Brand
name: DUZELA
( Cymbalta, Duloxetine )™
Cymbalta
Pronounced: sim-BALL-ta
Generic name: Duloxetine hydrochloride
Why is Cymbalta prescribed?
Cymbalta is used to treat major depression--a disorder marked by continuing,
serious, and overwhelming feelings of depression that interfere with
daily functioning. Symptoms may include major changes in appetite or
sleep habits; lack of interest in social or work life; feelings of
sadness, guilt, or worthlessness; fatigue; difficulty concentrating
or making decisions; and suicidal thoughts or attempted suicide.
Cymbalta is also used to treat diabetic peripheral neuropathy, a painful
nerve disorder associated with diabetes that affects the hands, legs,
and feet.
Cymbalta is thought to work by correcting an imbalance of two brain
chemicals known to influence mood--serotonin and norepinephrine. It
belongs to a class of antidepressants called selective serotonin and
norepinephrine reuptake inhibitors (SNRIs).
Most important fact about Cymbalta
Serious, sometimes fatal reactions can occur if Cymbalta is taken
with antidepressants known as MAO inhibitors, including Marplan, Nardil
and Parnate. Never combine Cymbalta with one of these drugs, and wait
at least 14 days after stopping an MAO inhibitor before starting treatment
with Cymbalta. Likewise, after stopping therapy with Cymbalta, allow
at least 5 days before starting treatment with an MAO inhibitor.
How should you take Cymbalta?
Take Cymbalta at about the same time each day. Swallow the capsule
whole; do not chew it or break it open. Cymbalta may be taken with
or without food.
It may take several weeks before the drug begins to work. Continue
taking Cymbalta even if you begin to feel better. Do not stop taking
Cymbalta without your doctor's approval. Abruptly stopping treatment
may cause severe side effects.
If you miss a dose...
Take the forgotten dose as soon as you remember. However, if it is
almost time for your next dose, skip the one you missed and return
to your regular schedule. Do not take two doses at once.
Storage instructions...
Store at room temperature.
Cymbalta side effects
Side effects cannot be anticipated. If any develop or change in intensity,
tell your doctor as soon as possible. Only your doctor can determine
if it is safe to continue using Cymbalta.
* Side effects may include:
Appetite changes, constipation, diarrhea, dizziness, dry mouth, fatigue, headache,
insomnia, nausea, sexual difficulties, sleepiness, sweating, tremor, urinary
difficulties, vomiting, weakness
Why should Cymbalta not be prescribed?
You will not be able to use Cymbalta if it causes an allergic reaction.
In addition, you should not take Cymbalta if you have uncontrolled
narrow-angle glaucoma, a disease that causes increased pressure in
the eyes.
Never combine Cymbalta with an MAO inhibitor such as Marplan, Nardil,
or Parnate (see "Most important fact about Cymbalta").
Do not take the drug thioridazine (Mellaril) with Cymbalta, as it
could cause fatal heartbeat irregularities.
Special warnings about Cymbalta
In clinical studies, antidepressants increased the risk of suicidal
thinking and behavior in children and adolescents with depression and
other psychiatric disorders. Anyone considering the use of Cymbalta
or any other antidepressant in a child or adolescent must balance this
risk with the clinical need. Cymbalta has not been studied in children
or adolescents and is not approved for treating anyone less than 18
years old.
Additionally, the progression of major depression is associated with
a worsening of symptoms and/or the emergence of suicidal thinking or
behavior in both adults and children, whether or not they're taking
antidepressants. Individuals being treated with Cymbalta and their
caregivers should watch for any change in symptoms or any new symptoms
that appear suddenly--especially agitation, anxiety, hostility, panic,
restlessness, extreme hyperactivity, and suicidal thinking or behavior--and
report them to the doctor immediately. Be especially observant at the
beginning of treatment or whenever there is a change in dose.
Some medical conditions require careful monitoring during treatment
with Cymbalta. Be sure to tell the doctor if you have diabetes, glaucoma,
high blood pressure, or a seizure disorder. Cymbalta can cause episodes
of mania (abnormally high feelings of excitement and energy), so be
sure the doctor is aware if you have this condition.
Using Cymbalta is not recommended if you have liver problems or severe
kidney disease.
Like other antidepressants, Cymbalta can cause drowsiness and affect
judgment or motor skills. Use caution when driving, operating dangerous
machinery, or participating in hazardous activities until you know
how the drug affects you.
Possible food and drug interactions when taking Cymbalta
Never take Cymbalta with MAO inhibitors (see "Most important
fact about Cymbalta") or the drug thioridazine (Mellaril). Consult
your doctor first before taking drugs that act on the central nervous
system, such as antipsychotics, narcotic painkillers, sleep inducers,
or tranquilizers.
Due to the possibility of liver damage, do not take Cymbalta if you
use alcohol more than occasionally.
If Cymbalta is taken with certain other drugs, the effects of either
could be increased, decreased, or altered. It is especially important
to check with your doctor before combining Cymbalta with the following:
Antibiotics known as quinolones, such as Cipro, Floxin, and Trovan
Antidepressants known as tricyclics, including Elavil, Pamelor, and
Tofranil
Antidepressants that raise serotonin levels, such as Effexor, Paxil,
Prozac, and Zoloft
Antipsychotic medication known as phenothiazines, including Compazine,
Prolixin, Serentil, Thorazine, and Trilafon
Flecainide (Tambocor)
Fluvoxamine
Propafenone (Rythmol)
Quinidine
Special information if you are pregnant or breastfeeding
Cymbalta had negative effects during pregnancy when given to animals.
There have been no adequate studies in pregnant women. Cymbalta should
be used during pregnancy only if the benefits outweigh the potential
risks.
Cymbalta appears in the breast milk of animals. It is unknown whether
the drug appears in human breast milk. Therefore, it's recommended
that you avoid breastfeeding while taking Cymbalta.
Recommended dosage for Cymbalta
ADULTS 18 YEARS AND OLDER
Overdosage
