Cymbalta

Cymbalta

     * Generic Name: duloxetine hcl
     * Brand Name: Cymbalta


     * What is duloxetine (Cymbalta, Irenka)?
     * What are the possible side effects of duloxetine (Cymbalta,
       Irenka)?
     * What is the most important information I should know about
       duloxetine (Cymbalta, Irenka)?
     * What should I discuss with my healthcare provider before taking
       duloxetine (Cymbalta, Irenka)?
     * How should I take duloxetine (Cymbalta, Irenka)?
     * What happens if I miss a dose (Cymbalta, Irenka)?
     * What happens if I overdose (Cymbalta, Irenka)?
     * What should I avoid while taking duloxetine (Cymbalta, Irenka)?
     * What other drugs will affect duloxetine (Cymbalta, Irenka)?
     * Where can I get more information (Cymbalta, Irenka)?

What is duloxetine (Cymbalta, Irenka)?

   Duloxetine is a selective serotonin and norepinephrine
   reuptake inhibitor antidepressant (SSNRI). Duloxetine affects
   chemicals in the brain that may be unbalanced in people with
   depression.

   Duloxetine is used to treat major depressive disorder in adults.
   Duloxetine is also used to treat general anxiety disorder in adults
   and children who are at least 7 years old.

   Duloxetine is also used in adults to treat fibromyalgia (a
   chronic pain disorder), or chronic muscle or joint pain (such
   as low back pain and osteoarthritis pain).

   Duloxetine is also used to treat pain caused by nerve damage in adults
   with diabetes (diabetic neuropathy).

   Duloxetine may also be used for purposes not listed in this medication
   guide.

What are the possible side effects of duloxetine (Cymbalta, Irenka)?

   Get emergency medical help if you have signs of an allergic reaction:
   skin rash or hives; difficulty breathing; swelling of your face, lips,
   tongue, or throat.

   Report any new or worsening symptoms to your doctor, such as: mood or
   behavior changes, anxiety, panic attacks, trouble sleeping, or if
   you feel impulsive, irritable, agitated, hostile, aggressive, restless,
   hyperactive (mentally or physically), more depressed, or have thoughts
   about suicide or hurting yourself.

   Call your doctor at once if you have:
     * a light-headed feeling, like you might pass out;
     * vision changes, eye pain or swelling, eye redness;
     * easy bruising, unusual bleeding;
     * painful or difficult urination;
     * a seizure;
     * a manic episode--racing thoughts, increased energy, reckless
       behavior, feeling extremely happy or irritable, talking more than
       usual, severe problems with sleep;
     * liver problems--right-sided upper stomach pain, itching, dark
       urine, jaundice (yellowing of the skin or eyes);
     * low levels of sodium in the body--headache, confusion, slurred
       speech, severe weakness, vomiting, loss of coordination,
       feeling unsteady; or
     * severe skin reaction--fever, sore throat, swelling in your face
       or tongue, burning in your eyes, skin pain, followed by a red or
       purple skin rash that spreads (especially in the face or upper
       body) and causes blistering and peeling.

   Seek medical attention right away if you have symptoms of serotonin
   syndrome, such as: agitation, hallucinations, fever, sweating,
   shivering, fast heart rate, muscle stiffness, twitching, loss of
   coordination, nausea, vomiting, or diarrhea.

   Older adults may be more sensitive to the side effects of this
   medicine.

   Common side effects may include:
     * dry mouth;
     * drowsiness, dizziness;
     * tired feeling;
     * nausea, constipation, loss of appetite, weight loss; or
     * increased sweating.

   This is not a complete list of side effects and others may occur. Call
   your doctor for medical advice about side effects. You may report side
   effects to FDA at 1-800-FDA-1088.

What is the most important information I should know about duloxetine
(Cymbalta, Irenka)?

   Do not take duloxetine within 5 days before or 14 days after you have
   used an MAO inhibitor, such as isocarboxazid, linezolid,
   methylene blue injection, phenelzine, rasagiline, selegiline,
   or tranylcypromine.

   Some young people have thoughts about suicide when first taking an
   antidepressant. Stay alert to changes in your mood or symptoms. Report
   any new or worsening symptoms to your doctor.

   Do not stop using duloxetine without first talking to your doctor.

   Cymbalta Patient Information including How Should I Take
   Fibromyalgia Symptoms, Diagnosis, and Treatment

   Fibromyalgia Overview Slideshow
   RxList

   Take the Fibromyalgia Quiz
   Fibromyalgia Treatments and Tips to Ease Pain and Other Symptoms

   Fibromyalgia Slideshow: 12 Tips for Coping

What should I discuss with my healthcare provider before taking duloxetine
(Cymbalta, Irenka)?

   You should not use duloxetine if you are allergic to it.

   Do not take duloxetine within 5 days before or 14 days after you have
   used an MAO inhibitor, such as isocarboxazid, linezolid, methylene blue
   injection, phenelzine, rasagiline, selegiline, or tranylcypromine. A
   dangerous drug interaction could occur.

   Some medicines can interact with duloxetine and cause a serious
   condition called serotonin syndrome. Be sure your doctor knows if you
   also take stimulant medicine, opioid medicine, herbal products, or
   medicine for depression, mental illness, Parkinson's disease,
   migraine headaches, serious infections, or prevention of nausea
   and vomiting. Ask your doctor before making any changes in how or when
   you take your medications.

   To make sure duloxetine is safe for you, tell your doctor if you have
   ever had:
     * liver or kidney disease;
     * seizures or epilepsy;
     * a bleeding or blood clotting disorder;
     * high blood pressure;
     * narrow-angle glaucoma;
     * bipolar disorder (manic depression); or
     * drug addiction or suicidal thoughts.

   Some young people have thoughts about suicide when first taking an
   antidepressant. Your doctor will need to check your progress at regular
   visits while you are using duloxetine. Your family or other caregivers
   should also be alert to changes in your mood or symptoms.

   It is not known whether duloxetine will harm an unborn baby. However,
   duloxetine may cause problems in a newborn if you take the medicine
   during the third trimester of pregnancy. Tell your doctor if you are
   pregnant or plan to become pregnant while using this medicine.

   If you are pregnant, your name may be listed on a pregnancy registry.
   This is to track the outcome of the pregnancy and to evaluate any
   effects of duloxetine on the baby.

   Duloxetine can pass into breast milk, but effects on the nursing baby
   are not known. Tell your doctor if you are breast-feeding.

   Duloxetine is not approved for use by anyone younger than 18 years old.

How should I take duloxetine (Cymbalta, Irenka)?

   Follow all directions on your prescription label. Do not take this
   medicine in larger or smaller amounts or for longer than recommended.

   You may take duloxetine with or without food.

   Do not crush, chew, break, or open an extended-release capsule. Swallow
   it whole.

   It may take 1 to 4 weeks before your symptoms improve. Keep using the
   medication as directed. Do not stop using duloxetine without first
   talking to your doctor. You may have unpleasant side effects if you
   stop taking this medicine suddenly.

   Store at room temperature away from moisture and heat.

   Cymbalta Patient Information including If I Miss a Dose
   Fibromyalgia Symptoms, Diagnosis, and Treatment

   Fibromyalgia Overview Slideshow
   RxList

   Take the Fibromyalgia Quiz
   Fibromyalgia Treatments and Tips to Ease Pain and Other Symptoms

   Fibromyalgia Slideshow: 12 Tips for Coping

What happens if I miss a dose (Cymbalta, Irenka)?

   Take the missed dose as soon as you remember. Skip the missed dose if
   it is almost time for your next scheduled dose. Do not take extra
   medicine to make up the missed dose.

What happens if I overdose (Cymbalta, Irenka)?

   Seek emergency medical attention or call the Poison Help line at
   1-800-222-1222.

What should I avoid while taking duloxetine (Cymbalta, Irenka)?

   Avoid drinking alcohol. It may increase your risk of liver damage.

   Ask your doctor before taking a nonsteroidal anti-inflammatory drug
   (NSAID) for pain, arthritis, fever, or swelling. This includes
   aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib
   (Celebrex), diclofenac, indomethacin, meloxicam, and
   others. Using an NSAID with duloxetine may cause you to bruise or bleed
   easily.

   Duloxetine may impair your thinking or reactions. Be careful if you
   drive or do anything that requires you to be alert. Avoid getting up
   too fast from a sitting or lying position, or you may feel dizzy. Get
   up slowly and steady yourself to prevent a fall.

   Severe dizziness or fainting can cause falls, accidents, or severe
   injuries.

What other drugs will affect duloxetine (Cymbalta, Irenka)?

   Many drugs can interact with duloxetine. Not all possible interactions
   are listed here. Tell your doctor about all your current medicines and
   any you start or stop using, especially:
     * any other antidepressant;
     * cimetidine;
     * St. John's wort;
     * theophylline;
     * tryptophan (sometimes called L-tryptophan);
     * an amphetamine--Adderall, Focalin, Vyvanse,
       Ritalin, Concerta, Strattera, and others;
     * an antibiotic--ciprofloxacin, enoxacin;
     * a blood thinner--warfarin, Coumadin, Jantoven;
     * heart rhythm medication--flecainide, propafenone,
       quinidine, and others;
     * opioid medicine--fentanyl, tramadol;
     * medicine to treat mood disorders, thought disorders, or mental
       illness--buspirone, lithium, thioridazine, and many
       others; or
     * migraine headache medicine--sumatriptan, rizatriptan,
       zolmitriptan, and others.

   This list is not complete and many other drugs can interact with
   duloxetine. This includes prescription and over-the-counter medicines,
   vitamins, and herbal products. Give a list of all your medicines to any
   healthcare provider who treats you.

Where can I get more information (Cymbalta, Irenka)?

   Your pharmacist can provide more information about duloxetine.
     __________________________________________________________________

   Remember, keep this and all other medicines out of the reach of
   children, never share your medicines with others, and use this
   medication only for the indication prescribed.
   Every effort has been made to ensure that the information provided by
   Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete,
   but no guarantee is made to that effect. Drug information contained
   herein may be time sensitive. Multum information has been compiled for
   use by healthcare practitioners and consumers in the United States and
   therefore Multum does not warrant that uses outside of the United
   States are appropriate, unless specifically indicated otherwise.
   Multum's drug information does not endorse drugs, diagnose patients or
   recommend therapy. Multum's drug information is an informational
   resource designed to assist licensed healthcare practitioners in caring
   for their patients and/or to serve consumers viewing this service as a
   supplement to, and not a substitute for, the expertise, skill,
   knowledge and judgment of healthcare practitioners. The absence of a
   warning for a given drug or drug combination in no way should be
   construed to indicate that the drug or drug combination is safe,
   effective or appropriate for any given patient. Multum does not assume
   any responsibility for any aspect of healthcare administered with the
   aid of information Multum provides. The information contained herein is
   not intended to cover all possible uses, directions, precautions,
   warnings, drug interactions, allergic reactions, or adverse effects. If
   you have questions about the drugs you are taking, check with your
   doctor, nurse or pharmacist.