Cymbalta is the brand name of the medicine duloxetine, which is used to treat major depressive disorder in adults and generalized anxiety disorder in adults and kids who are at least 7 years old.

The prescription medicine is also given to help chronic muscle or joint pain, fibromyalgia (a chronic pain disorder), osteoarthritis, and nerve pain caused by diabetic neuropathy.

Cymbalta is in a class of drugs called selective serotonin and norepinephrine reuptake inhibitors (SNRIs). It works by boosting the amounts of serotonin and norepinephrine, which are natural substances in the brain.

The U.S. Food and Drug Administration (FDA) approved Cymbalta in 2004.

warnings

What is the most important information I should know about Cymbalta (Duloxetine)?

You should not use duloxetine if you are allergic to it.

Do not take duloxetine within 5 days before or 14 days after you have used an MAO inhibitor, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, or tranylcypromine. A dangerous drug interaction could occur.

Tell your doctor if you also take stimulant medicine, opioid medicine, herbal products, or medicine for depression, mental illness, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting. An interaction with duloxetine could cause a serious condition called serotonin syndrome.

Not approved for use by anyone younger than 7 years old.

Tell your doctor if you have ever had:

heart problems, high blood pressure;
liver or kidney disease;
slow digestion;
a seizure;
bleeding problems;
sexual problems;
narrow-angle glaucoma;
bipolar disorder (manic depression);
drug addiction or suicidal thoughts; or
if you drink large amounts of alcohol.

People with depression or mental illness may have thoughts about suicide. Some young people may have increased suicidal thoughts when first starting a medicine to treat depression. Stay alert to changes in your mood or symptoms. Your family or caregivers should also watch for sudden changes in your behavior.

Taking this medicine during pregnancy could harm the baby, but stopping the medicine may not be safe for you. Do not start or stop duloxetine without asking your doctor.

If you are pregnant, your name may be listed on a pregnancy registry to track the effects of duloxetine on the baby.

If you are breastfeeding, tell your doctor if you notice drowsiness, feeding problems, and slow weight gain in the nursing baby.

Side Effects

What are the side effects of Cymbalta (Duloxetine)?

Get emergency medical help if you have signs of an allergic reaction (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling).

Tell your doctor right away if you have new or sudden changes in mood or behavior, including new or worse depression or anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, more active or talkative, or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have:

pounding heartbeats or fluttering in your chest;
a light-headed feeling, like you might pass out;
easy bruising, unusual bleeding;
vision changes;
painful or difficult urination;
liver problems--right-sided upper stomach pain, itching, dark urine, jaundice (yellowing of the skin or eyes);
low blood sodium--headache, confusion, problems with thinking or memory, weakness, feeling unsteady; or
manic episodes--racing thoughts, increased energy, decreased need for sleep, risk-taking behavior, being agitated or talkative.

Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.

Common side effects may include:

drowsiness;
nausea, constipation, loss of appetite;
dry mouth; or
increased sweating.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Pregnancy & Breastfeeding

Can I take Cymbalta (Duloxetine) if I’m pregnant or breastfeeding?

Taking this medicine during pregnancy could harm the baby, but stopping the medicine may not be safe for you. Do not start or stop duloxetine without asking your doctor.

If you are pregnant, your name may be listed on a pregnancy registry to track the effects of duloxetine on the baby.

If you are breastfeeding, tell your doctor if you notice drowsiness, feeding problems, and slow weight gain in the nursing baby.

Interactions

What drugs and food should I avoid while taking Cymbalta (Duloxetine)?

Ask your doctor before taking a nonsteroidal anti-inflammatory drug (NSAID) such as aspirin, ibuprofen, naproxen, Advil, Aleve, Motrin, and others. Using an NSAID with duloxetine may cause you to bruise or bleed easily.

Avoid driving or hazardous activity until you know how this medicine will affect you. Dizziness or drowsiness can cause falls, accidents, or severe injuries.

Avoid getting up too fast from a sitting or lying position, or you may feel dizzy.

Drinking alcohol may increase your risk of liver damage, especially if you take Drizalma.

Dosage Guidelines & Tips

How to take Cymbalta (Duloxetine)?

Use Cymbalta (Duloxetine) exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended.

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

Taking duloxetine in higher doses or more often than prescribed will not make it more effective, and may increase side effects.

Swallow the capsule whole and do not crush, chew, break, or open it.

Take with or without food.

Your blood pressure will need to be checked often.

Tell your doctor if you have any changes in sexual function, such as loss of interest in sex, trouble having an orgasm, or (in men) problems with erections or ejaculation. Some sexual problems can be treated.

Your symptoms may not improve for up to 4 weeks.

Do not stop using duloxetine suddenly, or you could have unpleasant symptoms (such as agitation, confusion, tingling or electric shock feelings). Ask your doctor before stopping the medicine.

Store at room temperature away from moisture and heat.

What should I do if I missed a dose of Cymbalta (Duloxetine)?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What to Expect

It could take duloxetine two to four weeks to work. It might take longer if you’re using it to treat nerve pain.

Don’t stop taking this medicine if you’re not feeling better right away.

Once your symptoms improve, your doctor may recommend that you take it for another six months to a year longer, depending on your condition.

You’ll have to discuss the risks and benefits of using this medicine long-term with your doctor.