The
following information is a summary about Cymbalta.
It is not intended to replace a doctor's instructions.
Cymbalta USES
Cymbalta (duloxetine hcl) targets two chemicals,
serotonin and norepinephrine, that are believed
to play a role in how the brain and body affect
mood and pain. Cymbalta has been approved by the
FDA for both the treatment of depression and the
management of pain associated with diabetic peripheral
neuropathy.
Eli Lilly & Company, the manufacturer of Cymbalta,
provides an excellent, free,
'Self-Assessment
Checklist'
developed by the University
of Michigan Depression Center as part of their Understanding
Depression and Managing
Depression series of support articles for Cymbalta.
Lilly also provides a helpful
'Symptom
Body Map Checklist'
which allows you to learn about depression and
build a list of your symptoms, as well as rate
how much these symptoms are affecting your life.
Cymbalta DIRECTIONS
Cymbalta capsules should be swallowed whole and
should not be chewed or crushed, nor should the
contents be sprinkled on food or mixed with liquids.
Cymbalta may be taken with or without food. Try
to take Cymbalta at the same time each day. Do
not stop taking Cymbalta without first talking
to your doctor. It may take several weeks before
you start feeling better. It is important to take
Cymbalta regularly to get the most benefit. Your
doctor may want to perform tests or schedule appointments
to monitor your treatment with Cymbalta. Store
Cymbalta at room temperature away from moisture
and heat.
Cymbalta SIDE EFFECTS
Along with its needed effects, a medicine may cause
some unwanted effects. Other side effects may occur
that usually do not need medical attention. These
side effects may go away during treatment as your
body adjusts to the medicine. However, check with
your doctor if any of the following side effects
continue or are bothersome. * More Common o Cough;
diarrhea; difficulty having a bowel movement (stool);
dizziness ; dry mouth; fever; frequent urination;
headache; lack or loss of strength; loss of appetite
; muscle aches; nausea; sleepiness or unusual drowsiness;
sleeplessness ; sore throat; stuffy or runny nose;
sweating increased; trouble sleeping; unable to
sleep; unusual tiredness or weakness; vomiting;
weight loss * Less common o Abnormal orgasm; acid
or sour stomach ; belching; change or problem with
discharge of semen; decreased interest in sexual
intercourse; difficulty in moving; erectile dysfunction;
fear; feeling of warmth redness of the face, neck,
arms and occasionally, upper chest; heartburn;
inability to have or keep an erection; indigestion;
joint pain; longer than usual time to ejaculation
of semen; loose stools; loss in sexual ability,
desire, drive, or performance; muscle aching or
cramping; muscle pains or stiffness; nervousness;
shakiness in legs, arms, hands, feet; stomach discomfort
upset or pain; sudden sweating; swollen joints;
trembling or shaking of hands or feet; vision blurred
Other Cymbalta side effects not listed above may
also occur in some patients. If you notice any
other effects, check with your doctor.
Cymbalta PRECAUTIONS
It is important that your doctor check your progress
at regular visits, to allow for changes in your
dose and to help reduce any side effects. Cymbalta
has not been shown to add to the effects of alcohol.
However, use of alcohol is not recommended in patients
who are taking Cymbalta. Cymbalta may cause some
people to be agitated, irritable or display other
abnormal behaviors. It may also cause some people
to have suicidal thoughts and tendencies or to
become more depressed. If you or your caregiver
notice any of these adverse effects, tell your
doctor right away. Four weeks of Cymbalta may be
required before your symptoms improve. It is important
to continue Cymbalta after symptoms of depression
are relieved. Do not suddenly stop taking your
Cymbalta. If you have been instructed to stop taking
Cymbalta, ask you healthcare professional how to
slowly decrease the dose. This is to decrease the
chance of having discontinuation symptoms such
as dizziness, nausea, headache, vomiting, irritability,
nightmares, prickling or tingling feelings. Do
not take Cymbalta if you have taken a monoamine
oxidase (MAO) inhibitor (furazolidone, phenelzine,
procarbazine, selegiline, tranylcypromine) in the
past 2 weeks. Do not start taking an MAO inhibitor
within 5 days of stopping Cymbalta. If you do,
you may develop confusion, agitation, restlessness,
stomach or intestinal symptoms, sudden high body
temperature, extremely high blood pressure, severe
convulsions, or the serotonin syndrome. For diabetic
patients: * This medicine may affect blood sugar
levels. If you notice a change in the results of
your blood or urine sugar tests or if you have
any questions, check with your doctor. Cymbalta
may cause some people to become drowsy or have
blurred vision. Make sure you know how you react
to this medicine before you drive, use machines,
or do anything else that could be dangerous if
you are not alert or able to see clearly.
Cymbalta DRUG INTERACTIONS
In deciding to use a medicine, the risks of taking
the medicine must be weighed against the good it
will do. This is a decision you and your doctor
will make. For Cymbalta, the following should be
considered: Allergies—Tell your doctor if you have
ever had any unusual or allergic reaction to Cymbalta
(duloxetine hcl). Also tell your doctor and pharmacist
if you are allergic to any other substances, such
as foods, preservatives, or dyes. Pregnancy—Cymbalta
has not been studied in pregnant women. Cymbalta
should only be used during pregnancy if the potential
benefit outweighs the potential risk to the baby.
Before taking this medicine, make sure your doctor
knows if you are pregnant (especially if it is
the third trimester) or if you may become pregnant.
Breast-feeding—Cymbalta passes into the milk of
rats. It is not known whether it passes into human
milk. Because the effects of this medicine in nursing
babies is not known and because of the risks, Cymbalta
is not recommended if you are breast-feeding. Children—Cymbalta
must be used with caution in children with depression.
Studies have shown occurrences of children thinking
about suicide or attempting suicide in clinical
trials for this medicine. More study is needed
to be sure Cymbalta is safe and effective in children
Older adults—This medicine has been tested and
has not been shown to cause different side effects
or problems in older people than it does in younger
adults. However, elderly patients are more likely
to be sensitive than younger adults to the effects
of Cymbalta. Other medicines—Although certain medicines
should not be used together at all, in other cases
two different medicines may be used together even
if an interaction might occur. In these cases,
your doctor may want to change the dose, or other
precautions may be necessary. When you are taking
Cymbalta, it is especially important that your
doctor and pharmacist know if you are taking any
of the following: * Antidepressants (fluoxetine
[e.g., Prozac], paroxetine [e.g., Paxil])—Taking
certain medicines for depression with Cymbalta
may increase your chance for side effects. * Antiarrhythmics
(flecainide [e.g., Tambocor], propafenone [e.g.,
Rythmol], Quinidine [e.g., Quinaglute, Quinidex])—Taking
certain medicines for an uneven heartbeat together
with Cymbalta may increase the chance of getting
serious side effects. * Monoamine oxidase (MAO)
inhibitor activity (isocarboxazid [e.g., Marplan],
phenelzine [e.g., Nardil], procarbazine [e.g.,
Matulane], selegiline [e.g., Eldepryl], tranylcypromine
[e.g., Parnate])— Do not take Cymbalta while you
are taking or within 2 weeks of taking an MAO inhibitor,
or you may develop serious side effects. At least
14 days should be allowed between stopping treatment
with one medicine (Cymbalta or the MAO inhibitor)
and starting treatment with the other * Phenothiazines
(e.g., Compazine, Phenergan, Thorazine)—Taking
phenothiazines together with Cymbalta may increase
the risk of side effects. * Tricyclic antidepressants
(amitriptyline [e.g., Elavil], desipramine [e.g.,
Norpramin], imipramine [e.g., Tofranil], nortriptyline
[e.g., Aventyl])—Taking certain tricyclic antidepressants
together with Cymbalta may increase the risk of
side effects. * Thioridazine (e.g., Mellaril)—Taking
thioridazine with Cymbalta may cause serious heart
problems. Other medical problems — The presence
of other medical problems may affect the use of
Cymbalta. Make sure you tell your doctor if you
have any other medical problems, especially: *
Bipolar disorder (mood disorder with alternating
episodes of mania and depression) or risk of—May
make condition worse. Your doctor will check you
for this condition. * Diabetes mellitus (sugar
diabetes)—May increase your blood sugar. * Kidney
disease, severe, or Liver disease, severe—Higher
blood levels of Cymbalta may occur, increasing
the chance of side effects. * Mania (history of)—The
condition may be activated. * Narrow-angle Glaucoma—May
increase your chance of getting blurred vision.
* Seizures (history of)—The risk of seizures may
be increased.
Cymbalta OVERDOSE
If overdose is suspected, contact your local poison
control center or emergency room immediately.
Cymbalta NOTES
Do not share Cymbalta with others. Cymbalta is
used to treat mental depression. It is also used
for pain caused by nerve damage associated with
diabetes. Cymbalta belongs to a group of medicines
known as selective serotonin and norepinephrine
reuptake inhibitors (SSNRIs). These medicines are
thought to work by increasing the activity of chemicals
called serotonin and norepinephrine in the brain.
Cymbalta is available only with your doctor's prescription,
in the following dosage forms: * Oral Delayed-release
capsules (U.S.)
MISSED DOSE
If you miss a dose, use Cymbalta as soon as you
remember. If it is near the time of the next dose,
skip the missed dose and resume your usual dosing
schedule. Do not "double-up" the dose to catch
up.
Cymbalta STORAGE
Store Cymbalta duloxetine hcl at room temperature
between 36 and 77 degrees F (2 -25 degrees C) away
from light and moisture.
