Duloxetine (Cymbalta): Uses, Side Effects, Dosage & More - GoodRx (2024)

Pharmacist tips for Duloxetine (Cymbalta)

What are the risks and warnings for Duloxetine (Cymbalta)?

Duloxetine (Cymbalta) can raise the risk of worsening depression. It can also raise the risk for suicidal thoughts or behavior. Watch for new or worsening depression, thoughts of harming yourself, or abnormal behavior, especially during the first few months of treatment or when your dose changes. Let a healthcare professional (HCP) know right away if you notice any unusual changes in mood or behavior while you're taking this medication.

There have been rare reports of serious, and sometimes life-threatening, liver problems in people who took duloxetine (Cymbalta). Tell your HCP right away if you develop any stomach pain, nausea, vomiting, swelling in your legs, or yellowing of the whites of your eyes (jaundice). You'll probably need to stop duloxetine (Cymbalta) to prevent more harm to your liver.

It's important to regularly monitor your blood pressure because duloxetine (Cymbalta) can cause changes to your blood pressure (either up or down).

Your blood pressure might suddenly fall when you get up from a sitting or lying position. This might make you feel dizzy and can lead to falls or fainting. Drops in blood pressure when you stand and possible fainting tend to happen within the first week of treatment but can occur at any time, particularly after your dose is raised. Get up very slowly when you're changing positions, such as after lying down.

Duloxetine (Cymbalta) raises the serotonin levels in your brain to help improve mood and pain. Serotonin syndrome is a rare, but potentially life-threatening condition that can happen when there's too much serotonin in the brain. Get medical help right away if you have symptoms of serotonin syndrome, like fast heart rate, sweating, muscle stiffness or spasms, high fever, and confusion.

Your risk for serotonin syndrome goes up if you use duloxetine (Cymbalta) with other medications that affect serotonin levels, such as dextromethorphan (Delsym), tramadol (Ultram), and MAOIs. Tell your prescriber about all the medications you take (including over-the-counter medications and supplements) so they can make sure duloxetine (Cymbalta) is safe for you to take. Don't start any new medications while you're taking duloxetine (Cymbalta) without letting your pharmacist or HCP know.

Duloxetine (Cymbalta) can raise the risk of bleeding or bruising, especially if you're also taking aspirin, NSAIDs (nonsteroidal anti-inflammatory drugs), or blood thinners. The bleeding can range from nosebleeds to stomach bleeds and at times can be life-threatening. Tell an HCP right away about any bruising that doesn't go away, black-colored stools, pink or red urine, or unusual bleeding from the nose or gums.

In some rare cases, duloxetine (Cymbalta) can cause severe skin reactions. Get medical help as soon as possible if you experience painful blisters, a peeling rash, sores, or other signs of a skin reaction.

Stopping duloxetine (Cymbalta) suddenly can cause withdrawal symptoms such as nausea, upset stomach, anxiety, irritation, confusion, trouble sleeping, dizziness, and headache. Talk to your prescriber for guidance on how to lower your dose slowly and safely if you need to stop taking it.

Sometimes, depression is the first symptom of bipolar disorder. Treating someone with bipolar disorder with an antidepressant alone can cause a manic episode (great excitement, euphoria, delusions, and overactivity). This is more likely to happen if you or someone in your family has had bipolar disorder. Talk to your HCP right away if you notice unusual changes in your behavior after you take duloxetine (Cymbalta). This medication isn't approved for treating bipolar depression.

It's possible for duloxetine (Cymbalta) to cause low sodium levels in the body. In general, sodium levels tend to go back within normal ranges when the medication is stopped. Call your HCP if you experience signs and symptoms of low sodium levels, such as headaches, trouble concentrating, memory problems, confusion, weakness, or balance problems.

In clinical trials, some adults who took duloxetine (Cymbalta) had sexual problems. These problems included erectile dysfunction and low sex drive. Contact your HCP if you notice any bothersome sexual problems while you're taking duloxetine (Cymbalta).

Duloxetine (Cymbalta) dosage forms

Depending on your medical condition and age, you might start the medication at a low dose before your prescriber raises the dose slowly over a few weeks to the recommended dose. Your prescriber will adjust your dose based on how well the medication is working for you and whether you have side effects.

• Major depressive disorder

  • Adults: The typical dose ranges from 40 mg (given as 20 mg twice daily) to 60 mg (once daily or as 30 mg twice daily) by mouth.

• Generalized anxiety disorder

  • Adults: The typical dose is 60 mg by mouth once daily. Older adults might start the medication at a dose of 30 mg once daily before their dose is raised to 60 mg once daily.

  • Children age 7 years and older: The typical starting dose is 30 mg by mouth once daily. The recommended dose is between 30 mg to 60 mg once daily.

• Diabetic neuropathy

  • Adults: The typical dose is 60 mg by mouth once daily.

• Fibromyalgia

  • Adults and children age 13 years and older: The typical starting dose is 30 mg by mouth once daily. The dose can be raised to 60 mg once daily.

• Long-term pain in the muscles, bones, joints, or tendons

  • Adults: The typical starting dose is 30 mg by mouth once daily. The recommended dose is 60 mg once daily.

The typical maximum daily dose is 60 mg, but can go up to 120 mg when treating for depression or generalized anxiety disorder.