duloxetine

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duloxetine

Pronunciation:du LOX e teen
Brand:Cymbalta

Cymbalta 20 mg

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Cymbalta 30 mg

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Cymbalta 60 mg

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What is the most important information I should know about duloxetine?

donotDo not use duloxetine together with thioridazine (Mellaril), or an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate). A dangerous drug interaction could occur, leading to serious side effects.

You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

emtReport any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.
noalcoholAvoid drinking alcohol. It may increase your risk of liver damage.
dizzyDuloxetine may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

What is duloxetine?

Duloxetine is an antidepressant in a group of drugs called selective serotonin and norepinephrine reuptake inhibitors (SSNRIs). Duloxetine affects chemicals in the brain that may become unbalanced and cause depression.

Duloxetine is used to treat major depressive disorder and general anxiety disorder.

Duloxetine is also used to treat fibromyalgia (a chronic pain disorder), or chronic muscle or joint pain (such as low back pain and osteoarthritis pain).

Duloxetine is also used to treat pain caused by nerve damage in people with diabetes (diabetic neuropathy).

Duloxetine may also be used for purposes not listed in this medication guide.

What should I discuss with my healthcare provider before taking duloxetine?

donotDo not use duloxetine together with thioridazine (Mellaril), or an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate). A dangerous drug interaction could occur, leading to serious side effects. You must wait at least 14 days after stopping an MAO inhibitor before you can take duloxetine. After you stop taking duloxetine, you must wait at least 5 days before you start taking an MAOI.
donotDo not use this medication if you are allergic to duloxetine, or if you have untreated or uncontrolled glaucoma.

To make sure you can safely take duloxetine, tell your doctor if you have any of these other conditions:

  • liver or kidney disease;
  • seizures or epilepsy;
  • a bleeding or blood clotting disorder;
  • glaucoma;
  • bipolar disorder (manic depression); or
  • a history of drug abuse or suicidal thoughts.

You may have thoughts about suicide while taking an antidepressant, especially if you are younger than 24 years old. Tell your doctor if you have worsening depression or suicidal thoughts during the first several weeks of treatment, or whenever your dose is changed.

Your family or other caregivers should also be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

nopregFDA pregnancy category C. It is not known whether duloxetine will harm an unborn baby. However, duloxetine may cause problems in a newborn if you take the medicine during the third trimester of pregnancy. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

If you are pregnant, your name may be listed on a pregnancy registry. This is to track the outcome of the pregnancy and to evaluate any effects of duloxetine on the baby.

nobrfeedDuloxetine can pass into breast milk and may harm a nursing baby. You should not breast-feed while taking this medication.

Older adults may be more sensitive to the side effects of this medication.

nochildDo not give duloxetine to anyone younger than 18 years old without the advice of a doctor.

How should I take duloxetine?

Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results.

Try to take the medicine at the same time each day. Follow the directions on your prescription label.

nocrushDo not crush, chew, break, or open a delayed-release capsule. Swallow it whole. Breaking or opening the pill may cause too much of the drug to be released at one time.
emtIt may take 4 weeks or longer before your symptoms improve. Keep using the medication as directed. Do not stop using duloxetine without first talking to your doctor. You may have unpleasant side effects if you stop taking this medication suddenly.
rtStore at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

emtSeek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include agitation, hallucinations, fever, overactive reflexes, loss of coordination, extreme drowsiness, vomiting, diarrhea, seizure (convulsions), fast heart rate, feeling light-headed, or fainting.

What should I avoid while taking duloxetine?

noalcoholAvoid drinking alcohol. It may increase your risk of liver damage.
dizzyDuloxetine may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

What are the possible side effects of duloxetine?

emtGet emergency medical help if you have any of these signs of an allergic reaction: skin rash or hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
emtReport any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have any of these serious side effects:

  • nausea, pain in your upper stomach, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
  • feeling like you might pass out;
  • agitation, hallucinations, fever, fast heart rate, overactive reflexes;
  • very stiff (rigid) muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors;
  • easy bruising, unusual bleeding;
  • painful or difficult urination;
  • headache, trouble concentrating, memory problems, weakness, feeling unsteady, loss of coordination, fainting, seizure, shallow breathing or breathing that stops; or
  • severe skin reaction -- fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Less serious side effects may include:

  • dry mouth;
  • drowsiness;
  • tired feeling;
  • mild nausea or loss of appetite; or
  • constipation.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect duloxetine?

Talk to your doctor before taking any medicine for pain, arthritis, fever, or swelling. This includes aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), diclofenac (Voltaren), indomethacin, piroxicam (Feldene), nabumetone (Relafen), etodolac (Lodine), and others. Taking any of these drugs with duloxetine may cause you to bruise or bleed easily.

dizzyCold or allergy medicine, sedatives, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, or anxiety can add to sleepiness caused by duloxetine. Tell your doctor if you regularly use any of these medicines, or any other antidepressant.

Tell your doctor about all other medicines you use, especially:

  • a blood thinner such as warfarin (Coumadin);
  • cimetidine (Tagamet);
  • a diuretic (water pill);
  • fluvoxamine (Luvox);
  • linezolid (Zyvox);
  • lithium (Lithobid, Eskalith);
  • St. John's wort;
  • tramadol (Ultram);
  • tryptophan (sometimes called L-tryptophan);
  • an antibiotic such as ciprofloxacin (Cipro);
  • almotriptan (Axert), frovatriptan (Frova), sumatriptan (Imitrex), naratriptan (Amerge), rizatriptan (Maxalt), or zolmitriptan (Zomig); or
  • any other antidepressant such as desipramine (Norpramin), fluoxetine (Prozac, Sarafem), paroxetine (Paxil), and others.

This list is not complete and other drugs may interact with duloxetine. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

Your pharmacist can provide more information about duloxetine.


Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

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