Medication Information:
Duloxetine (Generic) - Cymbalta (Brand)

Classification: Antidepressant; selective serotonin and norepinephrine reuptake inhibitor.
Common Usage: Duloxetine is indicated for the treatment of major depressive disorder (MDD) in adults.  The safety and efficacy of duloxetine has not been established in pediatric patients (younger than 18).

Major Side Effects: The most common side effects associated with the use of duloxetine include: nausea, dry mouth, constipation, decreased appetite, fatigue, somnolence, and increased sweating. Discontinuation of duloxetine can cause similar problems and should be done slowly under the close supervision of your health care provider.  To minimize these effects, a gradual reduction in dose is recommended rather than abrupt cessation when possible.

Duloxetine may be associated with an increased risk of mydriasis (dilated pupils) and should be avoided in patients with uncontrolled narrow-angle glaucoma.

In some patients, duloxetine treatment is associated with sustained increases in blood pressure' therefore the manufacturer recommends that patients receiving duloxetine have regular monitoring of blood pressure.

As with other antidepressant medications, patients being treated with duloxetine should be observed closely for clinical worsening and suicidality, especially at the beginning of treatment. If you are planning to become pregnant, are pregnant, or are a nursing mother, the potential benefits of duloxetine must be weighed against the possible hazards.  Discuss these issues in advance with all of your health care providers.

This is not a complete list of all known or potential adverse effects.  Notify your prescriber or pharmacist of any symptoms that have started since you began taking this medication, changing its dose, or adding or changing other medication or diet.  Take care when performing any task (for example, driving or operating machinery) that requires your attention until you have experience with this drug and are confident you can perform the task safely.

Interactions with Other Medications: Duloxetine should be taken with caution in combination with other drugs that affect the central nervous system. Some medications increase the activity of duloxetine (fluvoxamine, paroxetine, fluoxetine, quinolone antibiotics, quinidine). Duloxetine may increase the activity some tricyclic antidepressants (TCAs) (e.g., nortriptyline, imipramine), phenothiazines and certain antiarrhythmics

Duloxetine should not be used in combination with any monoamine oxidase inhibitors (MAOIs) or within 14 days of discontinuing treatment with a MAOI. MAOIs should not be used less than 5 days after stopping duloxetine. MAOIs include: phenelzine (Nardil), tranylcypromine (Parnate), isocarboxazid (Marplan) and selegiline (Eldepryl).

This is not a complete list of all known or potential drug interactions.  To help prevent problems, always make sure your pharmacist and all prescribers know all the medications you are taking.  This includes over-the-counter drugs and any dietary or herbal supplements or medications.

Common Dosages: The initial dose of duloxetine is 40 mg/day (given as 20 mg twice daily) with an increase to 60 mg/day (given either once a day or as 30 mg twice daily).  There is no evidence that doses greater than 60 mg/day will provide any additional benefits. For elderly patients, no dose adjustment is recommended on the basis of age, however extra care should be taken when increasing the dose.

Identification: Duloxetine capsules are available in 20, 30, and 60 mg strengths.  The 20 mg capsules are green and are imprinted with "20 mg" and "LILLY 3235"; the 30 mg capsules are white and blue, and are imprinted with "30 mg" and "LILLY 3240"; the 60 mg capsules are green and blue, and are imprinted with "60 mg" and "LILLY 3237."

Storage: Store this medication at normal room temperature (59° F to 86° F) in a tightly closed, light- and moisture-resistant container.  If you have difficulty opening child-resistant containers, your pharmacist can provide a container that is easier to open.  Keep the medication out of direct sunlight and avoid storing it in a warm or humid area - such as the bathroom or kitchen - to prevent deterioration.  To prevent accidental poisoning, keep all medications out of the reach of children.  Do not take an expired medication.  Do not transfer medication from one container to another.  Carefully discard discontinued medication where children cannot find it.

A SERVICE OF…. Manisses Communications Group, Inc.

Note: These guidelines are for general information only. For more specific information, consult your physician or pharmacist.