Cymbalta (Duloxetine HCl)
Cymbalta
Duloxetine HCl
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Duloxetine (Generic)
Duloxetine HCl
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Duloxetine Hydrochloride (Generic)
Duloxetine Hydrochloride
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Cymbalta (Duloxetine HCl)?

What is Cymbalta?

Cymbalta is an oral medication containing the active ingredient duloxetine, prescribed primarily to treat depression and anxiety. It can also relieve nerve pain in diabetics or chronic back pain, arthritic pain, or fibromyalgia. Duloxetine belongs to a group of drugs known as serotonin-norepinephrine reuptake inhibitors (SNRI’s), which function to restore the balance of serotonin and norepinephrine in the brain.

Dosage

Cymbalta is to be taken by mouth once or twice a day as directed by your doctor. It can be taken with or without food, although taking it with food can help with nausea. Do not crush, chew, or dissolve the capsule as this can release all the drug at once, leading to negative side effects. It must be swallowed whole.

Dosage is calculated based on age, the severity of medical condition, and response to treatment.

Storage

This medication should be stored in its packaging until it is time to take them. Store in a place that will not exceed 25°C, out of direct sunlight and away from moisture. Keep out of reach of children and pets. Do not consume expired medication. Dispose of expired or surplus medication responsibly, following the directions of your healthcare provider. Do not flush medication down the toilet or sink.

Side Effects

Common Side Effects

All medications come with a risk of side effects. It is important to recognize that your doctor has determined that the risk of side effects is outweighed by the potential benefit this medication can provide. Side effects differ between individuals, and it is possible you will not experience any. Common side effects associated with Cymbalta are:

  • Nausea
  • Dry mouth
  • Constipation
  • Appetite loss
  • Drowsiness/fatigue
  • Unusual sweating

If you are worried about any of the above side effects, contact your healthcare provider, particularly if they worsen or do not resolve on their own.

Moderate Side Effects

Tell your doctor if you experience any of the following:

  • Confusion
  • Decreased libido
  • Changes in sexual ability
  • Muscle weakness or cramps
  • Tremor
  • Trouble urinating
  • Persistent nausea, abdominal pain, vomiting, yellowing of the skin or eyes, dark urine (signs of liver problems)
  • Easy bruising or bleeding

Severe Side Effects

Occasionally, Cymbalta can be associated with severe side effects that should be taken seriously. Seek medical attention right away if you experience any of the following:

  • Bloody or black stools
  • Vomit that resembles coffee grounds
  • Seizures
  • Pain, swelling, or redness of the eyes
  • Blurred vision or vision changes

As this medication increases serotonin levels in the brain, it can lead to a condition called serotonin toxicity (or serotonin syndrome). Taking other medications that increase serotonin concurrently increases the risk of this occurring. Seek medical attention immediately if you experience tachycardia (rapid heart rate), hallucinations, coordination loss, extreme dizziness, severe nausea, vomiting, and/or diarrhea, muscle twitching, idiopathic fever, or unusual restlessness.

Allergic reactions to Cymbalta are rare but not impossible. If you experience a rash, itching, facial swelling, severe dizziness, difficulty breathing, blisters on the skin, or mouth sores, get medical help right away.

This is not an exhaustive list of potential side effects. If you notice any unusual changes while taking this medication, consult your healthcare provider.

Warnings & Precautions

Allergies

Inform your doctor if you are allergic to any of the ingredients in Cymbalta, including the active ingredient duloxetine. Ensure your doctor is aware of any other allergies you have.

Medical History

Make sure your doctor is aware of your medical history, both family and personal, particularly of psychiatric disorders, suicide attempts, bleeding disorders, glaucoma, hypertension, liver or kidney disease, seizures, stomach problems, or substance abuse. They may like to adjust your medication schedule based on your history.

Dizziness

This medication can cause dizziness. It is recommended to avoid other products that can exacerbate this dizziness, such as alcohol and marijuana. Do not operate heavy machinery (including driving) until you are sure how this drug affects you.

Diabetes

Cymbalta can affect your blood sugar if you are diabetic. Monitor your blood sugar carefully while taking Cymbalta and share any changes or abnormalities with your doctor. They may need to adjust your medication or exercise schedule to accommodate.

Surgery

Always tell your doctor what medication you regularly take (including prescription and non-prescription) before having surgery.

Older Adults

Older adults can be more susceptible to side effects such as bleeding, light-headedness, and coordination loss. They are also more likely to develop hyponatremia (salt imbalance), especially if they are taking diuretics.

Children

Children can experience a greater susceptibility to appetite and weight loss. Monitor the weight and height of children taking Cymbalta. It is not recommended in children under seven years of age.

Pregnancy

Cymbalta is not normally recommended for people who are pregnant unless it is absolutely necessary. Cymbalta can increase the risk of bleeding at birth when taken in the final 30 days of gestation and may pose a risk to the unborn baby.

Breastfeeding

This medication can pass into breast milk and have negative effects on a nursing baby. It is therefore not recommended for people who are breastfeeding.

Interactions & Contraindications

Medications taken concurrently can interact with one another, changing how they act in the body or increasing the risk of side effects. Inform your doctor of all the medications you take regularly, including prescription and non-prescription drugs. They may adjust your medication schedule to accommodate Cymbalta. Do not start, stop, or change the dosage of any medication without talking to your doctor first.

Products that can interact with Cymbalta include drugs that cause bleeding, such as antiplatelets, NSAIDS, and blood thinners. Others can affect how duloxetine is removed from the body, which in turn affects its function. These include cimetidine, viloxazine, quinolone antibiotics, among others. Further, Cymbalta can affect how other medications are removed from the body, such as antiarrhythmic drugs, antipsychotics, and tricyclic antidepressants.

MAO inhibitors can have a severe reaction when taken with Cymbalta, possibly even fatal. All MAO inhibitors should be avoided while taking Cymbalta, including two weeks before starting and five days after finishing the medication.

The risk of developing serotonin syndrome increases when Cymbalta is taken in conjunction with other medications that also increase serotonin. Examples include MDMA, St John’s wort, other selective serotonin reuptake inhibitors (SSRI’s), other SNRI’, and tryptophan, among others. Take caution when combining these medications.

Check with your healthcare provider if you are taking other medications that lead to drowsiness, such as alcohol, marijuana, antihistamine, sleep medication, muscle relaxants, or opioid pain relievers. As Cymbalta can also lead to drowsiness, care must be taken when combining these medications.

Aspirin can lead to an increased risk of bleeding when taken alongside Cymbalta. If you are taking aspirin in a low dose for heart attack or stroke prevention then continue to do so regularly unless your doctor instructs you otherwise.

Frequently Asked Questions

Cymbalta contains the active ingredient duloxetine, which belongs to a group of drugs called serotonin-norepinephrine reuptake inhibitors (SNRI’s), which function to prolong the effects of serotonin and norepinephrine in the brain by delaying their reuptake. This is used to treat depression, anxiety, and chronic pain conditions.

Clinical treatment guidelines recommend staying on Cymbalta for four to twelve months once improvements are seen. Many people choose to take Cymbalta long term.

Improvements may be seen in one to two weeks after starting Cymbalta, however, it may take up to six to eight weeks to feel the full effects. This is dependent on taking the medication consistently and may differ between individuals.

If you miss a dose of Cymbalta, take it as soon as you remember. If you remember close to the time of your next dose, skip the missed dose altogether. Take the following dose according to your medication schedule. Do not take both doses to catch up.

Stopping Cymbalta suddenly can lead to negative side effects such as agitation, confusion, and tingling of the body. Your doctor will likely gradually decrease your dose to avoid this.

Cymbalta should not be prescribed to pregnant people (unless required), people who are breastfeeding, children under seven years of age, or people who are allergic to the ingredients.

Weight changes with Cymbalta are typically minimal but are more likely to occur in the first nine weeks of treatment. If you are concerned with weight gain (or loss), contact your doctor.