Drug and Supplements

Duloxetine (CYMBALTA) - Uses, Dosage, and Side Effects

Written by
Dr. Sneha Kannan
and medically reviewed by Dr. Ruhi Satija

Published on Sep 12, 2019   -  5 min read

Abstract

Abstract

Duloxetine helps treat depression in adults by affecting chemicals in the brain. Learn about its dosage, precautions, and side effects.

Duloxetine (CYMBALTA) - Uses, Dosage, and Side Effects

What Is Duloxetine?

Duloxetine belongs to the serotonin-norepinephrine reuptake inhibitors (SNRI) group of drugs. It is used to treat depression, anxiety, diabetic neuropathy, and pain in osteoarthritis and fibromyalgia. It acts on the central nervous system and is a neuropathic pain agent. It works on the unbalanced chemical in the brain in people suffering from depressive disorder and generalized anxiety disorder.

Points to Remember:

  1. Duloxetine is available only as a capsule, which you need to take orally.

  2. The brand names are Cymbalta and Irenka.

  3. It should be used only if prescribed by your doctor.

  4. Avoid driving or operating heavy machinery while under treatment, as it can cause drowsiness.

  5. It can result in severe drug interaction if taken 5 days before or 14 days after using MAO inhibitors.

  6. It can cause serotonin syndrome, which is a medical emergency.

  7. Do not stop taking the drug abruptly.

  8. This drug can cause orthostatic hypotension.

What Are the Uses of Duloxetine?

It is available as an oral capsule, which helps treat:

How Does Duloxetine Work?

Scientists believe that Duloxetine works by affecting the activity of serotonin and norepinephrine. Serotonin is a neurotransmitter present in the brain, which helps regulate mood, perception of pain, and other functions. Norepinephrine (noradrenaline) is a neurotransmitter and a hormone, which regulates the “fight-or-flight” reaction in the body. This “flight-or-fight” response regulates how the body responses to stress, pain, emotions, and it also affects the mood, thinking, and cognition.

Even though it is not proved, Duloxetine is believed to treat depression and anxiety by blocking the reuptake of serotonin and norepinephrine. And it reduces pain by blocking the sodium ion channel.

What Is the Dosage of Duloxetine?

It is available as oral delayed-release capsules of strengths 20 mg, 30 mg, 40 mg, and 60 mg. Avoid taking this medicine unless prescribed by a registered physician. The dosage may vary depending on the severity of your condition and its purpose, but the general dosage for adults is:

  • Starting dosage - 30 to 60 mg/day.

  • Maintenance dosage - 40 mg/day (20 mg twice a day) or 60 mg/day (30 mg twice a day or 60 mg once a day).

  • Maximum dosage - 120 mg/day.

What Are the Precautions to Be Taken Before Using Duloxetine?

This medicine should be avoided in the following conditions:

How to Use Duloxetine?

Always take it exactly as prescribed by your doctor. And for more information, read all medication guides or instruction sheets. Do not use Duloxetine in higher doses than prescribed, as it may increase side effects.

Do not crush, chew, break, or open the capsule, and swallow the capsule whole. You can take it with or without food. Do not stop taking it abruptly, and it will take up to 4 weeks before your symptoms improve. Your doctor will keep checking your blood pressure.

If you stop using the drug suddenly, you could have symptoms like dizziness, irritability, anxiety, and nausea. Consult a doctor now to know safer ways to stop this medicine.

What Are the Side Effects of Duloxetine?

The common side effects are:

  • Drowsiness.

  • Feeling tired.

  • Nausea.

  • Xerostomia (dry mouth).

  • Loss of appetite.

  • Sweating more.

  • Dizziness.

  • Stomach pain.

  • Constipation.

Severe side effects include:

  • Allergic reaction:

    • Difficulty breathing.

    • Hives.

    • Facial swelling.

    • Difficulty swallowing.

  • Liver damage:

    • Jaundice.

    • Itching.

    • Right side abdominal pain.

    • Dark urine.

  • Blood pressure changes:

    • Feeling dizzy on standing.

  • Serotonin syndrome:

    • Hallucinations.

    • Rise or drop in blood pressure.

    • Sweating.

    • Chills.

    • Fever.

    • Tremors.

    • Dizziness.

    • Seizures.

    • Coma.

    • Muscle twitching.

  • Increased risk of bruising and bleeding.

  • Eye problems:

    • Eye pain.

    • Pain and edema around the eyes.

    • Vision changes.

  • Drop in blood sodium levels.

  • Reduced urine flow.

  • Manic episodes.

What Other Drugs Does Duloxetine Interact With?

Interaction with other drugs might alter the way the Duloxetine works or result in side effects or might prevent it from working well. Always inform your doctor if you are taking any supplements or herbal medicines. The drugs that can cause interactions are:

  • Serotonergic drugs:

    • Selective serotonin reuptake inhibitors (SSRIs) - Fluoxetine.

    • Serotonin-norepinephrine reuptake inhibitors (SSNRIs) - Venlafaxine.

    • Opioids - Tramadol.

    • Triptans.

    • Lithium.

    • Amphetamines.

  • Monoamine oxidase inhibitors (MAOIs) - Selegiline.

  • Tricyclic antidepressants (TCAs) - Amitriptyline.

  • Thioridazine.

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) - Ibuprofen, Naproxen.

  • Aripiprazole.

  • Anticoagulant drugs - Warfarin, Clopidogrel.

  • Eliglustat.

  • Bupropion.

  • Doxorubicin.

  • Antibiotics - Ciprofloxacin.

What Are the Symptoms of Duloxetine Withdrawal?

If you abruptly stop taking this drug, it might result in withdrawal symptoms like:

  • Headaches.

  • Sweating.

  • Dizziness.

  • Vomiting.

  • Nausea.

  • Diarrhea.

  • Anxiety.

  • Mood swings.

  • Irritability.

  • Sleep disturbances.

  • Fatigue.

What Are the Symptoms of Duloxetine Overdose?

The symptoms of overdose are:

  • Seizures.

  • Loss of consciousness.

  • Vomiting.

  • Rise in blood pressure.

  • Severe fatigue.

If you develop any of these symptoms, get immediate medical help.

Even after using this medicine, if your symptoms are getting worse, it is best you consult your doctor. You can also consult experienced doctors online through phone or video consultation.

Frequently Asked Questions


1.

What Are the most common side effects of Duloxetine?

The most common side effects of Duloxetine are fatigue, dizziness, nausea, stomach pain, dry mouth, constipation, and excess sweating.

2.

What Is the best time to take Duloxetine?

Take the tablet as prescribed by your doctor at the same time every day. You can take it either in the morning or evening.

3.

What Are the Symptoms of Cymbalta withdrawal?

Stopping the drug suddenly can result in symptoms like sweating, dizziness, anxiety, irritability, sleep problems, and vomiting.

4.

Is Duloxetine a painkiller?

Duloxetine is used to reduce pain in cases of diabetic neuropathy, osteoarthritis, chronic back and joint pain, and fibromyalgia.

5.

Does Duloxetine make you gain weight?

Loss of appetite is a common side effect of Duloxetine, which makes people lose weight rather than gain it. But long-term use is said to cause weight gain.

6.

Can I take Cymbalta twice a day?

Take the capsule as prescribed by your doctor. Cymbalta should not be taken more than 120 mg per day. You can split the dosage for the day by taking it twice, but not more than what your doctor prescribed.

7.

Does Duloxetine cause liver damage?

Yes. People with a known liver condition should not take Duloxetine, as it increases the risk for further liver damage.

8.

Can Cymbalta make anxiety worse?

Cymbalta will not make your anxiety worse, as it is used in treating generalized anxiety disorder.

9.

Can Duloxetine cause urinary problems?

Some patients do experience urinary problems like difficulty in emptying bladder, weak urine stream, urinary dribbling, and urinary hesitancy.

10.

How Do I safely stop taking Cymbalta?

The dose is gradually decreased over at least 4 weeks before stopping the medicine. To know more, consult a doctor.

Last reviewed at:
12 Sep 2019  -  5 min read

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