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.
