The
following information is a summary about Cymbalta.
It is not intended to replace a doctor's instructions.
Cymbalta USES
Cymbalta (an SSNRI) targets two chemicals, serotonin
and norepinephrine, that are believed to play a role
in how the brain and body affect mood and pain. Cymbalta
has been approved by the FDA for both the treatment
of depression and the management of pain associated
with diabetic peripheral neuropathy.
Cymbalta DIRECTIONS
Take Cymbalta exactly as directed by your doctor.
If you do not understand these instructions, ask
your pharmacist, nurse, or doctor to explain them
to you. Take each dose with water. Cymbalta capsules
should be swallowed whole and should not be chewed
or crushed, nor should the contents be sprinkled
on food or mixed with liquids. Cymbalta may be taken
with or without food. Try to take Cymbalta at the
same time each day. Do not stop taking Cymbalta without
first talking to your doctor. It may take several
weeks before you start feeling better. It is important
to take Cymbalta regularly to get the most benefit.
Your doctor may want to perform tests or schedule
appointments to monitor your treatment with Cymbalta.
Store Cymbalta at room temperature away from moisture
and heat.
Cymbalta SIDE EFFECTS
Along with its needed effects, a medicine may cause
some unwanted effects. Other side effects may occur
that usually do not need medical attention. These
side effects may go away during treatment as your
body adjusts to the medicine. However, check with
your doctor if any of the following side effects
continue or are bothersome. * More Common o Cough;
diarrhea; difficulty having a bowel movement (stool);
dizziness ; dry mouth; fever; frequent urination;
headache; lack or loss of strength; loss of appetite
; muscle aches; nausea; sleepiness or unusual drowsiness;
sleeplessness ; sore throat; stuffy or runny nose;
sweating increased; trouble sleeping; unable to sleep;
unusual tiredness or weakness; vomiting; weight loss
* Less common o Abnormal orgasm; acid or sour stomach
; belching; change or problem with discharge of semen;
decreased interest in sexual intercourse; difficulty
in moving; erectile dysfunction; fear; feeling of
warmth redness of the face, neck, arms and occasionally,
upper chest; heartburn; inability to have or keep
an erection; indigestion; joint pain; longer than
usual time to ejaculation of semen; loose stools;
loss in sexual ability, desire, drive, or performance;
muscle aching or cramping; muscle pains or stiffness;
nervousness; shakiness in legs, arms, hands, feet;
stomach discomfort upset or pain; sudden sweating;
swollen joints; trembling or shaking of hands or
feet; vision blurred Other Cymbalta side effects
not listed above may also occur in some patients.
If you notice any other effects, check with your
doctor.
Cymbalta PRECAUTIONS
It is important that your doctor check your progress
at regular visits, to allow for changes in your dose
and to help reduce any side effects. Cymbalta has
not been shown to add to the effects of alcohol.
However, use of alcohol is not recommended in patients
who are taking Cymbalta. Cymbalta may cause some
people to be agitated, irritable or display other
abnormal behaviors. It may also cause some people
to have suicidal thoughts and tendencies or to become
more depressed. If you or your caregiver notice any
of these adverse effects, tell your doctor right
away. Four weeks of Cymbalta may be required before
your symptoms improve. It is important to continue
Cymbalta after symptoms of depression are relieved.
Do not suddenly stop taking your Cymbalta. If you
have been instructed to stop taking Cymbalta, ask
you healthcare professional how to slowly decrease
the dose. This is to decrease the chance of having
discontinuation symptoms such as dizziness, nausea,
headache, vomiting, irritability, nightmares, prickling
or tingling feelings. Do not take Cymbalta if you
have taken a monoamine oxidase (MAO) inhibitor (furazolidone,
phenelzine, procarbazine, selegiline, tranylcypromine)
in the past 2 weeks. Do not start taking an MAO inhibitor
within 5 days of stopping Cymbalta. If you do, you
may develop confusion, agitation, restlessness, stomach
or intestinal symptoms, sudden high body temperature,
extremely high blood pressure, severe convulsions,
or the serotonin syndrome. For diabetic patients:
* This medicine may affect blood sugar levels. If
you notice a change in the results of your blood
or urine sugar tests or if you have any questions,
check with your doctor. Cymbalta may cause some people
to become drowsy or have blurred vision. Make sure
you know how you react to this medicine before you
drive, use machines, or do anything else that could
be dangerous if you are not alert or able to see
clearly.
Cymbalta DRUG INTERACTIONS
In deciding to use a medicine, the risks of taking
the medicine must be weighed against the good it
will do. This is a decision you and your doctor will
make. For Cymbalta, the following should be considered:
Allergies—Tell your doctor if you have ever had any
unusual or allergic reaction to Cymbalta. Also tell
your doctor and pharmacist if you are allergic to
any other substances, such as foods, preservatives,
or dyes. Pregnancy—Cymbalta has not been studied
in pregnant women. Cymbalta should only be used during
pregnancy if the potential benefit outweighs the
potential risk to the baby. Before taking this medicine,
make sure your doctor knows if you are pregnant (especially
if it is the third trimester) or if you may become
pregnant. Breast-feeding—Cymbalta passes into the
milk of rats. It is not known whether it passes into
human milk. Because the effects of this medicine
in nursing babies is not known and because of the
risks, Cymbalta is not recommended if you are breast-feeding.
Children—Cymbalta must be used with caution in children
with depression. Studies have shown occurrences of
children thinking about suicide or attempting suicide
in clinical trials for this medicine. More study
is needed to be sure Cymbalta is safe and effective
in children Older adults—This medicine has been tested
and has not been shown to cause different side effects
or problems in older people than it does in younger
adults. However, elderly patients are more likely
to be sensitive than younger adults to the effects
of Cymbalta. Other medicines—Although certain medicines
should not be used together at all, in other cases
two different medicines may be used together even
if an interaction might occur. In these cases, your
doctor may want to change the dose, or other precautions
may be necessary. When you are taking Cymbalta, it
is especially important that your doctor and pharmacist
know if you are taking any of the following: * Antidepressants
(fluoxetine [e.g., Prozac], paroxetine [e.g., Paxil])—Taking
certain medicines for depression with Cymbalta may
increase your chance for side effects. * Antiarrhythmics
(flecainide [e.g., Tambocor], propafenone [e.g.,
Rythmol], Quinidine [e.g., Quinaglute, Quinidex])—Taking
certain medicines for an uneven heartbeat together
with Cymbalta may increase the chance of getting
serious side effects. * Monoamine oxidase (MAO) inhibitor
activity (isocarboxazid [e.g., Marplan], phenelzine
[e.g., Nardil], procarbazine [e.g., Matulane], selegiline
[e.g., Eldepryl], tranylcypromine [e.g., Parnate])—
Do not take Cymbalta while you are taking or within
2 weeks of taking an MAO inhibitor, or you may develop serious
side effects. At least 14 days should be allowed
between stopping treatment with one medicine (Cymbalta
or the MAO inhibitor) and starting treatment with
the other * Phenothiazines (e.g., Compazine, Phenergan,
Thorazine)—Taking phenothiazines together with Cymbalta
may increase the risk of side effects. * Tricyclic
antidepressants (amitriptyline [e.g., Elavil], desipramine
[e.g., Norpramin], imipramine [e.g., Tofranil], nortriptyline
[e.g., Aventyl])—Taking certain tricyclic antidepressants
together with Cymbalta may increase the risk of side
effects. * Thioridazine (e.g., Mellaril)—Taking thioridazine
with Cymbalta may cause serious heart problems. Other
medical problems — The presence of other medical
problems may affect the use of Cymbalta. Make sure
you tell your doctor if you have any other medical
problems, especially: * Bipolar disorder (mood disorder
with alternating episodes of mania and depression)
or risk of—May make condition worse. Your doctor
will check you for this condition. * Diabetes mellitus
(sugar diabetes)—May increase your blood sugar. *
Kidney disease, severe, or Liver disease, severe—Higher
blood levels of Cymbalta may occur, increasing the
chance of side effects. * Mania (history of)—The
condition may be activated. * Narrow-angle Glaucoma—May
increase your chance of getting blurred vision. *
Seizures (history of)—The risk of seizures may be
increased.
Cymbalta OVERDOSE
If overdose is suspected, contact your local poison
control center or emergency room immediately.
Cymbalta NOTES
Do not share Cymbalta with others. Cymbalta is used
to treat mental depression. It is also used for pain
caused by nerve damage associated with diabetes.
Cymbalta belongs to a group of medicines known as
selective serotonin and norepinephrine reuptake inhibitors
(SSNRIs). These medicines are thought to work by
increasing the activity of chemicals called serotonin
and norepinephrine in the brain. Cymbalta is available
only with your doctor's prescription, in the following
dosage forms: * Oral Delayed-release capsules (U.S.)
MISSED DOSE
If you miss a dose, use Cymbalta as soon as you remember.
If it is near the time of the next dose, skip the
missed dose and resume your usual dosing schedule.
Do not "double-up" the dose to catch up.
Cymbalta STORAGE
Store Cymbalta at room temperature between 36 and
77 degrees F (2 -25 degrees C) away from light and
moisture.
