USE
Duloxetine is used to treat major depression and anxiety. It is also used to relieve nerve pain (peripheral neuropathy) in people with diabetes.
This medication is a serotonin-norepinephrine reuptake inhibitor (SNRI) that works by helping to restore the balance of certain natural substances in the brain (neurotransmitters). Duloxetine may improve your mood, sleep, appetite, and energy level, and decrease nervousness. It can also decrease pain caused by nerve damage.
How to use Cymbalta - Oral
Read the Medication Guide provided by your pharmacist before you start using duloxetine and each time you get a refill. If you have any questions, consult your doctor or pharmacist.
Take this medication by mouth with or without food, usually 1 or 2 times a day or as directed by your doctor. Swallow the capsule whole. Do not crush or chew the capsule or mix the contents with food or liquid. Dosage is based on your medical condition and response to treatment.
To reduce your risk of side effects, your doctor may start you at a low dose and gradually increase your dose. Follow your doctor's instructions carefully. Do not take more or less medication or take it more frequently than prescribed. Your condition will not improve any faster, and your risk of side effects will increase. Use this medication regularly in order to get the most benefit from it. To help you remember, use it at the same time(s) each day.
It is important to continue taking this medication even if you feel well. Do not stop taking this medication without consulting your doctor.
Some conditions may become worse when the drug is suddenly stopped. Your dose may need to be gradually decreased.
This medication may cause dependence, especially if it has been used regularly for an extended time or if it has been used in high doses. In such cases, withdrawal reactions (e.g., nausea, vomiting, headache, numbness, tingling, nightmares) may occur if you suddenly stop this drug. To prevent withdrawal when stopping extended/regular treatment with this drug, gradually reduce the dosage as directed. Consult your doctor or pharmacist for more details, and report any withdrawal reactions immediately.
It may take 1 to 2 weeks to feel a benefit from this drug and 4 weeks to feel the full benefit of this medication. Tell your doctor if your condition persists or worsens.
SIDE EFFECTS
Nausea, dry mouth, constipation, loss of appetite, tiredness, drowsiness, dizziness, increased sweating, blurred vision, or yawning may occur. If any of these effects persist or worsen, tell your doctor promptly.
Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.
Tell your doctor immediately if any of these unlikely but serious side effects occur: fainting, unusual or severe mental/mood changes (e.g., nervousness, unusual high energy/excitement, rare thoughts of suicide), shakiness (tremor), decreased interest in sex, changes in sexual ability, difficulty urinating, change in the amount of urine, weight loss.
Tell your doctor immediately if any of these rare but very serious side effects occur: stomach pain, bloody/black/tarry stools, vomit that looks like coffee grounds, easy bruising/bleeding, muscle weakness/cramps, yellowing eyes/skin, dark urine, seizures, unusual tiredness, fast/irregular/pounding heartbeat.
This medication may rarely cause a very serious condition called serotonin syndrome. The risk increases when this medication is used with certain other drugs such as "triptans" used to treat migraine headaches (e.g., sumatriptan, eletriptan), certain antidepressants including SSRIs (e.g., citalopram, paroxetine) and other SNRIs (e.g., venlafaxine), lithium, tramadol, tryptophan, or a certain drug to treat obesity (sibutramine). See also Drug Interactions section. Before taking this drug, tell your doctor if you take any of these medications. Serotonin syndrome may be more likely when you start or increase the dose of any of these medications. Seek immediate medical attention if you develop some of the following symptoms: hallucinations, restlessness, loss of coordination, fast heartbeat, severe dizziness, unexplained fever, severe nausea/vomiting/diarrhea, twitchy muscles.
A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching, swelling, severe dizziness, trouble breathing.
This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.
PRECAUTIONS
Before taking duloxetine, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies.
This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: severe kidney disease, liver disease.
Before using this medication, tell your doctor or pharmacist your medical history, especially of: personal or family history of psychiatric disorders (e.g., bipolar/manic-depressive disorder), personal or family history of suicide attempts, diabetes, glaucoma (narrow-angle), kidney disease, stomach problems (e.g., bleeding or slow emptying of the stomach), low sodium in the blood, severe loss of body water (dehydration), drug or alcohol abuse, seizure disorder.
This drug may make you dizzy or drowsy. Use caution while driving, using machinery, or doing any other activity that requires alertness.
Avoid alcoholic beverages. Drinking alcohol can also increase your risk of liver problems.
To reduce dizziness and lightheadedness, get up slowly when rising from a sitting or lying position. Dizziness is more common when you start taking this medication and when your dose is increased.
If you have diabetes, duloxetine may affect your blood sugar levels. Monitor your blood sugar regularly and share the results with your doctor. Your doctor may need to adjust your medication, diet, and exercise when you start or stop duloxetine.
Caution is advised when using this product in the elderly because they may be more sensitive to its effects. The elderly are more likely to lose too much salt (hyponatremia), especially if they are also taking "water pills" (diuretics) with this medication.
This medication is not recommended for use during pregnancy. It may harm an unborn baby. Also, babies born to mothers who have used this drug during the last 3 months of pregnancy may infrequently develop withdrawal symptoms such as feeding/breathing difficulties, seizures, muscle stiffness, or constant crying. If you notice any of these symptoms in your newborn, tell the doctor promptly.
Since untreated depression can be a serious condition, do not stop taking this medication unless directed by your doctor. If you are planning pregnancy, become pregnant, or think you may be pregnant, immediately discuss the benefits and risks of using this medication during pregnancy with your doctor.
This drug may pass into breast milk and could have undesirable effects on a nursing infant. Therefore, breast-feeding is not recommended while using this drug. Consult your doctor before breast-feeding.
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