (such as venlafaxine), other antidepressants (such as sertraline, nortriptyline, amitriptyline, and imipramine), St. John's wort, theophylline, tramadol, tranquilizers, triptans, tryptophan, Type IC antiarrhythmic drugs (such as propafenone), and warfarin.
What are the possible side effects of Cymbalta?Side effects cannot be anticipated. If any develop or change in intensity, tell your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking this drug.
Side effects may include: agitation, appetite changes, constipation, diarrhea, difficulty sleeping, difficulty urinating, dizziness, dry mouth, headache, nausea, sleepiness, excessive sweating, tiredness, tremor, vomiting, weakness
Can I receive Cymbalta if I am pregnant or breastfeeding?If Cymbalta is used in the third trimester of pregnancy, serious complications may occur to your unborn baby. The effects of Cymbalta during breastfeeding are unknown. Tell your doctor immediately if you are pregnant, plan to become pregnant, or are breastfeeding.
What should I do if I miss a dose of Cymbalta?If you miss a dose of Cymbalta, take the missed dose as soon as you remember it. However, if it is almost time for your next dose, skip the one you missed and return to your regular dosing schedule. Do not take two doses at once.
How should I store Cymbalta?Store at room temperature.