cymbalta

Cymbalta (duloxetine) is a selective serotonin and norepinephrine reuptake inhibitor antidepressant (SSNRI). Duloxetine affects chemicals in the brain that may become unbalanced and cause depression.

Cymbalta is used to treat major depressive disorder in adults. It is also used to treat general anxiety disorder in adults and children who are at least 7 years old.

Cymbalta is also used in adults to treat fibromyalgia (a chronic pain disorder), or chronic muscle or joint pain (such as low back pain and osteoarthritis pain).

Cymbalta is also used to treat pain caused by nerve damage in adults with diabetes (diabetic neuropathy).

Important information

You should not use Cymbalta if you have untreated or uncontrolled glaucoma, or if you also take thioridazine.

Do not use Cymbalta if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others. After you stop taking Cymbalta, you must wait at least 5 days before you start taking an MAOI.

Some young people have thoughts about suicide when first taking an antidepressant. Your doctor will need to check your progress at regular visits while you are using Cymbalta. Your family or other caregivers should also be alert to changes in your mood or symptoms.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Before taking this medicine

You should not use this Cymbalta if you are allergic to duloxetine, or if you have untreated or uncontrolled glaucoma.

Do not use Cymbalta if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others. After you stop taking Cymbalta, you must wait at least 5 days before you start taking an MAOI.

To make sure Cymbalta is safe for you, tell your doctor if you have:

• liver or kidney disease;

• seizures or epilepsy;

• a bleeding or blood clotting disorder;

• high blood pressure;

• narrow-angle glaucoma;

• bipolar disorder (manic depression); or

• a history of drug abuse or suicidal thoughts.

Some young people have thoughts about suicide when first taking an antidepressant. Your doctor will need to check your progress at regular visits while you are using Cymbalta. Your family or other caregivers should also be alert to changes in your mood or symptoms.

It is not known whether Cymbalta will harm an unborn baby. However, Cymbalta may cause problems in a newborn if you take the medicine during the third trimester of pregnancy. Tell your doctor if you are pregnant or plan to become pregnant while using this medicine.

If you are pregnant, your name may be listed on a pregnancy registry. This is to track the outcome of the pregnancy and to evaluate any effects of Cymbalta on the baby.

Duloxetine can pass into breast milk and may harm a nursing baby. You should not breast-feed while taking this medicine.

Do not give this medicine to anyone younger than 18 years old without the advice of a doctor.

How should I take Cymbalta?

Take Cymbalta exactly as prescribed by your doctor. Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Try to take the medicine at the same time each day. Follow the directions on your prescription label.

Do not crush, chew, break, or open an extended-release capsule. Swallow it whole.

It may take 4 weeks or longer before your symptoms improve. Keep using the medication as directed. Do not stop using Cymbalta without first talking to your doctor. You may have unpleasant side effects if you stop taking this medicine suddenly.

Store at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking Cymbalta?

Avoid drinking alcohol. It may increase your risk of liver damage.

Ask your doctor before taking a nonsteroidal anti-inflammatory drug (NSAID) for pain, arthritis, fever, or swelling. This includes aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib (Celebrex), diclofenac, indomethacin, meloxicam, and others. Using an NSAID with Cymbalta may cause you to bruise or bleed easily.

Cymbalta may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall. Severe dizziness or fainting can cause falls, accidents, or severe injuries.

Cymbalta side effects

Get emergency medical help if you have any signs of an allergic reaction to Cymbalta: skin rash or hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have:

• a light-headed feeling, like you might pass out;

• blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights;

• easy bruising, unusual bleeding;

• painful or difficult urination;

• liver problems - nausea, upper stomach pain, itching, tired feeling, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);

• high levels of serotonin in the body - agitation, hallucinations, fever, fast heart rate, overactive reflexes, nausea, vomiting, diarrhea, loss of coordination, fainting;

• low levels of sodium in the body - headache, confusion, slurred speech, severe weakness, vomiting, loss of coordination, feeling unsteady;

• severe nervous system reaction - very stiff (rigid) muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors; or

• severe skin reaction - fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Older adults may be more sensitive to the side effects of this medicine.

Common Cymbalta side effects may include:

• vision changes;

• dry mouth;

• drowsiness, dizziness;

• tired feeling;

• loss of appetite; or

• increased sweating.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

What other drugs will affect Cymbalta?

Taking this medicine with other drugs that make you sleepy can worsen this effect. Ask your doctor before taking Cymbalta with a sleeping pill, narcotic pain medicine, muscle relaxer, or medicine for anxiety, depression, or seizures.

Many drugs can interact with duloxetine. Not all possible interactions are listed here. Tell your doctor about all your medications and any you start or stop using during treatment with Cymbalta, especially:

• any other antidepressant;

• cimetidine;

• St. John"s wort;

• theophylline;

• tryptophan (sometimes called L-tryptophan);

• an antibiotic - ciprofloxacin, enoxacin;

• a blood thinner - warfarin, Coumadin, Jantoven;

• heart rhythm medication - flecainide, propafenone, quinidine, and others;

• narcotic pain medicine - fentanyl, tramadol;

• medicine to treat mood disorders, thought disorders, or mental illness - buspirone, lithium, and many others; or

• migraine headache medicine - sumatriptan, rizatriptan, zolmitriptan, and others.

This list is not complete and many other drugs can interact with duloxetine. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Give a list of all your medicines to any healthcare provider who treats you.