CYMBALTA
Generic Name for CYMBALTA
Duloxetine (as HCl) 20mg, 30mg, 60mg; e-c pellets in caps.
Legal Classification:
Rx
Pharmacological Class for CYMBALTA
Serotonin and norepinephrine reuptake inhibitor.
Manufacturer of CYMBALTA
Lilly, Eli and Company
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Indications for CYMBALTA
Generalized anxiety disorder (GAD).
Adult dose for CYMBALTA
Swallow whole. Initially 60mg once daily (may start at 30mg once daily for 1 week then increase to 60mg once daily); usual target 60mg/day (doses up to 120mg/day have been given; if needed, may increase by increments of 30mg/day). Maintenance: 60–120mg once daily.
Children's dosing for CYMBALTA
Not recommended.
Contraindications for CYMBALTA
Allow at least 14 days after MAOI discontinuance before starting duloxetine; allow at least 5 days after duloxetine discontinuance before starting an MAOI. Uncontrolled narrow-angle glaucoma.
Precautions for CYMBALTA
Severe renal impairment (CrCl<30mL/min), end stage renal disease, hepatic insufficiency, evidence of chronic liver disease, or substantial alcohol use: not recommended. History of seizure or mania/hypomania. Controlled narrow-angle glaucoma. Decreased GI motility. Cardiac disease. Monitor BP prior to and during therapy. Diabetes. Suicidal tendencies (monitor). Avoid abrupt cessation. Reevaluate periodically. Elderly. Labor & delivery. Pregnancy (Cat.C) (avoid 3rd trimester; consider tapering, see literature for effects on neonate). Nursing mothers: not recommended.
Interactions for CYMBALTA
See Contraindications. Concomitant tryptophan, other SSRIs, SNRIs: not recommended. Concomitant thioridazine (may cause arrhythmias): not recommended. Potentiated by CYP1A2 inhibitors; avoid (eg, cimetidine, fluvoxamine, quinolones). May potentiate or be potentiated by CYP2D6 inhibitors (eg, paroxetine, fluoxetine, quinidine) or substrates (eg, tricyclics, phenothiazines, type 1C antiarrhythmics) or other highly protein-bound drugs; caution with CYP2D6 substrates with narrow therapeutic indexes. Caution with potent CYP1A2 inhibitors, antihypertensives, other drugs that induce orthostatic hypotension. Caution with triptans, linezolid, lithium, tramadol, St. John's wort; may cause serotonin syndrome. Monitor concomitant CNS-acting drugs, and with those that affect gastric pH (eg, proton pump inhibitors). Increased bleeding risk with aspirin, anticoagulants, NSAIDs.
Adverse Reactions for CYMBALTA
Nausea, dry mouth, constipation, somnolence, hyperhidrosis, decreased appetite, weight changes, GI disturbances, fatigue, dizziness, increased sweating, mania/hypomania, tremor, blurred vision, insomnia, hot flushes, urinary hesitation/retention, abnormal ejaculation, genital disorders, decreased libido, increased BP, orthostatic hypotension, syncope, hepatotoxicity (eg, elevated liver transaminases, cholestatic jaundice); discontinue if occurs, hyponatremia, asthenia, others; rare: seizure.
How is CYMBALTA supplied?
Caps 20mg—60
30mg, 60mg—30, 90, 1000
Related Disease:
Generalized anxiety disorder