Indications
Cymbalta, also known as duloxetine HCl, is an oral medication prescribed for the treatment of major depressive disorder, generalized anxiety disorder, diabetic peripheral neuropathic pain, fibromyalgia, and chronic musculoskeletal pain. Cymbalta treats depression, anxiety, diabetic peripheral neuropathy, fibromyalgia, and chronic muscle or bone pain.
Duloxetine Hydrochloride, the active ingredient in Cymbalta, belongs to a class of drugs known as Selective Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs). SNRIs work by increasing the levels of two neurotransmitters, serotonin, and norepinephrine, which are responsible for communication between neurons in the brain and are involved in regulating mood.
Cymbalta has antidepressant, anxiolytic, and central pain inhibitory properties due to its ability to potentiate noradrenergic and serotonergic activity in the central nervous system. It is used to treat major depressive disorder in adults, general anxiety disorder in adults and children who are at least 7 years old, and nerve pain caused by diabetes (diabetic neuropathy) or chronic muscle or joint pain (such as low back pain and osteoarthritis pain) in adults.
Uses and Dosage
Cymbalta should be taken orally in the form of a delayed-release capsule, either once or twice daily, with or without food, depending on the indication. It is available in 60 mg, 30 mg, and 20 mg capsule forms.
The dosing information provided here is for Duloxetine in oral capsule form. It is important to note that not all dosages and forms are listed here. The dosage, form, and frequency of administration of the medication will depend on individual factors such as age, weight, medical history, severity of condition, and other medications being taken.
Dosage for Major Depressive Disorder
Adult dosage (ages 18 years and older):
- Typical starting dosage: 30–60 mg per day.
- Typical maintenance dosage: Total daily dose of 40 mg (given as 20-mg doses twice daily) or 60 mg (given either once daily or as 30-mg doses twice daily).
- Maximum dosage: 120 mg per day.
Child dosage (ages 0–17 years): Dosage for people younger than 18 years has not been established.
Dosage for generalized anxiety disorder
Adult dosage (ages 18–64 years):
- Typical starting dosage: 30–60 mg per day.
- Typical maintenance dosage: 60 mg per day.
- Maximum dosage: 120 mg per day.
Child dosage (ages 7–17 years):
- Typical starting dosage: 30 mg per day for 2 weeks.
- Typical maintenance dosage: 30–60 mg per day.
- Maximum dosage: 120 mg per day.
Child dosage (ages 0–6 years): Dosage for people younger than 7 years has not been established.
Senior dosage (ages 65 years and older):
- Typical starting dosage: 30 mg per day for 2 weeks.
- Typical maintenance dosage: 60 mg per day.
- Maximum dosage: 120 mg per day.
Nerve pain caused by diabetes
Adult dosage (ages 18–64 years):
- Typical starting dosage: 60 mg per day.
- Maximum dosage: 60 mg per day.
Child dosage (ages 0–17 years): Dosage for people younger than 18 years has not been established.
Dosage for Fibromyalgia
Adult dosage (ages 18 years and older):
- Typical starting dosage: 30 mg per day for 1 week.
- Typical maintenance dosage: 30–60 mg per day.
- Maximum dosage: 60 mg per day.
Child dosage (ages 13–17 years):
- Typical starting dosage: 30 mg per day for 1 week.
- Typical maintenance dosage: 30–60 mg per day.
- Maximum dosage: 60 mg per day.
Child dosage (ages 0–12 years): Dosage for people younger than 13 years has not been established.
Dosage for Chronic Muscle and Joint Pain
Adult dosage (ages 18 years and older):
- Typical starting dosage: 30 mg per day for 1 week.
- Typical maintenance dosage: 60 mg per day.
- Maximum dosage: 60 mg per day.
Child dosage (ages 0–17 years): Dosage for people younger than 18 years has not been established.
Side Effects
Common Side Effects of Cymbalta:
- Constipation
- Diarrhea
- Dizziness
- Drowsiness
- Dry mouth
- Fatigue
- Loss of appetite
- Nausea
Some Severe Side Effects of Cymbalta Includes
- Bleeding or easy bruising
- Confusion
- Difficulty urinating
- Muscle weakness
- Seizure
- Tremors
- Eye pain
- Widened pupils
- Signs of a liver problem (abdominal pain, persistent vomiting, yellowish skin and eyes, dark urine)
- Serotonin syndrome or toxicity (palpitations, hallucinations, loss of coordination, muscle twitching, agitation, unexplained fever)
Form and Strength
Cymbalta and its Generic Alternatives Duloxetine come forms and strengths:
Cymbalta Delayed Release Capsule
- 20 mg
- 30 mg
- 60 mg
Duloxetine Delayed Release Capsule
- 20 mg
- 30 mg
- 40 mg
- 60 mg
Cautions
- You should avoid taking Cymbalta within a period of 5 days before or 14 days after using a MAO Inhibitor such as isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, tranylcypromine, or methylene blue injection.
- Careful monitoring is necessary when prescribing Cymbalta, an antidepressant, as it has been known to increase the risk of suicidal ideation in some patients. It is important to recognize potential changes in the mood or symptoms of those taking the medication, and any further changes should be immediately reported to a medical professional.
- Patients taking Cymbalta should exercise caution when engaging in activities that require a high degree of alertness, such as operating machinery or driving, and should avoid consuming alcoholic beverages due to the potential for drowsiness, dizziness, and vision changes, which may be associated with use of the drug.
- If a breastfeeding mother is taking Cymbalta, caregivers should be vigilant and observe infants for any unusual changes in behavior, such as sedation, poor feeding, or inadequate weight gain.
Frequently Asked Questions (FAQ)
How long does it take Cymbalta to work?
People will need to take Cymbalta every day for one to two weeks before they notice any improvement in depression or anxiety symptoms. It may take longer to improve pain symptoms.
How long does Cymbalta stay in your system?
With a half-life of 12 hours, it takes the body about two days to completely clear a dose of Cymbalta from the body, but this will vary from person to person.
What happens if I miss a dose of Cymbalta?
If a dose is missed, take it as soon as it’s remembered. However, if it is nearly time for the next dose, skip the missed dose and take the next dose on schedule. Do not take extra medicine to make up for a missed dose.
Is it safe to take Cymbalta during pregnancy?
Cymbalta is given cautiously in pregnant women, particularly in the third trimester. The risk of harming the fetus is small, but when given in the third trimester, there is a risk that the baby will be born with withdrawal symptoms or serotonin syndrome.
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