Cymbalta 80mg

Cymbalta - Clinical Pharmacology Mechanism of Action Although the exact mechanisms of the antidepressant, central pain inhibitory and 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. Pharmacodynamics Preclinical studies have shown that duloxetine is a potent inhibitor of neuronal serotonin and norepinephrine reuptake and a less potent inhibitor of dopamine reuptake.

Duloxetine has no significant affinity for dopaminergic, adrenergic, cholinergic, histaminergic, opioid, glutamate, and GABA receptors in vitro. Duloxetine does not inhibit monoamine oxidase MAO. Cymbalta is in a class of drugs known to affect urethral resistance. If symptoms of urinary hesitation develop during treatment with Cymbalta, consideration should be given to the possibility that they might be drug-related.

Pharmacokinetics Duloxetine has an elimination half-life of about 12 hours range 8 to 17 hours and its pharmacokinetics are dose proportional over the therapeutic range. Steady-state plasma concentrations are typically achieved after 3 days of dosing. Absorption and Distribution — Orally administered duloxetine hydrochloride is well absorbed. There is a median 2 hour lag until absorption begins Tlag , with maximal plasma concentrations Cmax of duloxetine occurring 6 hours post dose.

There is a 3 hour delay in absorption and a one-third increase in apparent clearance of duloxetine after an evening dose as compared to a morning dose.

The interaction between duloxetine and other highly protein bound drugs has not been fully evaluated. Plasma protein binding of duloxetine is not affected by renal or hepatic impairment.

Metabolism and Elimination — Biotransformation and disposition of duloxetine in humans have been determined following oral administration of 14C-labeled duloxetine. The major biotransformation pathways for duloxetine involve oxidation of the naphthyl ring followed by conjugation and further oxidation. Metabolites found in plasma include 4-hydroxy duloxetine glucuronide and 5-hydroxy, 6-methoxy duloxetine sulfate. Many additional metabolites have been identified in urine, some representing only minor pathways of elimination.

Duloxetine undergoes extensive metabolism, but the major circulating metabolites have not been shown to contribute significantly to the pharmacologic activity of duloxetine.

Children and Adolescents ages 7 to 17 years — Duloxetine steady-state plasma concentration was comparable in children 7 to 12 years of age , adolescents 13 to 17 years of age and adults. The model-predicted duloxetine steady state plasma concentrations in children and adolescents were mostly within the concentration range observed in adult patients and did not exceed the concentration range in adults. Nonclinical Toxicology Carcinogenesis, Mutagenesis, Impairment of Fertility Carcinogenesis — Duloxetine was administered in the diet to mice and rats for 2 years.

Mutagenesis — Duloxetine was not mutagenic in the in vitro bacterial reverse mutation assay Ames test and was not clastogenic in an in vivo chromosomal aberration test in mouse bone marrow cells.

Additionally, duloxetine was not genotoxic in an in vitro mammalian forward gene mutation assay in mouse lymphoma cells or in an in vitro unscheduled DNA synthesis UDS assay in primary rat hepatocytes, and did not induce sister chromatid exchange in Chinese hamster bone marrow in vivo.

As suicidal ideation and behavior in clinical trials are rare, the results for any drug taken separately usually do not reach statistical significance. In the United States FDA released a public health advisory noting that there had been 11 reports of suicide attempts and 3 reports of suicidality within the mostly middle-aged women participating in the open label extension trials of duloxetine for the treatment of stress urinary incontinence.

The FDA described the potential role of confounding social stressors "unclear". The suicide attempt rate in the SUI study population based on 9, patients was calculated to be per , person years.

This rate is greater than the suicide attempt rate among middle-aged U. In addition, one death from suicide was reported in a Cymbalta clinical pharmacology study in a healthy female volunteer without SUI. No increase in suicidality was reported in controlled trials of Cymbalta for depression or diabetic neuropathic pain.

These symptoms should be looked for especially early during treatment and when the dose is adjusted up or down. However, people should look for these symptoms on a day-to-day basis, since these changes may be abrupt. These symptoms may be associated with an increased risk of suicidal thinking and behavior. Close monitoring by a doctor or health care professional and possibly a change in medication may be needed if these symptoms occur.

Food and Drug Administration by visiting https: Anxiety can be caused by many factors. For more specific information, consult with your doctor for guidance based on your health status and current medications, particularly before taking any action. Derek Dore, PharmD Q: I started taking Cymbalta last year to help ease the problems associated with fibromyalgia. I have gained about 25 pounds. I have not ever weighed what I do now even when I was pregnant? Could the Cymbalta have a part in that? According to the manufacturer's product information, patients taking Cymbalta generic name is Duloxetine during one clinical trial which was for depression generally lost weight.

The weight loss was between 1 to 2. During another clinical study, which was conducted to measure the effects of Cymbalta Duloxetine for fibromyalgia, patients had an average weight gain of 1. The final conclusion by the manufacturer was that the long-term effects of Cymbalta Duloxetine on changes in weight are not known. Based on the manufacturer information, Cymbalta can cause both weight gain or weight loss.

The proposed way that Cymbalta Duloxetine may increase or decrease weight is by either increasing or decreasing appetite. I have also included a link about Cymbalta Duloxetine for more information.

What is the starting dose for Cymbalta? The starting dose for Cymbalta generic name is duloxetine is really dependent on the reason the physician has prescribed it. For the treatment of major depression, the manufacturer's recommended starting dose is 40 to 60 mg orally per day. The initial dose for generalized anxiety disorder is 60 mg orally daily.

Cymbalta is also prescribed for diabetic neuropathy. The starting dose for this diagnosis is 60 mg orally daily. The last indication for Cymbalta is for pain associated with fibromyalgia.

The manufacturer recommends a starting dose of 30 mg orally daily for one week followed by an increase to 60 mg orally daily. I have also included a link for more information about Cymbalta. Does Cymbalta cause memory problems? I'm taking 30 mg a day and seem to have more trouble remembering things. When reviewing the information in the Patient Package Insert of Cymbalta, I can find no direct finding of impaired memory. The manufacturer Lilly did state that there was a possibility that Cymbalta could decrease levels of sodium in the blood.

This can only be confirmed by blood testing. One of the possible symptoms of decreased levels of sodium in the blood is memory impairment. This could be worsened if you were on any other medication that caused you to lose water, like a water pill, or had some other underlying condition that caused you to be dehydrated. Also severe kidney and liver disease could affect how Cymbalta is broken down by the body. It stands to reason that if there was more drug available, there could be more possibility for decreased levels of sodium.

When I did a search of Cymbalta and memory issues I did find several complaints. This may be a possible side effect that has been "discovered" after the drug was released and the manufacturer may be in the process of evaluating its merit. My doctor prescribed one Prozac every other day for three days to get me weaned off Cymbalta, but I am dealing with extreme dizziness. Is there a way to get rid of dizzy spells while trying to get off Cymbalta?

Side effects of withdrawal side effects from Cymbalta duloxetine can range from bothersome to severe. Consult your health care provider about the dizzy spells. Your health care provider is best able to guide your dose taper based on your specific circumstances. It may be necessary to temporarily increase your dose to control side effects. Do not change the amount of medication you take without talking to your health care provider first.

Will Cymbalta cause me to gain weight? I have been taking it for 2 months and have gained 10 pounds. It was prescribed for me for depression and fibromyalgia. Cymbalta duloxetine is a serotonin and norepinephrine reuptake inhibitor antidepressant which is approved by the U. Food and Drug Administration FDA to treat diabetic peripheral neuropathic pain, fibromyalgia, generalized anxiety disorder and major depressive disorder.

Cymbalta can also cause decreased appetite and weight loss in some patients. Prescription medications can affect weight in different ways. Some medications can cause fluid retention which can increase weight. Other medications may increase appetite or cause cravings for high calorie foods. Talk to you doctor about any unpleasant side effects you experience from your medications.

If Cymbalta is working well for you, it may be best to work on losing extra weight through diet and exercise. If Cymbalta is not effective your doctor may wish to try a different medication to treat depression and fibromyalgia. It is important to keep in mind that many medications that affect the central nervous system, such as Cymbalta, do have a possible weight gain side effect. However, everyone responds to medications differently, a medication that causes weight gain in one person may not affect weight in a different person.

I have hypothryoidism and fibromyalgia, which I take Cymbalta for. What are the side effects I can expect? Cymbalta duloxetine is an antidepressant that is used to treat major depressive disorder, general anxiety disorder, fibromyalgia, and diabetic neuropathy.

Some of the most common side effects associated with Cymbalta are nausea, dry mouth, constipation, insomnia, dizziness, fatigue, diarrhea, decrease in appetite, sweating, vomiting, blurred vision, headache, decrease in libido, tremor, anxiety, increase in blood pressure, and hot flashes.

Some of the more serious reactions are suicidality, seizures, glaucoma, abnormal bleeding, urinary retention, and decreased sodium levels. This is not a complete list of the side effects associated with Cymbalta. Why does Cymbalta kill my libido? I am taking 60mg daily will a 30mg dose help? Cymbalta duloxetine is a serotonin and norepinephrine reuptake inhibitor antidepressant medication prescribed for the treatment of depression, anxiety, diabetic peripheral neuropathy, and fibromyalgia.

Like other agents prescribed for the treatment of depression, Cymbalta can cause sexual dysfunction or decreased libido. Clinical research studies indicate that sexual dysfunction or decreased libido can be a symptom of the disease depression and not the medication.

The manufacturer of Cymbalta does list sexual dysfunction as a side effect. Medications affect each individual differently. In some patients, the severity or degree of sexual dysfunction can improve with the duration of therapy or with lower dosages or by changing to a different medication.

Please consult with your physician your concerns prior to making any changes. Consuelo Worley, RPh Q: I've been taking Cymbalta 60 mg for over a year now for the pain of fibromyalgia. I'm concerned that I may be damaging my liver.

I keep my 6 month check-ups with my rheumatologist, and she says to continue taking it. Am I damaging myself by doing this? I am a pretty healthy 70 year old.

The most common side effects with Cymbalta are drowsiness, headache, dizziness, insomnia, fatigue, nausea, dry mouth, constipation, diarrhea and decreased appetite.

Cymbalta does carry a risk of causing liver damage or liver failure, however it is rare. Those with current liver damage or substantial alcohol intake should avoid using Cymbalta. Your doctor can do blood tests to check for liver damage. It is recommended to avoid alcohol while on Cymbalta to decrease the risk of developing liver damage. I have taken Cymbalta for 3 years now. My medical plan has changed and I cannot afford it. I take gabapentin now and it doesn't work as well.

Is there going to be a generic version of Cymbalta that is more affordable? Cymbalta increases certain natural chemicals in the brain -- serotonin and norepinephrine -- which assist in keeping a healthy mental balance and prevent pain signals from moving in the brain. Gabapentin is in a drug class called anticonvulsants. Gabapentin is used to control certain types of seizures. Gabapentin is also used to treat postherpetic neuralgia, which is pain in the area where shingles has occurred.

Pain can last for months to years after shingles. Gabapentin is also used treat pain and tingling associated with diabetic neuropathy. Gabapentin works to reduce seizures by reducing abnormal excitement in the brain.

Gabapentin works to relieve pain by altering the way the body senses pain. Currently, there is no generic version of Cymbalta available in the United States. Brand name Cymbalta is protected by a patent. It appears that patent protection for Cymbalta expires in , at which time, drug manufacturers may be able to make and sell generic versions of Cymbalta. The price of a medication, like Cymbalta, can vary depending on the wholesaler and pharmacy from which the medication is acquired.

Pharmacies sell medication to consumers at a price that includes the cost for acquiring the drug from the wholesaler, plus a retail markup. If a third-party payer for example, a health insurance company or Medicare is providing coverage for a medication, such as Cymbalta, they determine the final cost of the product. Costs will vary from one plan to another, and the payer may cover or reimburse part or all of the cost. Some pharmaceutical companies have patient assistance programs for people having difficulty affording their medications.

Specific information about these individual programs can often be obtained by visiting the drug maker's website or asking your physician or local pharmacist. In addition, the Pharmaceutical Research and Manufacturers of America and its member companies sponsor an interactive website with information about drug assistance programs. The Partnership for Prescription Assistance helps people who qualify without prescription medication coverage obtain needed medications for free or almost free.

People can find more information by visiting https: It is important to work with your doctor and pharmacist to find a safe, effective, and affordable treatment option for you. My son has been diagnosed with bipolar and has been given Cymbalta. Is it used for bipolar disorder? Cymbalta duloxetine is a medication that is used to treat depression, anxiety, and panic disorders. Cymbalta is in the class of medications called serotonin-norepinephrine reuptake inhibitors, or SNRIs.

This medication works by bringing a balance to both serotonin and norepinephrine, chemicals in the brain that cause symptoms of depression. Cymbalta is not approved by the U. Food and Drug Administration FDA to treat bipolar disorder, but is often used as an off-label treatment for the depression associated with bipolar disorder manic depression.

The manufacturer of Cymbalta does state that it should be used with caution in patients who experience manic episodes because the medication may induce an episode of manic behavior. For more information regarding the off-label uses of Cymbalta, consult with your son's health care provider. I take Cymbalta and am still depressed. Are there other options? Cymbalta duloxetine is an antidepressant medication commonly used to treat depression, anxiety, diabetic neuropathy, fibromyalgia.

Cymbalta mg daily is a very high dosage. For major depressive disorder, it is recommended Cymbalta be dosed initially at 30mg daily increasing to 60mg daily as a maintenance dose. Doses up to mg were reviewed in clinical trials. While the mg dose was found to be effective, it was not considered any more effective than 60mg of Cymbalta. Cymbalta duloxetine should be swallowed whole do not cut, crush, or chew and can be taken with or without food.

Do not stop Cymbalta duloxetine abruptly. Cymbalta duloxetine should be tapered off slowly to prevent withdrawal symptoms. Withdrawal symptoms from Cymbalta duloxetine can include abnormal dreams, headache, insomnia, dizziness, nausea, vomiting, irritability, fatigue, diarrhea, anxiety, confusion, and seizures. Talk to your healthcare provider about your current symptoms, your opinion on how effective Cymbalta duloxetine has been, and establish a future treatment plan. Since depression can be caused by physical, emotional, and social problems, a complete treatment plan should take all of these factors into consideration.

Can Cymbalta cause bruising? Cymbalta is indicated for the treatment of major depressive disorder, diabetic neuropathy, generalized anxiety disorder, and fibromyalgia, but may also be prescribed for other conditions. As elderly patients tend to have a higher underlying risk for falls due to a higher prevalence of risk factors such as use of multiple medications, medical comorbidities and gait disturbances, the impact of increasing age by itself is unclear.

Serotonin Syndrome The development of a potentially life-threatening serotonin syndrome has been reported with SNRIs and SSRIs, including CYMBALTA, alone but particularly with concomitant use of other serotonergic drugs including triptans, tricyclic antidepressants , fentanyl, lithium , tramadol, tryptophan , buspirone, amphetamines, and St.

Serotonin syndrome symptoms may include mental status changes e. Patients should be monitored for the emergence of serotonin syndrome. No reports involved the administration of methylene blue by other routes such as oral tablets or local tissue injection or at lower doses. If concomitant use of CYMBALTA with other serotonergic drugs including triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, buspirone, tryptophan, amphetamines, and St.

Treatment with CYMBALTA and any concomitant serotonergic agents, should be discontinued immediately if the above events occur and supportive symptomatic treatment should be initiated. Concomitant use of aspirin, nonsteroidal anti-inflammatory drugs, warfarin, and other anti-coagulants may add to this risk. Case reports and epidemiological studies case-control and cohort design have demonstrated an association between use of drugs that interfere with serotonin reuptake and the occurrence of gastrointestinal bleeding.

The reporting rate is generally accepted to be an underestimate due to underreporting. CYMBALTA should be discontinued at the first appearance of blisters, peeling rash, mucosal erosions, or any other sign of hypersensitivity if no other etiology can be identified. During marketing of other SSRIs and SNRIs serotonin and norepinephrine reuptake inhibitors , there have been spontaneous reports of adverse events occurring upon discontinuation of these drugs, particularly when abrupt, including the following: Although these events are generally self-limiting, some have been reported to be severe.

A gradual reduction in the dose rather than abrupt cessation is recommended whenever possible. 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.

A gradual reduction in dosage rather than abrupt cessation is recommended whenever possible [see Warnings and Precautions 5. In a patient who requires more urgent treatment of a psychiatric condition, other interventions, including hospitalization, should be considered [see Contraindications 4 ]. If acceptable alternatives to linezolid or intravenous methylene blue treatment are not available and the potential benefits of linezolid or intravenous methylene blue treatment are judged to outweigh the risks of serotonin syndrome in a particular patient, CYMBALTA should be stopped promptly, and linezolid or intravenous methylene blue can be administered.

The patient should be monitored for symptoms of serotonin syndrome for 5 days or until 24 hours after the last dose of linezolid or intravenous methylene blue, whichever comes first. The clinician should, nevertheless, be aware of the possibility of emergent symptoms of serotonin syndrome with such use [see Warnings and Precautions 5.

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