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heart rhythm medication - flecainide, propafenone, quinidine, and others;

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Important information
Dosage

Ask your doctor before taking a nonsteroidal anti-inflammatory drug (NSAID) for pain, arthritis, fever, or swelling. This includes aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib (Celebrex), diclofenac, indomethacin, meloxicam, and others. Using an NSAID with Cymbalta may cause you to bruise or bleed easily.
high levels of serotonin in the body - agitation, hallucinations, fever, fast heart rate, overactive reflexes, nausea, vomiting, diarrhea, loss of coordination, fainting;
liver or kidney disease;






It is not known whether Cymbalta will harm an unborn baby. However, Cymbalta may cause problems in a newborn if you take the medicine during the third trimester of pregnancy. Tell your doctor if you are pregnant or plan to become pregnant while using this medicine.


Do not crush, chew, break, or open an extended-release capsule. Swallow it whole.

Your pharmacist can provide more information about Cymbalta.




See also: Side effects (in more detail) What other drugs will affect Cymbalta?




Where can I get more information?
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What happens if I overdose?

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Do not use Cymbalta if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others. After you stop taking Cymbalta, you must wait at least 5 days before you start taking an MAOI.

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Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Many drugs can interact with duloxetine. Not all possible interactions are listed here. Tell your doctor about all your medications and any you start or stop using during treatment with Cymbalta, especially:
Breastfeeding Warnings
If you are pregnant, your name may be listed on a pregnancy registry. This is to track the outcome of the pregnancy and to evaluate any effects of Cymbalta on the baby.

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Cymbalta is also used in adults to treat fibromyalgia (a chronic pain disorder), or chronic muscle or joint pain (such as low back pain and osteoarthritis pain).

Some young people have thoughts about suicide when first taking an antidepressant. Your doctor will need to check your progress at regular visits while you are using Cymbalta. Your family or other caregivers should also be alert to changes in your mood or symptoms.

Cymbalta (duloxetine) is a selective serotonin and norepinephrine reuptake inhibitor antidepressant (SSNRI). The way duloxetine works is still not fully understood. It is thought to positively affect communication between nerve cells in the central nervous system and/or restore chemical balance in the brain.


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It may take 4 weeks or longer before your symptoms improve. Keep using the medication as directed. Do not stop using Cymbalta without first talking to your doctor. You may have unpleasant side effects if you stop taking this medicine suddenly.


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.
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Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.
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Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
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Older adults may be more sensitive to the side effects of this medicine.

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Some young people have thoughts about suicide when first taking an antidepressant. Your doctor will need to check your progress at regular visits while you are using Cymbalta. Your family or other caregivers should also be alert to changes in your mood or symptoms.







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Take Cymbalta exactly as prescribed by your doctor. Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.

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Taking this medicine with other drugs that make you sleepy can worsen this effect. Ask your doctor before taking Cymbalta with a sleeping pill, narcotic pain medicine, muscle relaxer, or medicine for anxiety, depression, or seizures.


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How should I take Cymbalta?
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Store at room temperature away from moisture and heat.

To make sure Cymbalta is safe for you, tell your doctor if you have:
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Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
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Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

This list is not complete and many other drugs can interact with duloxetine. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Give a list of all your medicines to any healthcare provider who treats you.

Consumer resources Cymbalta Cymbalta delayed-release capsules Cymbalta (Advanced Reading) Other brands: Irenka Professional resources Cymbalta (AHFS Monograph) Cymbalta (FDA) Related treatment guides Chronic Pain Back Pain Anxiety Depression Diabetic Peripheral Neuropathy More (4) »




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You should not use this Cymbalta if you are allergic to duloxetine, or if you have untreated or uncontrolled glaucoma.


Duloxetine can pass into breast milk and may harm a nursing baby. You should not breast-feed while taking this medicine.

loss of appetite; or
Try to take the medicine at the same time each day. Follow the directions on your prescription label.
You should not use Cymbalta if you have untreated or uncontrolled glaucoma, or if you also take thioridazine.
Cymbalta may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall. Severe dizziness or fainting can cause falls, accidents, or severe injuries.

Do not use Cymbalta if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others. After you stop taking Cymbalta, you must wait at least 5 days before you start taking an MAOI.


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Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.
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Call your doctor at once if you have:
seizures or epilepsy;



What should I avoid while taking Cymbalta?


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See also: Dosage Information (in more detail) What happens if I miss a dose?
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Generic Name: duloxetine (du LOX e teen) Brand Names: Cymbalta
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Cymbalta is used to treat major depressive disorder in adults. It is also used to treat general anxiety disorder in adults and children who are at least 7 years old.
Get emergency medical help if you have any signs of an allergic reaction to Cymbalta: skin rash or hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
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Cymbalta is also used to treat pain caused by nerve damage in adults with diabetes (diabetic neuropathy) .

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Do not give this medicine to anyone younger than 18 years old without the advice of a doctor.

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