Cymbalta (Duloxetine HCl)

Cymbalta (duloxetine) is an oral capsule used to treat depression, generalized anxiety disorder, diabetic nerve pain, fibromyalgia, and chronic musculoskeletal pain. It works by increasing serotonin and norepinephrine levels in the brain, which may help improve mood, ease anxiety, and manage pain. It is available in several strengths and comes as a delayed-release capsule.

Directions

Take Cymbalta exactly as prescribed by your doctor or healthcare provider. Swallow the capsule whole; do not crush, chew, or open it. Cymbalta may be taken with or without food.

For major depressive disorder, the typical starting dose is 40 to 60 mg per day, taken once daily or divided into two doses. For generalized anxiety disorder, the recommended dose is 60 mg once daily, though your doctor may start you at a lower dose. For diabetic nerve pain, the dose is 60 mg once daily. For fibromyalgia and chronic musculoskeletal pain, the usual starting dose is 30 mg once daily for one week, then increased to 60 mg once daily. Do not stop taking Cymbalta suddenly without your doctor's guidance.

Ingredients

The active ingredient in Cymbalta is duloxetine hydrochloride. Inactive ingredients may include FD and C Blue No. 2, gelatin, hypromellose, hydroxypropyl methylcellulose acetate succinate, sodium lauryl sulfate, sucrose, sugar spheres, talc, titanium dioxide, and triethyl citrate. The 20 mg and 60 mg capsules also contain iron oxide yellow.

Cautions

Before using this medication, you may want to consult a healthcare provider about the following:

• Any existing health conditions
• Any allergies
• A list of all medications currently being taken

Cymbalta carries a boxed warning about an increased risk of suicidal thoughts and behavior in children, adolescents, and young adults under 25 years of age. Patients and caregivers should monitor closely for changes in mood or behavior, especially during the first few months of treatment or when the dose is changed.

Cymbalta may cause liver damage. Tell your doctor if you have a history of liver disease or heavy alcohol use.

This medication may cause dizziness, lightheadedness, or fainting when standing up, also known as orthostatic hypotension, especially when first starting treatment. It is important to get up slowly from sitting or lying down.

Serotonin syndrome, a potentially life-threatening condition, can occur when Cymbalta is used with other serotonergic drugs. Seek immediate medical attention if you develop agitation, hallucinations, rapid heartbeat, fever, muscle stiffness, or loss of coordination.

Cymbalta may increase the risk of bleeding, especially when taken with blood thinners, aspirin, or NSAIDs.

Do not stop taking Cymbalta abruptly. Gradually reducing the dose under medical supervision is recommended to avoid discontinuation symptoms such as dizziness, nausea, headache, and irritability.

Contraindications

Avoid taking or using this medication if any of the following apply:

• You are currently taking a monoamine oxidase inhibitor (MAOI) or have taken one within the last 14 days
• You are being treated with linezolid or intravenous methylene blue
• You have a known hypersensitivity to duloxetine or any of the inactive ingredients in Cymbalta

Side Effects

Common side effects of Cymbalta include:

• Nausea
• Headache
• Dry mouth
• Drowsiness
• Fatigue
• Constipation
• Dizziness
• Decreased appetite
• Increased sweating

Serious side effects are rare but can include suicidal thoughts or behavior, liver problems, serotonin syndrome, severe skin reactions, and unusual bleeding or bruising.

Symptoms of liver problems may include dark urine, yellowing of the skin or eyes, or unexplained abdominal pain.

Seek medical attention immediately if you experience any of these.