Cymbalta

Generic name: Duloxetine hydrochloride

What is Cymbalta?

Cymbalta is used to treat major depression and diabetic neuropathy, a painful nerve disorder associated with diabetes that affects the hands, legs, and feet. Cymbalta is also used to treat generalized anxiety disorder and fibromyalgia.

What is the most important information I should know about Cymbalta?

Cymbalta is not approved for use in children or adolescents.

Antidepressant medicines 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. Some people may have a particularly high risk of having suicidal thoughts or actions. These include people who have (or have a family history of) bipolar disorder (also called manic-depressive illness) or suicidal thoughts or actions.

Individuals being treated with antidepressants and their caregivers can help reduce the risk of suicidal thoughts and actions by doing the following:

Pay close attention to any changes, especially sudden ones, in mood, behavior, thoughts, or feelings. This is very important when an antidepressant medicine is first started or when the dose is changed.

Call the doctor right away to report new or sudden changes 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.

Keep all follow-up visits as scheduled, and call the doctor between visits as needed, especially if you have concerns about symptoms.

Who should not take Cymbalta?

Do not use Cymbalta if you are allergic to it; if you are taking a monoamine oxidase inhibitor (MAOI) or the drug thioridazine; if you have uncontrolled increased pressure in your eyes (narrow-angle glaucoma); or if you have serious kidney or liver disease or 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, or if you consume large amounts of alcohol.

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.

Major Depression

Adults: The total daily dose ranges from 40 milligrams (mg) taken as a 20-mg capsule twice a day to 60 mg taken as a 60-mg capsule once a day or as a 30 mg capsule taken twice a day.

Diabetic Peripheral Neuropathy, Generalized Anxiety Disorder, and Fibromyalgia

Adults: The recommended dose is 60 mg taken once daily.

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 this drug affects you.

What are possible food and drug interactions associated with Cymbalta?

Never take Cymbalta with the drug thioridazine.

Due to the possibility of liver damage, do not take Cymbalta if you use alcohol more than occasionally.

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: antibiotics known as quinolones, such as ciprofloxacin; antidepressants known as tricyclics, including amitriptyline, nortriptyline, and imipramine; antidepressants such as fluoxetine, paroxetine, sertraline, and venlafaxine; antipsychotic medications known as phenothiazines, including chlorpromazine, fluphenazine, mesoridazine, perphenazine, and prochlorperazine; flecainide; fluvoxamine; narcotic painkillers; propafenone; quinidine; sleep inducers; and tranquilizers.

Never combine Cymbalta with any drug classified as an MAOI. Drugs in this category include the antidepressants phenelzine and tranylcypromine. Cymbalta and MAOIs should not be taken together or within 14 days of each other. Combining these drugs with Cymbalta can cause serious and even fatal reactions such as high body temperature, muscle rigidity, twitching, and agitation leading to delirium and coma.

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: appetite changes, constipation, diarrhea, dizziness, dry mouth, fatigue, headache, insomnia, nausea, sexual difficulties, sleepiness, sweating, tremor, urinary difficulties, vomiting, weakness

Can I receive Cymbalta if I am pregnant or breastfeeding?

The effects of Cymbalta during pregnancy and breastfeeding are unknown. Talk with your doctor before taking this drug if you are pregnant or plan to become pregnant. Avoid breastfeeding while taking Cymbalta.

What should I do if I miss a dose of Cymbalta?

Take the missed dose as soon as you remember. However, if it is almost time for your next dose, skip the one you missed and return to your regular schedule. Do not take two doses at once.

How should I store Cymbalta?

Store at room temperature.