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Cymbalta Patient Tips

Medically reviewed on Aug 21, 2017 by C. Fookes, BPharm.

How it works

  • Cymbalta is a brand (trade) name for duloxetine. Duloxetine may be used in the treatment of depression, chronic pain, or anxiety. Experts aren't sure exactly how duloxetine works but believe its antidepressant, pain relieving and anti-anxiety actions are due to its ability to enhance the effects of serotonin and noradrenaline in the central nervous system.
  • Cymbalta belongs to a group of medicines called Selective Serotonin and Norepinephrine Reuptake Inhibitors (SSNRIs).

Upsides

  • Used in the treatment of moderate-to-severe depression (Major Depressive Disorder).
  • May be used to relieve symptoms of anxiety in adults and children aged over 7 years with generalized anxiety disorder.
  • May relieve nerve pain associated with diabetes (diabetic peripheral neuropathy).
  • May be used to relieve pain associated with fibromyalgia and in the treatment of chronic musculoskeletal pain.
  • Cymbalta is available as a generic under the name duloxetine.

Downsides

If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include:

  • Drowsiness, insomnia, nausea, a headache, dry mouth constipation and dizziness are the most commonly reported side effects. Most people experience side effects with duloxetine and one in six stop taking the drug because of them.
  • An increased risk of suicidal thoughts, especially in young adults under the age of 24 (similar to other antidepressants).
  • Associated with a discontinuation syndrome if stopped abruptly or even when tapered. Symptoms may include anxiety, headache, dizziness, diarrhea, abnormal sensations such as pins and needles, irritability, insomnia, increased sweating, and tiredness. Discontinue slowly on a doctor's advice.
  • Interaction or overdosage may cause serotonin syndrome (symptoms include mental status changes [such as agitation, hallucinations, coma, delirium), fast heart rate, dizziness, flushing, muscle tremor or rigidity and stomach symptoms (including nausea, vomiting, and diarrhea).
  • May precipitate a manic episode in people with undiagnosed bipolar disorder.
  • May cause a lowering of blood pressure - this may be particularly noticeable when going from a sitting to standing position. May also increase blood pressure in some people.
  • May increase the risk of bleeding; caution when using with other drugs that increase bleeding risk (such as aspirin and NSAIDs).
  • May cause a lowering of total body sodium (called hyponatremia); elderly people or people taking diuretics or already dehydrated may be more at risk.
  • The dosage of Cymbalta needs reducing in people with mild to moderate kidney or liver disease. Avoid in severe kidney and liver disease.
  • May worsen blood sugar control in people with diabetes.

Notes: In general, seniors or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures) or people who take other medications are more at risk of developing a wider range of side effects. For a complete list of all side effects, click here.

Bottom Line

Cymbalta has antidepressant, anti-anxiety, and pain-relieving properties; however, it has been associated with a discontinuation syndrome on withdrawal even when tapered.

Tips

  • May be taken with or without food.
  • Cymbalta is a delayed-release product. Swallow Cymbalta capsules whole, do not crush or chew. Do not open the capsule and sprinkle on foods or liquids, as this may affect the way the contents of the capsule are absorbed.
  • Dosages of 30 mg/day for at least one week may be desirable initially to improve tolerance to the effects of Cymbalta. There is no evidence that dosages greater than 60mg/day offer any additional benefit.
  • Cymbalta may make you feel dizzy when going from a sitting or lying position to standing. Get up slowly.
  • Report to your doctor any signs of worsening of depression or suicidal thoughts particularly during the first few months of therapy. Also report any symptoms such as agitation, hallucinations, a fast heart rate, dizziness, flushing, muscle tremor or rigidity, nausea, vomiting or diarrhea.
  • Do not stop suddenly as withdrawal or discontinuation symptoms may occur. Taper off slowly on a doctor's advice.
  • Do not drive or operate machinery if this medicine makes you drowsy or impairs your judgment. Avoid alcohol.
  • Report any problems with bleeding or bruising to your doctor. Also report any unexplained skin changes (such as blisters or rashes), problems with urination, eye pain or swelling, and vision changes.

Response and Effectiveness

  • May take up to two hours before absorption occurs. Peak concentrations are reached approximately six hours after a dose. Full clinical effects (including relief from depression, anxiety, or pain) may not occur for several weeks.
  • For some conditions (such as diabetic peripheral neuropathy), 60mg of Cymbalta is as effective as 120mg, with fewer side effects.
  • Generally, dosages greater than 60mg a day are associated with more side effects.

References

Cymbalta (duloxetine hydrochloride) [Package Insert]. Reviewed 10/2016. Eli Lilly and Company https://www.drugs.com/pro/cymbalta.html

  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Cymbalta only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that this information is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. This drug information does not endorse drugs, diagnose patients or recommend therapy. It is an informational resource designed as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Drugs.com does not assume any responsibility for any aspect of healthcare administered with the aid of this information. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2017 Drugs.com. Revision Date: 2017-08-21 03:12:17

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