- Uses
- What is duloxetine (Cymbalta) and what is it used for?
- Side Effects
- What are the side effects of duloxetine (Cymbalta)?
- Dosage
- What is the dosage for duloxetine (Cymbalta)?
- Drug Interactions
- What drugs interact with duloxetine (Cymbalta)?
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- Is Cymbalta (duloxetine) safe to take if I'm pregnant or breastfeeding?
- Things to Know
- What else should I know about Cymbalta (duloxetine)?
- Comments
- **COMMENTSTAGLIST**
- More
- **OTHERTAGLIST**
Brand Name: Cymbalta
Generic Name:duloxetine
Drug Class: Antidepressants, SNRIs
What is duloxetine (Cymbalta) and what is it used for?
Duloxetine (Cymbalta) is a selective serotonin and norepinephrine reuptake inhibitor (SNRI) antidepressantused for treating depression, anxiety disorder, and pain. Other drugs in this class include milnacipran (Savella), venlafaxine (Effexor), and desvenlafaxine (Pristiq).
Duloxetine (Cymbalta) is used for the treatment of depression, generalized anxiety disorder, pain associated with diabetic peripheral neuropathy, fibromyalgia, and chronic musculoskeletal pain.
Duloxetine (Cymbalta) affects neurotransmitters, the chemicals that nerves within the brain make and release in order to communicate with one another. Neurotransmitters either travel across the space between nerves and attach to receptors on the surface of nearby nerves or they attach to receptors on the surface of the nerves that produced them, to be taken up by the nerve and released again (a process referred to as re-uptake).
Many experts believe that an imbalance among neurotransmitters is the cause of depression as well as other psychiatric disorders. Serotonin and norepinephrine are two neurotransmitters released by nerves in the brain. Duloxetine (Cymbalta) works by preventing the reuptake of serotonin and epinephrine by nerves after they have been released.
Since uptake is an important mechanism for removing released neurotransmitters and terminating their actions on adjacent nerves, the reduced uptake caused by Duloxetine (Cymbalta) increases the effect of serotonin and norepinephrine in the brain. The mechanism responsible for its effectiveness in treating pain is not known but also is thought to involve its effects on serotonin and norepinephrine in the brain. Cymbalta (duloxetine) was approved by the FDA in August 2004.
Duloxetine (Cymbalta) is approved for treating the following conditions:
- Major depressive disorder (MDD)
- Generalized anxiety disorder (GAD)
- Diabetic peripheral neuropathic pain
- Fibromyalgia
- Chronic musculoskeletal pain
What are the side effects of duloxetine (Cymbalta)?
The most common side effects of Duloxetine (Cymbalta) are nausea, dry mouth, constipation, diarrhea, fatigue, difficulty sleeping, and dizziness. Increased blood pressure can occur and should be monitored. Seizures have been reported. Sexual dysfunction (decreased sex drive and delayed org*sm and ejacul*tion) has been associated with duloxetine (Cymbalta).
Some patients may experience withdrawal reactions upon stopping duloxetine (Cymbalta). Symptoms of withdrawal include:
- dizziness,
- anxiety,
- nausea,
- vomiting,
- nervousness,
- diarrhea,
- irritability, and
- insomnia.
The duloxetine (Cymbalta) dosage should be gradually reduced when therapy is discontinued to prevent symptoms of withdrawal.
Antidepressants increased the risk of suicidal thinking and behavior (suicidality) in short-term studies in children and adolescents with depression and other psychiatric disorders. Anyone considering the use of Cymbalta (duloxetine) or any other antidepressant in a child or adolescent must balance this risk with the clinical need. Patients who are started on therapy should be closely observed for clinical worsening, suicidality, or unusual changes in behavior.
What is the dosage for duloxetine (Cymbalta)?
The recommended dose of duloxetine (Cymbalta) for treating depression is 20 or 30 mg twice daily or 60 mg once daily. Patients may be started with 30 mg once daily for one week before the dose is advanced to 60 mg daily.
The recommended dose of duloxetine (Cymbalta) for anxiety disorder, pain associated with diabetic neuropathy, fibromyalgia, or chronic musculoskeletal pain is 60 mg daily. Starting at 30 mg daily for one week before increasing to 60 mg daily may help patients adjust to the drug. No evidence that doses greater than 60 mg/day provide additional benefits. However, the maximum dose for depression or anxiety disorder is 120 mg/day.
What drugs interact with duloxetine (Cymbalta)?
- Duloxetine (Cymbalta) should not be used in combination with a monoamine oxidase inhibitor (MAOI) such as phenelzine (Nardil), tranylcypromine (Parnate), isocarboxazid (Marplan), and selegiline (Eldepryl), or within 14 days of discontinuing the MAOI. At least 5 days should be allowed after stoppingCymbalta (duloxetine)before starting an MAOI. Combinations of SNRIs and MAOIs may lead to serious, sometimes fatal, reactions including very high body temperature, muscle rigidity, rapid fluctuations of heart rate and blood pressure, extreme agitation progressing to delirium, and coma. Similar reactions may occur if Cymbalta (duloxetine) is combined with antipsychotics, tricyclic antidepre, scents, or other drugs that affect serotonin in the brain. Examples include tryptophan, sumatriptan (Imitrex), lithium, linezolid (Zyvox), tramadol (Ultram), and St. John’s Wort.
- Fluoxetine (Prozac, Serafem), paroxetine (Paxil, Paxil CR, Pexeva), fluvoxamine (Luvox), and quinidine increase blood levels of duloxetine by reducing its metabolism in the liver. Such combinations may increase the adverse effects of Cymbalta (duloxetine).
- Combining duloxetine with aspirin, nonsteranti-inflammatorymatory drugs (NSAIDs), warfarin (Cou,madin), or other drugs that are associated with bleeding may increase the risk of bleeding because duloxetine itself is associated with bleeding.
- Duloxetine (Cymbalta) has an enteric coating that prevents dissolution until it reaches a segment of the gastrointestinal that has a pH higher than 5.5. In theory, drugs that raise the pH in the gastrointestinal system (for example, Prilosec) may cause duloxetine to be released early while conditions that slow gastric emptying (for example, diabetes) may cause premature breakdown of duloxetine. Nevertheless, administration of duloxetine with an antacid or famotidine (Axid) did not significantly affect the absorption of duloxetine.
- Cymbalta (duloxetine) may reduce the breakdown of desipramine (Norpramine), leading to increased blood concentrations of desipramine and potential side effects.
Is Cymbalta (duloxetine) safe to take if I'm pregnant or breastfeeding?
Cymbalta (duloxetine) is excreted into the milk of lactating women. Because the safety of Cymbalta (duloxetine) in infants is not known, breastfeeding while on Cymbalta (duloxetine) is not recommended.
What else should I know about Cymbalta (duloxetine)?
Do I need a prescription for Cymbalta (duloxetine)?
Yes, a prescription is needed.
What brand names are available for duloxetine?
Cymbalta
What preparations of Cymbalta (duloxetine) are available?
Delayed-release capsules: 20, 30, and 60 mg
How should I keep Cymbalta (duloxetine) stored?
Capsules should be stored at room temperature, between 15 C to 30 C (59 F to 86 F).
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Summary
Duloxetine (Cymbalta) is in the drug class SSRI. Cymbalta is prescribed for the treatment of depression, generalized anxiety disorder, and neuropathic pain associated with diabetic peripheral neuropathy. The most common side effects of Cymbalta are nausea, dry mouth, constipation, diarrhea, insomnia, and dizziness.
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Related Disease Conditions
- Peripheral Neuropathy Peripheral neuropathy occurs when peripheral nerves become damaged. Peripheral neuropathy causes include diabetes, shingles, vitamin deficiency, and alcohol use. Learn about the four types of peripheral neuropathy.
- Anxiety Disorders Anxiety is a feeling of apprehension and fear characterized by symptoms such as trouble concentrating, headaches, sleep problems, and irritability. Anxiety disorders are serious medical illnesses that affect approximately 19 million American adults. Treatment for anxiety may incorporate medications and psychotherapy.
- Pain Management The goal of pain management for each patient is to minimize suffering and improve quality of life. This goal may be different depending on the patient’s circ*mstances and disease or injury.
- Fibromyalgia Fibromyalgia is a chronic condition that causes body-wide muscle pain. Fibromyalgia is characterized by symptoms such as fatigue, sleep disturbances, and tender points. Stress reduction, exercise, and medication are the standard treatments for fibromyalgia.
- Mental Health Mental health is an optimal way of thinking, relating to others, and feeling. All of the diagnosable mental disorders fall under the umbrella of mental illness. Depression, anxiety, and substance-abuse disorders are common types of mental illness. Symptoms and signs of mental illness include irritability, moodiness, insomnia, headaches, and sadness. Treatment may involve psychotherapy and medication.
- Depression Depression is an illness that involves the body, mood, and thoughts and affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. The principal types of depression are major depression, dysthymia, and bipolar disease (also called manic-depressive disease).
- Duck Syndrome Duck syndrome is a situation initially coined at Stanford University whereby a college student may seem to be calm on the surface when actually he or she is frantically struggling to stay above water to meet the demands of student life.
- Bipolar Disorder Bipolar disorder (or manic depression) is a mental illness characterized by depression, mania, and severe mood swings. Treatment may incorporate mood-stabilizer medications, antidepressants, and psychotherapy.
- Obsessive Compulsive Disorder (OCD) Obsessive-compulsive disorder (OCD) is an anxiety disorder that causes a person to suffer repeated obsessions and compulsions. Symptoms include irresistible impulses despite a person's realization that the thoughts are irrational, excessive hand washing, skin picking, lock checking, or repeatedly rearranging items. People with OCD are more likely to develop trichotillomania, muscle or vocal tics, or an eating disorder. Treatment for OCD includes psychotherapy, behavioral therapy, and medication.
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- What Is Diabetic Neuropathy? Diabetic neuropathy a condition in which nerve damage has occurred as a complication of diabetes. The pain from the nerve damage can be severe with tingling or numbness in the part of the body affected. Diabetic neuropathy can occur anywhere in the body. Diabetic neuropathy can cause symptoms like intense pain, numbness, burning, or tingling in the part of the body affected by the condition.There are four types of neuropathy include peripheral, autonomic, proximal and focal. Natural therapies and medications may help relieve the pain and other symptoms of diabetic neuropathy.
- Postherpetic Neuralgia Postherpetic neuralgia (PHN) is a painful complication of shingles. Symptoms include severe pain, itchy skin, and possible weakness or paralysis of the area.There is no treatment for postherpetic neuralgia that is effective for all patients.
- Post-traumatic Stress Disorder Post-traumatic stress disorder (PTSD), a psychiatric condition, can develop after any catastrophic life event. Symptoms include nightmares, flashbacks, sweating, rapid heart rate, detachment, amnesia, sleep problems, irritability, and exaggerated startle response. Treatment may involve psychotherapy, group support, and medication.
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- Postpartum Depression Postpartum depression is a form of depression that occurs within a year after delivery. It is thought that rapid hormone changes after childbirth may lead to depression. Symptoms of postpartum depression include crying a lot, headaches, chest pains, eating too little or too much, sleeping too little or too much, withdrawal from friends and family, and feeling irritable, sad, hopeless, worthless, guilty, and overwhelmed. Treatment typically involves talk therapy and medication.
- Persistent Depressive Disorder (Dysthymia) Dysthymia is a less severe form of chronic depression. Symptoms and signs include insomnia, suicidal thoughts, guilt, empty feeling, loss of energy, helplessness, sluggishness, and persistent aches and pains. Treatment may involve psychotherapy, electroconvulsive therapy, and antidepressants.
- Depression in Children Childhood depression can interfere with social activities, interests, schoolwork and family life. Symptoms and signs include anger, social withdrawal, vocal outbursts, fatigue, physical complaints, and thoughts of suicide. Treatment may involve psychotherapy and medication.
- Pain Management: Neuropathic Pain Neuropathic pain is chronic pain resulting from injury to the nervous system. The injury can be to the central nervous system (brain and spinal cord) or the peripheral nervous system (nerves outside the brain and spinal cord).
Treatment & Diagnosis
Medications & Supplements
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
See more info: duloxetine on RxList
Medically Reviewed on 10/31/2022
References
FDA Prescribing Information.
