Cymbalta

Cymbalta Medication Information:

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Generic is available for less money: Generic Duloxetine

Cymbalta medication comes in several different strengths; click on the strength you need to view prices from pharmacies competing to earn your business.

Cymbalta 20 mg
Cymbalta 30 mg
Cymbalta 60 mg

Cymbalta General Information

Cymbalta is an antidepressant medication used in the treatment of depression, generalized anxiety disorder, diabetic nerve pain, and fibromyalgia.

How does Cymbalta work?

While the exact details are still unknown, it is believed that Cymbalta works by increasing the amount of serotonin and norepinephrine in the brain. These two neurotransmitters are known to affect mood as well as behavior. Serotonin is commonly associated with mood, while norepinephrine is associated with energy. As a Serotonin-Norepinephrine Reuptake Inhibitor, or SNRI, Cymbalta increases the levels of both of these neurotransmitters by stopping them from being reabsorbed into the brain. As a result, neurotransmission is enhanced; and, symptoms of depression and anxiety, such as sadness, fatigue, irritability, and muscle aches are greatly relieved.

When/How is Cymbalta taken/used/applied?

Cymbalta, or duloxetine hydrochloride, comes in delayed-release capsule form. It is available in twenty, thirty, and sixty milligram forms. Cymbalta is most commonly prescribed as a 60 mg capsule to be taken by mouth, once per day. It is recommended that the capsule be taken whole, not chewed, crushed, or sprinkled on food or in drinks. Cymbalta can but does not need to be taken with food. Missed doses can be taken when remembered unless it is time for the next dose. In this case the missed dose should be skipped and daily dosage should resume.

Side Effects of Cymbalta

The most common side effects of Cymbalta are nausea, constipation, drowsiness, dry mouth, an increase in sweating, and a decrease in appetite. Dizziness and weakness have also been reported in certain trials. Less common side effects are headaches, insomnia, diarrhea, sore throat, weakness, vomiting, decreased sex drive, coughing, shaking, frequent need to urinate, muscle pain, blurred vision, yawning, abdominal pain, vertigo, gas, indigestion, changes in taste, abnormal dreaming, and muscle spasms.

Other Brand Names for Cymbalta:

Currently no other brand names for Cymbalta

Safety Information:

Not everyone should take Cymbalta. Anyone who has taken a monoamine oxidase inhibitor, or MAOI, antidepressant in the recent past should not take this medication. Additionally, anyone taking Mellaril, or thioridazine, should not take Cymbalta. Finally, anyone with narrow-angle glaucoma should not take Cymbalta. Cymbalta has not been approved for use with children.

Dosage:

  • Delayed-release capsule 20mg
  • Delayed-release capsule 30mg
  • Delayed-release capsule 60mg

Visual Description:

  • Cymbalta 20mg capsules are oblong, green, and are imprinted with LILLY 3235 and 20mg.
  • Cymbalta 30mg capsules are oblong, white, and are imprinted with LILLY 3240 and 30mg.
  • Cymbalta 60mg capsules are oblong, blue, and are imprinted with LILLY 3237 and 60mg.

About Cymbalta

What Cymbalta is used for

Depression and/or anxiety

CYMBALTA has been prescribed by your doctor to relieve your symptoms of depression and/or excessive anxiety and worry, which can include feeling sad, restless, irritable, a change in appetite or weight, difficulty concentrating or sleeping, feeling tired, headaches, unexplained aches and pains.

Pain associated with Diabetic Peripheral Neuropathy (DPN)

CYMBALTA has been prescribed by your doctor to treat the pain associated with diabetic peripheral neuropathy (DPN), which is commonly described as burning, stabbing, stinging, shooting or aching or like an electric shock. There may be loss of feeling in the affected area, or sensations such as touch, heat, cold or pressure may cause pain.

Pain associated with Fibromyalgia (FM)

CYMBALTA is also used for the symptomatic relief of pain associated with fibromyalgia (a condition which includes widespread pain).

What Cymbalta does

Depression and/or anxiety

  • Depression and/or anxiety are illnesses that are believed to be caused by an imbalance of certain chemicals such as serotonin and norepinephrine.

  • CYMBALTA belongs to a group of medicines called serotonin and norepinephrine reuptake inhibitors (SNRIs).

  • By increasing the levels of serotonin and norepinephrine in your brain and other parts of your body, CYMBALTA helps relieve the emotional and physical symptoms of depression and/or anxiety.

  • CYMBALTA works to correct the imbalances of these chemicals.

  • CYMBALTA is a delayed-release formulation designed to prevent the duloxetine from being broken down in your stomach.

  • You may notice improvement within 1-4 weeks; it is important for you to continue therapy as directed by your doctor.

Pain Associated with Diabetic Peripheral Neuropathy and/or Fibromyalgia

  • Pain associated with diabetic peripheral neuropathy is a result of nerve damage believed to be caused by high blood sugar.

  • Fibromyalgia is a condition which includes widespread pain.

  • CYMBALTA belongs to a group of medicines called serotonin and norepinephrine reuptake inhibitors (SNRIs).

  • CYMBALTA affects two naturally occurring chemical messengers, or neurotransmitters, serotonin and norepinephrine. These chemicals exist in the brain and spinal cord and are thought to help dampen or “turn down” the feelings of pain.

  • CYMBALTA helps to manage the pain often associated with the disorder by increasing the activity of serotonin and norepinephrine, two neurotransmitters (chemical messengers) believed to be important in diabetic peripheral neuropathic pain and fibromyalgia.

  • You may notice improvement within 1 week; it is important for you to continue therapy as directed by your doctor.

When Cymbalta should not be used

Do not use CYMBALTA if you:

  • are allergic to it or any of the components of its formulation (see list of components at the end of this section). Stop taking the drug and contact your doctor immediately if you experience an allergic reaction (e.g., skin rash, hives) or any severe or unusual side effects.

  • have liver impairment. Liver impairment is when a person’s liver can no longer carry out its normal function. General symptoms of liver impairment may include: yellow skin, yellow eyes, decreased appetite, nausea, and dark urine.

  • have kidney impairment.

  • have uncontrolled narrow-angle glaucoma.

  • are currently taking monoamine oxidase inhibitors (MAOIs) (e.g. phenelzine sulphate, moclobemide or the antibiotic linezolid) or have discontinued treatment within the last 14 days.

  • are currently taking or have taken the drug thioridazine.

  • are currently taking a potent CYP1A2 inhibitor (e.g. fluvoxamine) or some antibiotics (e.g. ciprofloxacin, or enoxacine).

What the medicinal ingredient is

Duloxetine hydrochloride.

What the important nonmedicinal ingredients for Cymbalta are

CYMBALTA capsules contain the following inactive ingredients: FD&C blue No. 2, gelatin, hydroxypropyl methylcellulose, hydroxypropyl methylcellulose acetate succinate, sodium lauryl sulphate, sucrose, sugar spheres, talc, titanium dioxide, and triethyl citrate. The 60 mg capsules also contain iron oxide yellow.

What dosage forms Cymbalta comes in

CYMBALTA delayed-release capsules are available in 30 and 60 mg strengths of duloxetine.


Warnings and Precautions

During treatment with these types of medications, it is important that you and your doctor have good ongoing communication about how you are feeling.

CYMBALTA is not for use in children under 18 years of age.

New or Worsened Emotional or Behaviour Problems

Particularly in the first few weeks or when doses are adjusted, a small number of patients taking drugs of this type may feel worse instead of better; for example, they may experience unusual feelings of agitation, hostility or anxiety, or have impulsive or disturbing thoughts such as thoughts of self-harm or harm to others. Should this happen to you, or those in your care if you are a caregiver or guardian, consult your doctor immediately, do not discontinue your medication on your own.

BEFORE you use CYMBALTA talk to your doctor or pharmacist about

  • All your medical conditions, including a history of liver or kidney problems, diabetes, heart problems, or history of seizures.

  • If you have liver impairment. Liver impairment is when a person’s liver can no longer carry out its normal function. General symptoms of liver impairment may include: yellow skin, yellow eyes, decreased appetite, nausea, and dark urine.

  • Any medications (prescription or nonprescription) you are taking or have recently taken, especially MAOIs (e.g., phenelzine sulfate, tranylcypromine sulfate, moclobemide or selegeline), thiorizadine, any other antidepressants, any natural health products (including St. John’s Wort), or drugs used to thin the blood (anticoagulants).

  • If you have high blood pressure.

  • If you have low sodium levels in the blood (hyponatremia). Symptoms may include tiredness, weakness, confusion combined with achy, stiff, or uncoordinated muscles.

  • If you are pregnant or thinking about becoming pregnant, or if you are breastfeeding.

  • Your habits of alcohol and/or street drug consumption.

  • If you have ever had an allergic reaction to any medication.

  • If you have a rare hereditary problem of fructose (a type of sugar) intolerance

  • If you drive a vehicle or perform hazardous tasks during your work.

Effects on Pregnancy and Newborns

Post-marketing reports indicate that some newborns whose mothers took an SSRI (selective serotonin reuptake inhibitor) or other newer antidepressants, such as CYMBALTA, during pregnancy have developed complications at birth requiring prolonged hospitalization, breathing support and tube feeding. Reported symptoms included feeding and/or breathing difficulties, seizures, tense or overly relaxed muscles, jitteriness, and constant crying.

In most cases, the newer antidepressant was taken during the third trimester of pregnancy. These symptoms are consistent with either a direct adverse effect of the antidepressant on the baby, or possibly a discontinuation syndrome caused by sudden withdrawal from the drug. These symptoms normally resolve over time. However, if your baby experiences any of these symptoms, contact your doctor as soon as you can.

If you are pregnant and taking an SSRI, or other newer antidepressant, you should discuss the risks and benefits of the various treatment options with your doctor. It is very important that you do NOT stop taking these medications without first consulting your doctor. See Side Effects and What to Do About Them: for more information.


Interactions with Cymbalta

Do not use CYMBALTA if you are taking or have recently taken monoamine oxidase inhibitors (MAOIs), linezolid or thioridazine.

You should inform your doctor if you are taking or have recently taken any medications (prescription, over-the-counter or natural/herbal) especially:

  • other antidepressants, such as SSRIs or SNRIs (e.g. fluoxetine, venlafaxine, paroxetine), certain tricyclics (e.g. amitriptyline), drugs used to treat schizophrenia (e.g. olanzapine, risperidone), or bipolar depression (e.g. lithium)

  • drugs which may affect blood clotting and increase bleeding, such as drugs used to thin the blood (anticoagulants, e.g. warfarin), as well as acetylsalicylic acid (e.g. aspirin) and other non-steroidal anti-inflammatory drugs (e.g. ibuprofen)

  • certain medicines used to treat patients with irregular heart beats

  • other drugs that affect serotonin, such as lithium, tramadol, drugs containing tryptophan, St. Johns Wort, triptans used to treat migraines

  • antibiotics such as ciprofloxacin, enoxacine or linezolid

As with many drugs that work directly on the brain, use of alcohol should be kept to a minimum while taking CYMBALTA.


Proper Use of Cymbalta

Usual dose for adults

  • It is very important that you take CYMBALTA exactly as your doctor has instructed. The usual dose is 60 mg once daily. Your doctor may adjust the dose during the course of your treatment.

  • Never increase the amount of CYMBALTA you are taking unless your doctor tells you.

  • CYMBALTA is usually taken once a day.

  • CYMBALTA capsules may be taken with or without food; however, food may help reduce the incidence of initial nausea.

  • CYMBALTA should be swallowed whole and should not be chewed or crushed, nor should the contents be sprinkled on food or mixed with liquids. All of these might affect the enteric coating.

  • You should not open CYMBALTA capsules, but if they are accidentally opened or broken, avoid contact with the powder and wash away any loose powder as soon as possible with water. If any of the powder gets in your eyes you should rinse them with water immediately and contact your doctor.

  • Keep taking your CYMBALTA until the doctor tells you to stop. Your doctor may tell you to continue to take your medicine for several months or longer.

  • Talk to your doctor before you stop taking CYMBALTA on your own. See Side Effects and What to Do About Them: for more information.

  • Patients being treated for pain associated with diabetic peripheral neuropathy: Although CYMBALTA does not change the underlying nerve damage caused by diabetic peripheral neuropathy, it can help you manage the pain often associated with the disorder. It is important that you continue to see your doctor regularly for proper management of diabetes. This will help to control blood sugar levels, and prevent further nerve damage. It is also important that you continue to do daily foot examinations.

Remember: This medicine has been prescribed only for you. Do not give it to anybody else, as they may experience undesirable effects, which may be serious.

Cymbalta Facts

The FDA approved Cymbalta for the treatment of depression in 2004.

Cymbalta was developed by Eli Lilly and Company, which is headquartered in Indianapolis, Indiana.

Cymbalta's sales worldwide were more than $2 billion dollars in 2007.

Eli Lilly and Company, founded in 1876, was in 2009 the world's tenth largest pharmaceutical company.

 

Technical Information