cymbalta reviews Uses, Dosage, Side Effects, dosage& Interactions
what is cymbalta ?
- Duloxetine improves mood , reduces anxiety and anxiety, strengthens the muscles around the urethra and reduces pain symptoms.
- For depression , anxiety, tension, urinary incontinence, nerve pain and pain due to fibromyalgia.
- You do not immediately notice that your mood improves. This will take several weeks. With nerve pain you can notice the effect after 1 week, with urinary incontinence within 2 weeks, with pain from fibromyalgia within 3 months.
- Swallow the capsule whole with half a glass of water.
- You can immediately experience side effects. Such as nausea, constipation , headache or a dry mouth. Do you suffer from nausea? Then take duloxetine with some food.
- Other side effects: drowsiness, drowsiness or dizziness. These side effects are strongest at the beginning. Therefore, do not drive a car for the first week. Then only if you no longer suffer from these side effects.
- Watch out with alcohol. This can still make you suffer.
- Have you been using the drug for a few weeks? Then don’t stop at once. Slowly reduce the use in consultation with your doctor or pharmacist.
- Interactions with other means. Therefore, have your pharmacist check whether you can safely use duloxetine with your other medicines, including those bought without a prescription.
what is the medication cymbalta used for and indication?
Cialis 2.5 mg, 5 mg, 10 mg and 20 mg:
- Treatment of erectile dysfunction in adult men.
- Sexual stimulation is required for tadalafil to be effective in the treatment of erectile dysfunction.
- Cialis is not indicated for women.
Cialis 5 mg:
- Treatment of signs and symptoms of benign prostatic hypertrophy in adult men.
- Cialis is not indicated for women.
what is the dosage for cymbalta?
Major depressive disorder
- The initial and recommended dosage for maintenance of response is 60 mg once daily, taken with or without food. Dosages greater than 60 mg per day once, up to a maximum dose of 120 mg per day, have been evaluated in terms of safety in clinical studies. However, the benefit of increasing the dose in patients not responding to the recommended initial dose has not been established.
- The therapeutic response usually appears after 2-4 weeks of treatment.
- After obtaining the expected therapeutic effect, it is recommended to continue the treatment for several months in order to prevent relapses. In patients responding to duloxetine, and presenting a history of repeated major depressive episodes, long-term continuation of treatment may be considered, at a dosage of 60 to 120 mg / day.
Generalized anxiety disorder
- The recommended starting dose in patients with generalized anxiety disorder is 30 mg once daily, taken with or without food. In patients with insufficient response the dose should be increased to 60 mg, which is the usual maintenance dose in most patients.
- In patients with associated major depressive disorder, the starting and maintenance dose is 60 mg once daily (please also read the dosage recommendations above).
- Doses of up to 120 mg per day have been shown to be effective and their safety has been evaluated in clinical trials. In patients with insufficient response to the 60 mg dose, dose escalation up to 90 mg or 120 mg may therefore be considered. Dose escalation should be based on clinical response and tolerance.
- After consolidation of the response, it is recommended to continue the treatment for several months in order to avoid a relapse.
Peripheral diabetic neuropathic pain
- The recommended starting and maintenance dose is 60 mg once daily, taken with or without food. The safety of using dosages above 60 mg once daily, up to a maximum dose of 120 mg per day, given in multiple equivalent doses, has been evaluated in clinical trials. Plasma concentrations of duloxetine have shown great inter-individual variability (see section 5.2 ). Therefore, in some patients, in case of insufficient response to the 60 mg dose, the dosage may be increased.
- Response to treatment should be assessed after 2 months. In patients with an insufficient initial response, a response to treatment beyond this period is unlikely.
- The therapeutic benefit should be reassessed regularly (at least every 3 months) (see section Pharmacodynamic properties ).
- No dosage adjustment on the basis of age alone is necessary in the elderly. However, as with any drug, caution should be exercised in the elderly, mainly with Cymbalta at a dosage of 120 mg per day for major depressive disorder, due to limited data (see sections 4.4. and Pharmacokinetic properties ).
Children and adolescents
- The use of duloxetine is not recommended in children and adolescents due to insufficient safety and efficacy data .
- Cymbalta should not be used in patients with liver disease resulting in hepatic impairment (see sections 4.3 and Pharmacokinetics ).
- No dosage adjustment is necessary in patients with mild to moderate renal impairment (creatinine clearance between 30 and 80 ml / min). Cymbalta should not be used in patients with severe renal impairment (creatinine clearance <30 ml / min; .
Discontinuation of treatment
- Abrupt discontinuation of treatment should be avoided. When stopping treatment with Cymbalta the dose should be gradually reduced over a period of at least one to two weeks in order to limit the risk of withdrawal reactions (see sections warnings and precautions for use and effects unwanted ).
- If non-tolerable symptoms appear when the dose is reduced or when treatment is discontinued, a return to the previously prescribed dose may be considered.
- The doctor can then resume reducing the dose, but at a more gradual rate.
- Hypersensitivity to the active substance or to any of the excipients.
- Combination with non-selective, irreversible mono-amine oxidase inhibitors (MAOIs) (see section Interactions with other medicinal products and other forms of interaction ).
- Liver disease resulting in hepatic impairment.
- Combination with fluvoxamine, ciprofloxacin or enoxacin (strong inhibitors of CYP1A2), combinations resulting in increased plasma concentrations of duloxetine (see section Interactions with other medicinal products and other forms of interactions ).
- Severe renal impairment (creatinine clearance <30 ml / min).
- The initiation of treatment with Cymbalta is contraindicated in patients with unbalanced arterial hypertension which could put them at a potential risk of hypertensive crisis.
how cymbalta works?
- The active substance in this drug has a beneficial effect on the action of certain brain substances. These brain substances (= neurotransmitters) play an important role in the brain functions that determine our mood. Disruption of the balance of these substances can cause depression.
- The analgesic effect is attributed to strengthening the descending inhibitory pain pathways in the central nervous system
What are the most common side effects of Cymbalta?
In addition to the desired effect, this drug may cause side effects.
The main side effects are the following.
Uncommon (affects 10 to 30 in 100 people)
- Gastrointestinal complaints , such as nausea. This usually resolves within a few days when you have become used to the drug. You will be less affected by these side effects if you take it with some food.
- Constipation . Eat fiber-rich foods and drink a lot. Contact your doctor if you continue to experience constipation .
- Dry mouth , because you produce less saliva. If you experience a lot of dry mouth at the beginning of the treatment, you can stimulate the production of saliva with (sugar-free) chewing gum or by sucking on ice cubes. The dry mouth creates cavities in your teeth and inflammation of the mucous membrane of the oral cavity. Brush and floss extra well if you continue to experience dry mouth. If necessary, have the dentist checked more often.
- Sleepiness , headache, fatigue and drowsiness. Rarely general feeling of weakness, trouble seeing, such as blurred vision. These side effects are especially troublesome in activities that require your attention, such as driving, climbing a ladder, or monitoring a process at work. Do not undertake risky activities.
Rare (affects 1 to 10 in 100 people)
- Diarrhea , flatulence, abdominal pain, vomiting, loss of taste and appetite, and weight loss.
- Insomnia . If you suffer from this, always take the medicine in the morning.
- Dizziness, feeling of weakness, ringing in the ears and dry eyes problems with vision, such as blurred vision.
- Sexual disturbances , such as less sex, inability to reach orgasm, difficult erection and late ejaculation. These side effects will disappear when you stop taking the medicine. Contact your doctor if you experience this.
- Anxiety , excitement and abnormal dreams.
- Tingling or numbness .
- Trembling hands, twitching, muscle stiffness and muscle pain. Consult your doctor if you experience this.
- Sweating a lot .
- Attacks of heat, restlessness and red head, similar to hot flashes.
- Increase in blood pressure . Do you already suffer from high blood pressure ? Then have your blood pressure checked regularly, especially during the first month of treatment.
- Skin rash.
Very rare (affects less than 1 in 100 people)
- Mood change, increase in depressed thoughts, hostile feelings toward themselves or others . This can manifest itself in aggression, self-harm or thoughts of suicide. Contact your doctor if feelings of depression increase or worsen. Young people under the age of 18 are more likely to experience these side effects. Therefore, doctors usually do not prescribe this drug to them.
- Bleeding faster and longer when injured. You will also notice this from bruises and nosebleeds. In this case, consult your doctor.
- Attacks can be triggered in people with epilepsy . Talk to your doctor about this.
- If you have diabetes mellitus you may get a higher blood sugar level from this medicine. Therefore, check your blood glucose level more often.
- Difficulty urinating in men . This is especially important if you already have trouble urinating through an enlarged prostate . Contact your doctor if you notice this. Another drug may be more suitable for you.
- Liver disorders . You may notice this by a sensitive, swollen abdomen or a yellowing of the whites of the eyes or skin. Then notify a doctor.
- Damage to the stomach or intestines . You will notice this by blood in the stools or black, tar-like stools . Stop using it and contact a doctor.
- Hypersensitivity to this drug. You will notice this by a rash or hives . A severe hypersensitivity can manifest itself in ‘ angioedema ‘: a swelling of the face, lips, mouth, tongue or throat . You may be very short of breath . If it develops, see a doctor immediately or go to the emergency room. You should no longer use this type of substance in the future. Therefore, tell the pharmacy that you are hypersensitive to duloxetine. The pharmacy team can then make sure that you do not get this medicine or the other similar medicine again.
In rare cases, the hypersensitivity causes a serious skin defect. Stop using it and consult your doctor. Tell the pharmacy that you are hypersensitive to duloxetine.
- Lung problems . Consult your doctor if you experience tightness or chest pain.
- Sensitivity of the skin to UV light (sun, tanning bed, UV lamp). Exposure to sunlight, even for short periods of time, can cause rashes, itching, redness and other skin discoloration or severe sunburn. Then discontinue use immediately and contact your doctor.
- Menstrual disorders.
- Vaginal bleeding after delivery if duloxetine is used one month before delivery.
Consult your doctor if you experience any of the above side effects too much or if you experience any other side effects that you are concerned about.
Alcohol (preferably not combine)
Caution is advised when combined with serotonergic drugs such as the SSRIs, tricyclic antidepressants, St. John’s wort, venlafaxine, triptans, tramadol and tryptophan.
Combination with potent CYP1A2 inhibitors such as fluvoxamine, fluoroquinolones and cimetidine
Drive and use machines
- It can be dangerous to drive if you take this medicine. This is due to side effects, such as drowsiness, drowsiness, dizziness and blurred vision.
- You should not drive the first week of using this medication. Also, do not drive a car if the dose increases. You can only drive again after using the same dose for 1 week .
- After a week, most people have become accustomed to the effects. You may then drive again. But only do that if you no longer suffer from the side effects.
Note: Depression can also be a reason that you are not allowed to drive. Consultationwith your doctor or if this is the case for you. Would you like more information about driving in certain conditions? Then visit the website of the CBR .
For more general information, you can read the theme ‘ Medicines in traffic ‘. In this theme you can read, for example, what the law says about medicines in traffic. You will also find advice that you should take into account if you are allowed to drive (again).
- Alcohol enhances the numbing effect of this drug. Even if you no longer notice this because you have become used to duloxetine, you can become very drowsy by using alcohol.
- Therefore, limit the consumption of alcohol and prefer not to drink it.
- There are no restrictions with this medicine.
Cymbalta and PREGNANCY / BREAST FEEDING / FERTILITY
Cymbalta in PREGNANCY
Do not use this medication during pregnancy (unless directed otherwise by the doctor).
Do not breastfeed while taking this drug .
- Some medicines can have a harmful effect on the course of pregnancy or on the unborn child. However, this is not yet known for many medicines.
- Many medicines pass into breast milk and thus reach the infant.
Therefore, during pregnancy or breastfeeding, use only prescription drugs .
- Also tell a replacement doctor or medical specialist if you plan to become pregnant, are already pregnant, or are breast-feeding. This can prevent you from being prescribed medicines that should not be used during pregnancy or breastfeeding.
- Consult your doctor first if you plan to use old medicines , over -the-counter medicines or alternative medicines during pregnancy or breastfeeding .
- Also read the Patient Information Leaflet for information about using this medication during pregnancy or breastfeeding.
What should I do if I miss a dose?
- If you take this medicine once a day : does it take more than 8 hours before you take the next dose normally? Then take the forgotten dose . Does it take less than 8 hours? Then skip the forgotten capsule. Do you swallow it during the day instead of at night? Keep in mind that this drug gives drowsiness. For example, you cannot drive now.
- If you take this medicine twice a day : does it take more than 4 hours before you take the next dose normally? Then take the forgotten dose . Does it take less than 4 hours? Then skip the forgotten dose .
What happens if I overdose from Cymbalta ?
(We currently do not have information regarding the possible symptoms after
overdose with this drug.)
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