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Cymbaltaź
Generic Name: duloxetine
Brand Names: Cymbalta
See:
Celexa
Elavil Effexor Fluoxetine
Lexapro Paxil
Paxil CR Prozac
Remeron Zoloft
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Cymbalta is an antidepressant in a group of drugs called selective serotonin and
norepinephrine reuptake inhibitors (SSNRIs). Cymbalta affects chemicals in the
brain that may become unbalanced and cause depression.
Cymbalta is used to treat major depressive disorder and general anxiety
disorder. It is also used to treat pain caused by nerve damage in people with
diabetes (diabetic neuropathy).
Do not take Cymbalta together with thioridazine (Mellaril), or a monoamine
oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil),
rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate).
You must wait at least 14 days after stopping an MAOI before you can take
Cymbalta. After you stop taking Cymbalta, you must wait at least 5 days before
you start taking an MAOI.
You may have thoughts about suicide when you first start taking an
antidepressant, especially if you are younger than 24 years old. Your doctor
will need to check you at regular visits for at least the first 12 weeks of
treatment.
Call your doctor at once if you have any new or worsening symptoms 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.
Avoid using other medicines that make you sleepy (such as cold medicine, pain
medication, muscle relaxers, medicine for seizures, other medication for
depression or anxiety). They can add to sleepiness caused by Cymbalta.
Cymbalta can cause side effects that may impair your thinking or reactions. Be
careful if you drive or do anything that requires you to be awake and alert.
Do not use Cymbalta together with thioridazine (Mellaril), or an MAO inhibitor
such as isocarboxazid (Marplan), tranylcypromine (Parnate), phenelzine (Nardil),
rasagiline (Azilect), or selegiline (Eldepryl, Emsam). Serious and sometimes
fatal reactions can occur when these medicines are taken with Cymbalta. You must
wait at least 14 days after stopping an MAO inhibitor before you can take
Cymbalta. After you stop taking Cymbalta, you must wait at least 5 days before
you start taking an MAOI. Do not use Cymbalta if you are allergic to duloxetine,
or if you have untreated or uncontrolled glaucoma.
Before taking Cymbalta, tell your doctor if you are allergic to any drugs, or if
you have:
liver or kidney disease; seizures or epilepsy; bipolar disorder (manic
depression); or a history of drug abuse or suicidal thoughts.
If you have any of these conditions, you may not be able to use Cymbalta, or you
may need a dosage adjustment or special tests during treatment.
You may have thoughts about suicide when you first start taking an
antidepressant, especially if you are younger than 24 years old. Tell your
doctor if you have worsening symptoms of depression or suicidal thoughts during
the first several weeks of treatment, or whenever your dose is changed.
Your family or other caregivers should also be alert to changes in your mood or
symptoms. Your doctor will need to check you at regular visits for at least the
first 12 weeks of treatment.
FDA pregnancy category C. Cymbalta may be harmful to an unborn baby, and may
cause problems in a newborn baby if the mother takes the medication late in
pregnancy (during the third trimester). Tell your doctor if you are pregnant or
plan to become pregnant during treatment. Cymbalta can pass into breast milk and
may harm a nursing baby. Do not use this medication without telling your doctor
if you are breast-feeding a baby. Older adults may be more sensitive to the side
effects of this medication.
Do not give Cymbalta to anyone younger than 18 years old without the advice of a
doctor.
Take this medication exactly as it was prescribed
for you. Do not take the medication in larger amounts, or take it for longer
than recommended by your doctor. Your doctor may occasionally change your dose
to make sure you get the best results from the medication.
Try to take the medicine at the same time each day. Follow the directions on
your prescription label.
Do not crush, chew, break, or open a delayed-release capsule. Swallow the pill
whole. It is specially made to release medicine slowly in the body. Breaking or
opening the pill would cause too much of the drug to be released at one time.
It
may take 4 weeks or longer for your symptoms to improve. For best results, keep
using the medication as directed. Do not stop using Cymbalta without first
talking to your doctor. You may have unpleasant side effects if you stop taking
this medication suddenly. Store Cymbalta at room temperature away from moisture
and heat.
What if I miss a dose?
Take the missed dose as soon as you remember. However, if it is almost time for
the next regularly scheduled dose, skip the missed dose and take the next one as
directed. Do not take extra medicine to make up the missed dose.
What if I overdose?
Seek emergency medical attention if you think you have taken too much of this
medication. Symptoms of a Cymbalta overdose may include nausea, vomiting,
diarrhea, agitation, confusion, hallucinations, fast heart rate, feeling
light-headed, or fainting.
Avoid drinking alcohol while taking Cymbalta. Alcohol may increase the risk of
damage to your liver.
Avoid using other medicines that make you sleepy (such as cold medicine, pain
medication, muscle relaxers, medicine for seizures, other medication for
depression or anxiety). They can add to sleepiness caused by Cymbalta.
Cymbalta can cause side effects that may impair your thinking or reactions. Be
careful if you drive or do anything that requires you to be awake and alert.
Cymbalta side effects
Get emergency medical help if you have any
of these signs of an allergic reaction: skin rash or hives; difficulty
breathing; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have any new or worsening symptoms 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 any of these serious side effects: nausea,
stomach pain, low fever, loss of appetite, dark urine, clay-colored stools,
jaundice (yellowing of the skin or eyes); restlessness, overactive reflexes,
hallucinations, loss of coordination, fainting, coma; or nausea, vomiting,
diarrhea, fever, and fast heartbeat.
Other less serious side effects are more likely to occur, such as: constipation;
drowsiness, dizziness, headache; sleep problems (insomnia); weight changes;
feeling anxious or nervous, increased sweating; sore throat; or decreased sex
drive, impotence, or difficulty having an orgasm.
Side effects other than those listed here may also occur. Talk to your doctor
about any side effect that seems unusual or that is especially bothersome.
What other drugs will affect Cymbalta?
Before taking Cymbalta, tell your doctor if you are using any of the following
medicines: cimetidine (Tagamet); linezolid (Zyvox); lithium (Lithobid, Eskalith);
St. John's wort; tramadol (Ultram); tryptophan (sometimes called L-tryptophan);
almotriptan (Axert), frovatriptan (Frova), sumatriptan (Imitrex), naratriptan (Amerge),
rizatriptan (Maxalt), or zolmitriptan (Zomig); or any other antidepressants such
as amitriptyline (Elavil), amoxapine (Ascendin), clomipramine (Anafranil),
desipramine (Norpramin), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem),
fluvoxamine (Luvox), imipramine (Janimine, Tofranil), nortriptyline (Pamelor),
paroxetine (Paxil), protriptyline (Vivactil), sertraline (Zoloft), trimipramine
(Surmontil), or venlafaxine (Effexor).
If you are using any of the above drugs, you may not be able to use Cymbalta, or
you may need dosage adjustments or special tests during treatment.
There may be other drugs not listed that can affect Cymbalta. Tell your doctor
about all the prescription and over-the-counter medications you use. This
includes vitamins, minerals, herbal products, and drugs prescribed by other
doctors. Do not start using a new medication without telling your doctor.
Your pharmacist has additional information about Cymbalta written for health
professionals that you may read.
Duloxetine is available with a prescription generically and under the brand name
Cymbalta. Other brand or generic formulations may also be available. Ask your
pharmacist any questions you have about this medication, especially if it is new
to you.
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Cymbalta 20 mg - green capsules
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Cymbalta 30 mg - white/blue capsules
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Cymbalta 60 mg - green/blue capsules
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.
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