Cymbalta

Duloxetine is a serotonin and norepinephrine reuptake inhibitor antidepressant (SNRI).

Duloxetine is used to treat major depressive disorder in adults. Duloxetine is also used to treat general anxiety disorder in adults and children at least 7 years old.

Duloxetine is also used in adults to treat diabetic nerve pain or chronic muscle or joint pain (such as low back pain and osteoarthritis pain).

Some brands of duloxetine are also used to treat fibromyalgia (a chronic pain disorder). Drizalma is for treating fibromyalgia only in adults. Cymbalta may be used to treat fibromyalgia in adults and children at least 13 years old.

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

You should not use duloxetine if you are allergic to it.

Do not take duloxetine within 5 days before or 14 days after you have used an MAO inhibitor, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, or tranylcypromine. A dangerous drug interaction could occur.

Tell your doctor if you also take stimulant medicine, opioid medicine, herbal products, or medicine for depression, mental illness, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting. An interaction with duloxetine could cause a serious condition called serotonin syndrome.

Not approved for use by anyone younger than 7 years old.

Tell your doctor if you have ever had:

• heart problems, high blood pressure;
• liver or kidney disease;
• slow digestion;
• a seizure;
• bleeding problems;
• narrow-angle glaucoma;
• bipolar disorder (manic depression);
• drug addiction or suicidal thoughts; or
• if you drink large amounts of alcohol.

Some young people have thoughts about suicide when first taking an antidepressant. Your doctor should check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms.

Taking this medicine during pregnancy could harm the baby, but stopping the medicine may not be safe for you. Do not start or stop duloxetine without asking your doctor.

If you are pregnant, your name may be listed on a pregnancy registry to track the effects of duloxetine on the baby.

If you are breastfeeding, tell your doctor if you notice drowsiness, feeding problems, and slow weight gain in the nursing baby.

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

Taking duloxetine in higher doses or more often than prescribed will not make it more effective, and may increase side effects.

Swallow the capsule whole and do not crush, chew, break, or open it.

Take with or without food.

Your blood pressure will need to be checked often.

Your symptoms may not improve for up to 4 weeks. You may have unpleasant symptoms if you stop using duloxetine suddenly. Ask your doctor before stopping the medicine.

Store at room temperature away from moisture and heat.

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

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

Overdose symptoms may include vomiting, dizziness or drowsiness, seizures, fast heartbeats, fainting, or coma.

Avoid driving or hazardous activity until you know how this medicine will affect you. Dizziness or drowsiness can cause falls, accidents, or severe injuries.

Avoid getting up too fast from a sitting or lying position, or you may feel dizzy.

Drinking alcohol may increase your risk of liver damage, especially if you take Drizalma.

Get emergency medical help if you have signs of an allergic reaction (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling).

Report 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:

• pounding heartbeats or fluttering in your chest;
• a light-headed feeling, like you might pass out;
• easy bruising, unusual bleeding;
• vision changes;
• painful or difficult urination;
• impotence, sexual problems;
• liver problems--right-sided upper stomach pain, itching, dark urine, jaundice (yellowing of the skin or eyes);
• low blood sodium--headache, confusion, problems with thinking or memory, weakness, feeling unsteady; or
• manic episodes--racing thoughts, increased energy, decreased need for sleep, risk-taking behavior, being agitated or talkative.

Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.

Common side effects may include:

• drowsiness;
• nausea, constipation, loss of appetite;
• dry mouth; or
• increased sweating.

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.

Sometimes it is not safe to use certain medications at the same time. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective.

Ask your doctor before taking a nonsteroidal anti-inflammatory drug (NSAID) such as aspirin, ibuprofen, naproxen, Advil, Aleve, Motrin, and others. Using an NSAID with duloxetine may cause you to bruise or bleed easily.

Many drugs can affect duloxetine. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here. Tell your doctor about all other medicines you use.

Your pharmacist can provide more information about duloxetine.