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Home / Should I Start Taking Cymbalta Again

Should I Start Taking Cymbalta Again

Brand names:

  • Cymbalta®
    • Capsules (delayed release): 20 mg, thirty mg, lx mg
  • Drizalma Sprinkle™
    • Capsules (delayed release sprinkle): 20 mg, 30 mg, 40 mg, 60mg
  • Duloxetine
    • Capsules (delayed release): 20 mg, 30 mg, 40 mg, threescore mg


Generic proper name:Duloxetine (doo LOX east teen)

All FDA black box warnings are at the end of this fact sheet. Please review before taking this medication.

What Is Duloxetine And What Does Information technology Treat?

Duloxetine is an antidepressant medication that works in the encephalon. It is approved for the treatment of major depressive disorder (MDD), generalized anxiety disorder (GAD), diabetic peripheral neuropathic pain (DPNP), fibromyalgia, and chronic musculoskeletal pain.

Symptoms of depression include:

  • Depressed mood - feeling sorry, empty, or tearful
  • Feeling worthless, guilty, hopeless, and helpless
  • Loss of involvement or pleasure in your usual activities
  • Sleep and swallow more or less than usual (for near people it is less)
  • Low energy, trouble concentrating, or thoughts of decease (suicidal thinking)
  • Psychomotor agitation ('nervous energy')
  • Psychomotor retardation (feeling like you are moving and thinking in dull move)
  • Suicidal thoughts or behaviors


Generalized Feet Disorder (GAD) occurs when a person experiences excessive anxiety or worry for at least half-dozen months. Other symptoms include:

  • Restlessness
  • Fatigue (low energy, feeling tired all the time)
  • Difficulty concentrating
  • Irritability
  • Muscle tension
  • Slumber disturbance (difficulty falling asleep or waking up in the middle of the dark)


What Is The Well-nigh Important Information I Should Know About Duloxetine?

Do not finish taking duloxetine, fifty-fifty when you lot feel meliorate. With input from yous, your health intendance provider will appraise how long you volition need to take the medicine.

Missing doses of duloxetine may increase your risk for relapse in your symptoms.

Stopping duloxetine abruptly may result in one or more of the following withdrawal symptoms: irritability, nausea, feeling dizzy, vomiting, nightmares, headache, and/or paresthesias (prickling, tingling awareness on the skin).

Depression is also a part of bipolar affliction. People with bipolar disorder who take antidepressants may be at hazard for "switching" from depression into mania. Symptoms of mania include "loftier" or irritable mood, very high self-esteem, decreased need for sleep, force per unit area to keep talking, racing thoughts, being hands distracted, frequently involved in activities with a large risk for bad consequences (for example, excessive buying sprees).

Medical attention should be sought if serotonin syndrome is suspected. Please refer to serious side effects for signs/symptoms.

Are There Specific Concerns Nigh Duloxetine And Pregnancy?

If you are planning on becoming pregnant, notify your wellness intendance provider to best manage your medications. People living with MDD who wish to become pregnant face important decisions. Untreated MDD has risks to the fetus, also as the female parent. Information technology is of import to hash out the risks and benefits of handling with your doctor and caregivers. For women who take antidepressant medications during weeks 13 through the end of their pregnancy (second and third trimesters), there is a risk that the infant tin can be born earlier it is fully developed (before 37 weeks).

Caution is advised with breastfeeding since duloxetine does pass into chest milk.

What Should I Discuss With My Wellness Care Provider Before Taking Duloxetine?

  • Symptoms of your status that carp you the most
  • If you take thoughts of suicide or harming yourself
  • Medications you lot take taken in the by for your condition, whether they were effective or acquired any adverse effects
  • If you experience side effects from your medications, discuss them with your provider. Some side effects may pass with time, merely others may crave changes to the medication.
  • Whatever other psychiatric or medical issues you lot have, including a history of bipolar disorder, kidney or liver disease
  • All other medications you are currently taking (including over the counter products, herbal and nutritional supplements) and any medication allergies you have
  • Other not-medication treatment you are receiving, such as talk therapy or substance abuse handling. Your provider tin can explain how these different treatments work with the medication.
  • If you are pregnant, plan to become meaning, or are breastfeeding
  • If you beverage alcohol or apply drugs


How Should I Accept Duloxetine?

Duloxetine is unremarkably taken 1 or 2 times per day with or without food.

Typically, patients brainstorm at a depression dose of medicine and the dose is increased slowly over several weeks.

The dose usually ranges from 20 mg to 120 mg. Only your health care provider can determine the correct dose for yous.

The capsule should be swallowed whole. It should not be chewed, crushed, or cleaved.

The duloxetine delayed release sheathing (Cymbalta® or generic duloxetine) should exist swallowed whole. It should non be chewed, crushed, or broken. Drizalma Sprinkle™ delayed release capsules may be opened and sprinkled on applesauce, if needed.

Consider using a agenda, pillbox, alarm clock, or cell phone alert to help yous recollect to take your medication. You lot may as well inquire a family fellow member or a friend to remind you lot or bank check in with you to be certain you are taking your medication.

What Happens If I Miss A Dose Of Duloxetine?

If you miss a dose of duloxetine accept information technology as soon as yous call back, unless it is closer to the time of your side by side dose. Discuss this with your wellness care provider. Do not double your side by side dose or accept more than what is prescribed.

What Should I Avoid While Taking Duloxetine?

Avert drinking alcohol or using illegal drugs while you are taking antidepressant medications. They may subtract the benefits (e.g., worsen your condition) and increase adverse effects (e.g., sedation) of the medication. Alcohol increases the risk of liver issues with duloxetine.

What Happens If I Overdose With Duloxetine?

If an overdose occurs, call your doctor or 911. Yous may demand urgent medical intendance. You may as well contact the poison command center at 1-800-222-1222.

A specific handling to reverse the furnishings of duloxetine does not exist.

What Are Possible Side Furnishings Of Duloxetine?

Common side effects

Headache, nausea, diarrhea, dry out mouth, decreased appetite, increased sweating, feeling nervous, restless, fatigued, sleepy or having trouble sleeping (insomnia). These volition often improve over the starting time calendar week or two as y'all keep to take the medication.

Sexual side effects, such equally problems with orgasm or ejaculatory filibuster, and blood pressure increases oftentimes practice not improve over time.

Rare/serious side effects

There accept been rare reports of liver failure (sometimes fatal) with duloxetine. This risk is increased in those with substantial alcohol use or chronic liver illness.

Orthostatic hypotension, or a drop in blood pressure level when standing or getting up from sleeping, has been reported in patients taking duloxetine. The risk may be greater in patients too taking medications for high blood pressure.

Increased centre rate, irregular menstrual cycle, increased frequency of urination or difficulty urinating, increased liver enzymes, teeth grinding, low sodium (symptoms of low sodium levels may include headache, weakness, difficulty concentrating and remembering), angle closure glaucoma (symptoms of angle closure glaucoma may include eye pain, changes in vision, swelling or redness in or effectually eye), serotonin syndrome (symptoms may include shivering, diarrhea, confusion, severe muscle tightness, fever, seizures, and death), hypertensive crunch (severely elevated blood pressure level), myocardial infarction (heart assault), Stevens-Johnson Syndrome (rash), pancreatitis

SNRI antidepressants, including duloxetine, may increase the risk of bleeding events. Combined utilise of aspirin, nonsteroidal anti-inflammatory drugs (eastward.thousand., ibuprofen, naproxen), warfarin, and other anti-coagulants may increase this risk. This may include gums that bleed more easily, nose bleed, or gastrointestinal bleeding. Some cases take been life threatening.

Are In that location Whatever Risks For Taking Duloxetine For Long Periods Of Time?

To engagement, in that location are no known problems associated with long term use of duloxetine. It is a safe and effective medication when used as directed.

What Other Medications May Interact With Duloxetine?

Duloxetine should non be taken with or inside two weeks of taking monoamine oxidase inhibitors (MAOIs). These include phenelzine (Nardil®), tranylcypromine (Parnate®), isocarboxazid (Marplan®), rasagiline (Azalect®) and selegiline (Emsam®).

Although rare, there is an increased run a risk of serotonin syndrome when duloxetine is used with other medications that increase serotonin, such as other antidepressants, migraine medications called "triptans" (eastward.m., Imitrex®), some pain medications (e.g., tramadol (Ultram®), the antibody linezolid (Zyvox®), and amphetamines.

The following medications may increment the levels and furnishings of duloxetine: cimetidine (Tagamet®), ciprofloxacin (Cipro®), fluoxetine (Prozac®), fluvoxamine (Luvox®), paroxetine (Paxil®)

Duloxetine may increment the effects of other medications that tin cause bleeding (east.thou., ibuprofen (Advil®, Motrin®), warfarin (Coumadin®) and aspirin).

How Long Does It Take For Duloxetine To Piece of work?

Slumber, energy, or appetite may show some comeback within the first 1-2 weeks. Improvement in these concrete symptoms tin can be an of import early signal that the medication is working. Depressed mood and lack of interest in activities may demand up to half-dozen-8 weeks to fully ameliorate.

Summary of FDA Blackness Box Warnings

Suicidal thoughts or deportment in children and adults

Depression and certain other psychiatric disorders are themselves associated with increases in the hazard of suicide. Patients with major depressive disorder (MDD), both adult and pediatric, may experience worsening of their depression and/or the emergence of suicidal ideation and beliefs (suicidality) or unusual changes in beliefs, whether or non they are taking antidepressant medications. This risk may persist until significant remission occurs.

In short-term studies, antidepressants increased the run a risk of suicidality in children, adolescents, and young adults when compared to placebo. Short-term studies did not bear witness an increase in the risk of suicidality with antidepressants compared to placebo in adults beyond age 24. Adults age 65 and older taking antidepressants have a decreased run a risk of suicidality. Patients, their families, and caregivers should be alert to the emergence of feet, restlessness, irritability, aggressiveness and indisposition. If these symptoms sally, they should be reported to the patient'south prescriber or health care professional. All patients beingness treated with antidepressants for any indication should watch for and notify their health care provider for worsening symptoms, suicidality and unusual changes in behavior, especially during the get-go few months of treatment.

Provided by

(December 2020)

©2020 The College of Psychiatric and Neurologic Pharmacists (CPNP) and the National Alliance on Mental Affliction (NAMI). CPNP and NAMI make this document available under the Creative Commons Attribution-No Derivatives 4.0 International License. Concluding Updated: January 2016.

This data is existence provided as a community outreach try of the Higher of Psychiatric and Neurologic Pharmacists. This information is for educational and informational purposes simply and is non medical advice. This information contains a summary of of import points and is non an exhaustive review of information about the medication. Ever seek the communication of a physician or other qualified medical professional with any questions you may have regarding medications or medical weather condition. Never delay seeking professional medical advice or disregard medical professional person advice as a result of any information provided herein. The College of Psychiatric and Neurologic Pharmacists disclaims any and all liability alleged as a result of the information provided herein.

Should I Start Taking Cymbalta Again

Source: https://www.nami.org/About-Mental-Illness/Treatments/Mental-Health-Medications/Types-of-Medication/Duloxetine-(Cymbalta)