Cymbalta (duloxetine)
CYMBALTA (duloxetine) – a serotonin reuptake inhibitor commonly used to treat depression, anxiety and certain pain disorders. The mechanism of action for duloxetine is unknown. However, it is believed that duloxetine’s actions are related to its ability to increase serotonergic and noradrenergic activity in the central nervous system.
FDA approved uses:
1. Treatment of major depressive disorder (MDD).
2. Treatment of generalized anxiety disorder (GAD).
3. Diabetic peripheral neuropathic pain (DPNP).
4. Fibromyalgia.
5. Chronic musculoskeletal pain.
Available dosage forms: Capsules -20, 30 and 60 mg.
Usual dosage: MDD: 40-60 mg/day start, 60 mg/day maintenance, 120 mg/day maximum. GAD: 60 mg/day to start, 60 mg/day maintenance, 120 mg/day maximum. DPNP: 60 mg/day to start, 60 mg/day maintenance, 60 mg/day maximum. Fibromyalgia: 30 mg/day to start, 60 mg/day maintenance, 60 mg/day maximum. Chronic musculoskeletal pain: 30 mg/day to start, 60 mg/day maintenance, 60 mg/day maximum.
Contraindications: Cymbalta should not be prescribed to patients with uncontrolled narrow angle glaucoma. Additionally, to avoid serotonin syndrome Cymbalta should not be used within 14 days of stopping a MAOI drug, and a MAOI drug should not be used within 5 days of stopping Cymbalta. Do not start patients on Cymbalta if they are being treated with linezolid or intravenous methylene blue.
Special Warnings: There is a risk of suicidal thinking and behavior in children, adolescents, and young adults taking antidepressants. Monitor for worsening and emergence of suicidal thoughts and behaviors. Cymbalta is not approved for use in pediatric patients.
Adverse reactions (side effects) of these medications: The most common side effects of Cymbalta include nausea, dry mouth, somnolence, constipation, decreased appetite, and hyperhidrosis. Other adverse reactions reported in clinical trial data include dizziness, fatigue, diarrhea, insomnia, headache, decreased libido, decreased weight, tremor, and hot flush.
Common drug interactions: MAOI drugs, linezolid, other serotonin-norepinephrine reuptake inhibitors (like venlafaxine, desvenlafaxine, or milnacipran), migraine drugs such as sumatriptan, rizatriptan and similar products, and platelet inhibitor drugs (like cilostazol, clopidogrel, dipyridamole, and ticlopidine).
Special instructions for patients: Take exactly as directed by physician. Tell the doctor or other health care provider about any other medications you are taking, including vitamins, herbals and non-prescription medications as these (especially St. John’s Wort) may interact with duloxetine. Notify doctor if you experience unusual symptoms of anxiety, mania, restlessness, suicidal thoughts, or if you notice abnormal bleeding.
Full prescribing information may be found at the manufacturer‘s official website Cymbalta.com or at the U.S. Food and Drug Administration’s website at Cymbalta FDA Info
Tags: Cymbalta, Cymbalta adverse events, Cymbalta adverse reactions, Cymbalta dose, what are the side effects of Cymbalta