|Brand Name||Duloxetine (generic Cymbalta)|
|Medication||10 20 30 and 60 mg|
Duloxetine hydrochloride (Cymbalta Duloxetine) has been licensed to treat the following conditions:
•Depression (also known as major depression or clinical depression)
•Peripheral diabetic neuropathy pain
•Generalized anxiety disorder (GAD)
•Chronic musculoskeletal pain (such as arthritis pain or back pain).
Treatment with Cymbalta (Duloxetine) (Duloxetine) is specifically for the treatment of anxiety and depression. Cymbalta (Duloxetine) (Duloxetine) is a selective serotonin and norepinephrine reuptake inhibitor (SSNRI) for oral administration only. Although the exact mechanisms of the antidepressant central pain inhibitory & anxiolytic actions of Duloxetine in humans are unknown, these actions are believed to be related to its potentiation of serotonergic and noradrenergic activity in the CNS. Duloxetine may improve your mood, sleep, appetite, and energy level, and decrease nervousness. This treatment was developed by Eli Lilly & co after details about Cymbalta (Duloxetine) (Duloxetine)'s run-away success hit the news. Approved by the FDA in 2003, Duloxetine has since then become well known in its own right. You can find many forums online. If you need any additional information about Duloxetine, just continue reading the FAQs that follow.
Usual Adult Dose for Pain
For use in the management of neuropathic pain associated with diabetic peripheral neuropathy and for the management of chronic musculoskeletal pain in patients with chronic low back pain and chronic pain due to osteoarthritis:
Usual Dose: 60 mg once a day without regard to meals.
For patients in whom tolerability is a concern, a lower starting dose may be considered.
Although a 120 mg per day dose was shown to be safe and effective, there is no evidence that doses higher than 60 mg have any additional benefit. Furthermore, the higher dose has been clearly less well tolerated.
Efficacy beyond 12 weeks has not been systematically studied in placebo-controlled studies, but a one year open label safety study has been conducted.
Usual Adult Dose for Depression
Initial Dose: 40 mg per day (administered as 20 mg twice daily) to 60 mg per day (given either once a day or as 30 mg twice daily) without regard to meals.
Usual Adult Dose for Anxiety
Initial dose: 60 mg orally once a day If necessary, dosage may be increased in increments of no more than 30 mg per day Maximum dose: 120 mg per day For patients in whom tolerability is a concern, a lower an initial dose of 30 mg orally once a day may be considered. Following one week of therapy, the dose may be increased to 60 mg orally once a day in this patient population. Although a 120 mg per day dose was shown to be safe and effective, there is no evidence that doses higher than 60 mg have any additional benefit.
It is generally agreed that episodes of generalized anxiety disorder require several months or longer of sustained pharmacological therapy. Maintenance of efficacy in generalized anxiety disorder has been demonstrated with duloxetine as monotherapy. Duloxetine should be administered in a dose range of 60 to 120 mg once daily. Patients should be periodically reassessed to determine the continued need for maintenance treatment and the appropriate dose for such treatment.
Usual Adult Dose for Fibromyalgia
Initial Dose: 30 mg once a day without regard to meals for one week.
Usual Dose: 60 mg once a day without regard to meals.
Treatment should begin at 30 mg once daily for 1 week, to allow patients to adjust to the medication before increasing to 60 mg once daily. Some patients may respond to the starting dose. There is no evidence that doses greater than 60 mg/day confer additional benefit, even in patients who do not respond to a 60 mg dose, and higher doses are associated with a higher rate of adverse reactions.
Fibromyalgia is recognized as a chronic condition. The efficacy of duloxetine in the management of fibromyalgia has been demonstrated in placebo-controlled studies up to three months. The efficacy of duloxetine was not demonstrated in longer studies; however, continued treatment should be based on individual patient response.
Renal Dose Adjustments
Use of duloxetine is not recommended in patients with severe renal impairment or end-stage renal disease (CrCl 30 mL/min or less).
Liver Dose Adjustments
Because duloxetine increases the risk of elevation of serum transaminase levels and may aggravate preexisting liver disease, duloxetine should ordinarily not be prescribed to patients with substantial alcohol use or evidence of chronic liver disease.
No dose adjustment is recommended for elderly patients on the basis of age. However, when individualizing the dosage in elderly patients, extra caution is recommended when increasing the dose.
Never take Cymbalta with the drug thioridazine.
Never combine Cymbalta with any drug classified as an MAOI. Cymbalta and MAOIs should not be taken together or within 14 days of each other.
If Cymbalta is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Cymbalta with the following: alcohol, aspirin, cimetidine, desipramine, fluoxetine, fluvoxamine, linezolid, lithium, narcotic painkillers, NSAIDs, paroxetine, phenothiazines, quinidine, quinolone antibiotics (such as ciprofloxacin), sleep inducers, other SNRIs (such as venlafaxine), other antidepressants (such as sertraline, nortriptyline, amitriptyline, and imipramine), St. John's wort, theophylline, tramadol, tranquilizers, triptans, tryptophan, Type IC antiarrhythmic drugs (such as propafenone), and warfarin.
In clinical studies, antidepressants increased the risk of suicidal thinking and behavior in children and adolescents with depression and other psychiatric disorders. Anyone considering the use of Cymbalta or any other antidepressant in a child or adolescent must balance this risk with the clinical need. Cymbalta has not been studied in children or adolescents and is not approved for treating anyone less than 18 years old.
Additionally, the progression of major depression is associated with a worsening of symptoms and/or the emergence of suicidal thinking or behavior in both adults and children, whether or not they are taking antidepressants. Individuals being treated with Cymbalta and their caregivers should watch for any change in symptoms or any new symptoms that appear suddenly—especially agitation, anxiety, hostility, panic, restlessness, extreme hyperactivity, and suicidal thinking or behavior—and report them to the doctor immediately. Be especially observant at the beginning of treatment or whenever there is a change in dose.
Some medical conditions require careful monitoring during treatment with Cymbalta. Be sure to tell the doctor if you have diabetes, glaucoma, high blood pressure, or a seizure disorder. Cymbalta can cause episodes of mania (abnormally high feelings of excitement and energy), so be sure the doctor is aware if you have this condition.
Using Cymbalta is not recommended if you have liver problems or severe kidney disease.
Like other antidepressants, Cymbalta can cause drowsiness and affect judgment or motor skills. Use caution when driving, operating dangerous machinery, or participating in hazardous activities until you know how the drug affects you.
Cymbalta (Duloxetine) or its generic alternatives all have certain side effects, the most common of which are vomiting sensation, dry mouth, constipation, loss of appetite, tiredness, drowsiness, dizziness, increased sweating, blurred vision, or drowsiness may occur. If any of these effects persist or worsen, tell your doctor immediately. Also observe serious side effects like fainting, unusual or severe mental/mood changes, decreased interest in sex, changes in sexual ability, difficulty urinating, change in the amount of urine, weight loss, headache, back pains, muscle pains, congested nose and indigestion. The severity of these Duloxetine side effects depends on the dosage taken. Duloxetine This medication is a habit forming medicine, especially if it has been used regular for an extended time or used in high doses. In such cases, withdrawal reactions may occur if you suddenly stop this drug. To prevent withdrawal when stopping regular treatment with this drug, gradually taper the dosage as directed. Consult your doctor or pharmacist for more details, and report any withdrawal reactions prompt on time.