Dizziness, lightheadedness, or loss of coordination can increase the risk of falling. Children may be more sensitive to the side effects of this drug, especially loss of appetite and weight loss. Monitor weight and height in children who are taking this drug. Discontinuation-emergent symptoms have been reported when stopping Cymbalta. The most commonly reported symptoms following discontinuation of Cymbalta in pediatric clinical trials have included headache, dizziness, insomnia, and abdominal pain [see Warnings and Precautions 5.

Pediatric patients treated with Cymbalta in clinical trials experienced a 0. Subsequently, over the 4- to 6-month uncontrolled extension periods, Cymbalta-treated patients on average trended toward recovery to their expected baseline weight percentile based on population data from age- and sex-matched peers. In studies up to 9 months, Cymbalta-treated pediatric patients experienced an increase in height of 1. Weight and height should be monitored regularly in children and adolescents treated with Cymbalta.

Postmarketing Spontaneous Reports The following adverse reactions have been identified during post approval use of Cymbalta. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure. Adverse reactions reported since market introduction that were temporally related to Cymbalta therapy and not mentioned elsewhere in labeling include: Other drugs that inhibit CYP1A2 metabolism include cimetidine and quinolone antimicrobials such as ciprofloxacin and enoxacin [see Warnings and Precautions 5.

Similar effects would be expected with other potent CYP2D6 inhibitors e. Drugs that Interfere with Hemostasis e. Epidemiological studies of the case-control and cohort design that have demonstrated an association between use of psychotropic drugs that interfere with serotonin reuptake and the occurrence of upper gastrointestinal bleeding have also shown that concurrent use of an NSAID or aspirin may potentiate this risk of bleeding. Because of the potential effect of duloxetine on platelets, patients receiving warfarin therapy should be carefully monitored when duloxetine is initiated or discontinued [see Warnings and Precautions 5.

Drugs that Affect Gastric Acidity Cymbalta has an enteric coating that resists dissolution until reaching a segment of the gastrointestinal tract where the pH exceeds 5. In extremely acidic conditions, Cymbalta, unprotected by the enteric coating, may undergo hydrolysis to form naphthol. Caution is advised in using Cymbalta in patients with conditions that may slow gastric emptying e.

Drugs that raise the gastrointestinal pH may lead to an earlier release of duloxetine. It is unknown whether the concomitant administration of proton pump inhibitors affects duloxetine absorption [see Warnings and Precautions 5.

If intolerable symptoms occur following a decrease in the dose or upon discontinuation of treatment, then resuming the previously prescribed dose may be considered. No activation of mania or hypomania was reported in DPNP, GAD , fibromyalgia , or chronic musculoskeletal pain placebo-controlled trials. Activation of mania or hypomania has been reported in a small proportion of patients with mood disorders who were treated with other marketed drugs effective in the treatment of major depressive disorder.

Angle-Closure Glaucoma The pupillary dilation that occurs following use of many antidepressant drugs including CYMBALTA may trigger an angle closure attack in a patient with anatomically narrow angles who does not have a patent iridectomy.

There was no significant difference in the frequency of sustained 3 consecutive visits elevated blood pressure. In a clinical pharmacology study designed to evaluate the effects of CYMBALTA on various parameters, including blood pressure at supratherapeutic doses with an accelerated dose titration, there was evidence of increases in supine blood pressure at doses up to mg twice daily.

At the highest mg twice daily dose, the increase in mean pulse rate was 5. In many cases, this hyponatremia appears to be the result of the syndrome of inappropriate antidiuretic hormone secretion SIADH. Also, patients taking diuretics or who are otherwise volume depleted may be at greater risk [see Use In Specific Populations]. Signs and symptoms of hyponatremia include headache, difficulty concentrating, memory impairment, confusion, weakness, and unsteadiness , which may lead to falls.

CYMBALTA has not been systematically evaluated in patients with a recent history of myocardial infarction or unstable coronary artery disease. In the week acute treatment phase of these studies, CYMBALTA was associated with a small increase in mean fasting blood glucose as compared to placebo. HbA1c increased by 0. If symptoms of urinary hesitation develop during treatment with CYMBALTA, consideration should be given to the possibility that they might be drug-related.

In post marketing experience, cases of urinary retention have been observed. Laboratory Tests No specific laboratory tests are recommended. Instruct patients, their families, and their caregivers to read the Medication Guide before starting CYMBALTA and each time their prescription is renewed, and assist them in understanding its contents.

Give patients the opportunity to discuss the contents of the Medication Guide and to obtain answers to any questions they may have. The complete text of the Medication Guide is reprinted at the end of this document.

Suicidal Thoughts and Behaviors - Encourage patients, their families, and their caregivers to be alert to the emergence of anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, akathisia psychomotor restlessness , hypomania, mania, other unusual changes in behavior, worsening of depression, and suicidal ideation, especially early during antidepressant treatment and when the dose is adjusted up or down.

Advise families and caregivers of patients to observe for the emergence of such symptoms on a day-to-day basis, since changes may be abrupt. CYMBALTA should be swallowed whole and should not be chewed or crushed, nor should the capsule be opened and its contents be sprinkled on food or mixed with liquids. Nevertheless, if a decision is made to increase the dose beyond 60 mg once daily, increase dose in increments of 30 mg once daily.

The safety of doses above mg once daily has not been adequately evaluated. Periodically reassess to determine the continued need for maintenance treatment and the appropriate dose for such treatment [see Clinical Studies Thereafter, patients may benefit from doses above 60 mg once daily. If a decision is made to increase the dose beyond 60 mg once daily, increase dose in increments of 30 mg once daily.

You may have trouble clearing the drug from your body. This can lead to further liver damage. For people with kidney disease: Avoid taking this drug if you have severe kidney disease or if you receive dialysis. Your kidneys may have trouble removing the drug from your body. This could lead to a buildup of the drug and increase your risk of side effects. For people with diabetes: If so, skip the missed dose, and go back to your regular medication schedule. Never double your dose to catch up.

You should not suddenly stop taking this medicine. Doing so may cause unpleasant side effects, including nausea and headache. If you wish or need to stop taking Cymbalta, your doctor will tell you how to reduce your dose gradually over time. Benefits of Cymbalta In clinical trials , Cymbalta significantly and quickly improved pain. More than half of the patients with fibromyalgia said they felt much better within one week.

Cymbalta for Fibromyalgia Treatment

I am at the point where I dosage if I should go on some other cymbalta for a while? They want you to have a good and safe pregnancy so be sure to talk cymbalta them. An adequate airway, oxygenation, and ventilation should be assured, and cardiac rhythm and vital signs should be monitored. Patients should consult their health care provider for any changes in their medical condition, panadol maximum daily dosage unusual weight gain. Then contact your health care provider, who can determine the best treatment option based on your individual needs and the formulary list of covered medications. The prescribing information lists the following as common side dosages of Cymbalta: Monitor weight and height in children who are taking this drug. I am getting more and more depressed because of all these side effects, cymbalta 40 mg dosage. Plasma protein binding of duloxetine is not affected by renal or hepatic impairment. The AUCs of the major circulating metabolites, cymbalta 40 mg dosage, 4-hydroxy duloxetine glucuronide and 5-hydroxy, 6-methoxy duloxetine sulfate, largely excreted in urine, were approximately 7-to 9-fold higher and would be expected to increase further with multiple dosing. Based on your medical and prescription history, your doctor can determine the underlying cause and possible treatment options. It would take about 5 days for Cymbalta to be completely eliminated from the body.

Truth about Cymbalta (Duloxetine)

duloxetine (Cymbalta)

There are also drugs that initially cause weight loss and then lead to weight gain with long-term use. Syncope and orthostatic hypotension tend to occur within the first week of therapy but can occur at any time during CYMBALTA treatment, particularly after dose increases. When taking Cymbalta duloxetinecymbalta should avoid drinking alcohol, since alcohol may increase the risk of damage to your liver. Plasma protein binding of duloxetine is not affected by renal or hepatic impairment, cymbalta 40 mg dosage. I am currently on Cymbalta 90 mg. This information is for educational purposes only, and not meant to provide dosage advice, treatment, or diagnosis. Please consult with your physician your concerns prior to making any changes. Duloxetine does not inhibit monoamine oxidase MAO. For more specific information, consult with your doctor or local pharmacist for guidance based on your health status and current medications, cymbalta 40 mg dosage, particularly before taking any action, cymbalta 40 mg dosage. The information on this page has been compiled for use by healthcare practitioners and consumers in the United States and therefore neither Everyday Health or its licensor warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. If cymbalta use of Cymbalta dosage other serotonergic drugs including triptans, tricyclic antidepressants, fentanyl, lithium, cymbalta 40 mg dosage, tramadol, buspirone, tryptophan, amphetamines, and St. I was put on this for anxiety and to lose weight because I was dosage eating. What is the protocol for getting off Cymbalta? Do not stop or change the amount of Cymbalta you take without talking to your health care provider first.

Cymbalta (Duloxetine) Tablets

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