What is Cymbalta?
Cymbalta is a serotonin and norepinephrine reuptake inhibitor (SSNRI) antidepressant. Duloxetine affects chemicals in the brain that may be out of balance in people with depression.
Cymbalta is used to treat major depressive disorder in adults. It is also used to treat generalized anxiety disorder in adults and children who are at least 7 years old.
Cymbalta is also used in adults to treat nerve pain caused by diabetes (diabetic neuropathy), or chronic muscle or joint pain (such as low back pain, osteoarthritis pain).
Some brands of Cymbalta are also used to treat fibromyalgia (a chronic pain disorder). Drizalma is used to treat fibromyalgia in adults only. Cymbalta can be used to treat fibromyalgia in adults and children who are at least 13 years old.
Warnings
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, tranylcypromine, and others. A dangerous drug interaction can occur.
People with depression or mental illness may have thoughts about suicide. Some young people may have increased suicidal thoughts when they first start treatment for depression. Tell your doctor right away if you have any sudden changes in mood or behavior, or thoughts about suicide.
Do not stop using Cymbalta without first talking to your doctor.
Before taking this medicine
You should not use duloxetine (Cymbalta) 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 can occur.
Tell your doctor if you also use stimulant medicines, opioid medicines, herbal products, or medicines to treat depression, mental illness, Parkinson’s disease, migraine headaches, serious infections, or to prevent nausea and vomiting. Interaction with duloxetine can cause a serious condition called serotonin syndrome.
Duloxetine is not approved for use by anyone younger than 7 years old.
To make sure duloxetine(Cymbalta) is safe for you, tell your doctor if you have:
>> Heart problems and high blood pressure.
>> Diseases of the liver or kidneys.
>> Slow digestion.
>> bout
>> Bleeding problems.
>> Sexual problems.
>>Narrow angle glaucoma.
>> Bipolar disorder (manic depression);
>> Drug addiction or suicidal thoughts. or
>> If you drink large amounts of alcohol.
People with depression or mental illness may have thoughts about suicide. Some young people may have increased suicidal thoughts when they first start treatment for depression. Stay alert for changes in your mood or symptoms. Your family or caregivers should also watch for sudden changes in your behavior.
Taking an SNRI antidepressant during late pregnancy may increase the risk of excessive bleeding after delivery, and may cause serious medical complications to the fetus. However, stopping the medication may not be safe if you experience a relapse of depression. 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 infant.
How should I take Cymbalta(duloxetine)?
Take duloxetine exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose.
Taking duloxetine in higher or more doses 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.
You can take duloxetine with or without food.
Your blood pressure should be checked often.
Tell your doctor if you have any changes in sexual function, such as loss of interest in sex, difficulty reaching orgasm, or (in men) erection or ejaculation problems. Some sexual problems can be treated.
Your symptoms may not improve for up to 4 weeks.
Do not stop using duloxetine suddenly, or you could have unpleasant symptoms (such as agitation, confusion, tingling or electric shock feeling). Ask your doctor before stopping the medication.
Store at room temperature away from moisture and heat.
Dosing information
Usual Adult Dose for Depression
Initial dose: 20 mg to 30 mg orally twice a day
Maintenance dose: 60 mg per day, given once per day or 30 mg orally twice per day
Maximum dose: 120 mg/day.
Usual Adult Dose for Fibromyalgia
Initial dose: 30 mg orally once a day for at least 1 week
Maintenance dose: 30 to 60 mg orally once a day.
Usual Adult Dose for Generalized Anxiety Disorder
Initial dose: 60 mg orally once a day
Maintenance dose: 60 to 120 mg orally once a day
Maximum dose: 120 mg/day.
Usual Adult Dose for Pain
Initial dose: 30 to 60 mg orally once a day
Maintenance dose: 60 mg orally once a day.
Usual Adult Dose for Neuropathic Pain
Initial dose: 30 to 60 mg orally once a day
Maintenance dose: 60 mg orally once a day.
Usual Adult Dose for Chronic Pain
Initial dose: 30 to 60 mg orally once a day
Maintenance dose: 60 mg orally once a day.
Usual Geriatric Dose for Generalized Anxiety Disorder:
Initial dose: 30 mg orally once a day for at least 2 weeks
Maintenance dose: 60 mg orally once a day
Maximum dose: 120 mg/day.
Usual Pediatric Dose for Generalized Anxiety Disorder
From 7 to 17 years old:
Initial dose: 30 mg orally once a day for at least 2 weeks
Treatment dose: 30 to 60 mg orally once a day
Maximum dose: 120 mg/day.
Usual Pediatric Dose for Fibromyalgia
13 years and over:
Initial dose: 30 mg orally once a day for at least 1 week
Treatment dose: 30 to 60 mg orally once a day.
Detailed information on the dosage of duloxetine
What happens if I miss a dose?
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.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
Overdose symptoms may include vomiting, dizziness, drowsiness, seizure, fast heartbeat, fainting, or coma.
What should I avoid while taking duloxetine?
Ask your doctor before taking a nonsteroidal anti-inflammatory drug (NSAID) such as aspirin, ibuprofen, naproxen, Advil, Aleve, Motrin, and others. Using NSAIDs with duloxetine may bruise or bleed easily.
Avoid driving or dangerous activity until you know how duloxetine will affect you. Your reactions can be impaired. Dizziness or fainting can cause a fall, accident, or serious injury.
Avoid getting up too quickly from a sitting or lying position, as you may feel dizzy.
Drinking alcohol may increase your risk of liver damage, especially if you are taking Drizalma.
Duloxetine side effects
Get emergency medical help if you have signs of an allergic reaction to duloxetine (hives, trouble breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning in the eyes, skin pain, red rash, or purple with blistering and peeling).
What happens if I miss a dose?
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.
What happens if I overdose?
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.
What should I avoid while taking duloxetine?
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.
Avoid driving or hazardous activity until you know how duloxetine will affect you. Your reactions could be impaired. Dizziness or fainting 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.
Duloxetine side effects
Get emergency medical help if you have signs of an allergic reaction to duloxetine (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).
Tell your doctor right away if you have new or sudden changes in mood or behavior, including new or worse depression or anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, more active or talkative, 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;
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.
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