Without a Prescription
Cymbalta is an antidepressant medication. It affects chemicals in the brain that may become unbalanced and cause depression. Cymbalta is prescribed to treat major depressive disorder (MDD) and for the management of pain associated with diabetic peripheral neuropathy.
Patients with major depressive disorder, both adult and pediatric, may experience worsening of their depression and/or the emergence of suicidal ideation and behavior (suicidality), whether or not they are taking antidepressant medications, and this risk may persist until significant remission occurs. Although there has been a long-standing concern that antidepressants may have a role in inducing worsening of depression and the emergence of suicidality in certain patients, a causal role for antidepressants in inducing such behaviors has not been established. Nevertheless, patients being treated with antidepressants should be observed closely for clinical worsening and suicidality, especially at the beginning of a course of drug therapy, or at the time of dose changes, either increases or decreases. Consideration should be given to changing the therapeutic regimen, including possibly discontinuing the medication, in patients whose depression is persistently worse or whose emergent suicidality is severe, abrupt in onset, or was not part of the patient's presenting symptoms. The following symptoms - anxiety, agitation, panic attacks, insomnia, irritability, hostility (aggressiveness), impulsivity, akathisia (psychomotor restlessness), hypomania, and mania - have been reported in adult and pediatric patients being treated with antidepressants for major depressive disorder as well as for other indications, both psychiatric and nonpsychiatric. Although a causal link between the emergence of such symptoms and either the worsening of depression and/or the emergence of suicidal impulses has not been established, consideration should be given to changing the therapeutic regimen, including possibly discontinuing the medication, in patients for whom such symptoms are severe, abrupt in onset, or were not part of the patient's presenting symptoms. A major depressive episode may be the initial presentation of Bipolar Disorder. Whether any of the symptoms described above represent such a conversion is unknown. However, prior to initiating treatment with an antidepressant, patients should be adequately screened to determine if they are at risk for Bipolar Disorder; such screening should include a detailed psychiatric history, including a family history of suicide, Bipolar Disorder, and depression. It should be noted that Cymbalta is not approved for use in treating bipolar depression
Drug interaction: Do not take Cymbalta if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) during the last 2 weeks. Wait at least 5 days after you stop taking Cymbalta before taking a MAOI. Serious, and sometimes fatal, reactions have occurred when these medicines have been prescribed together. Also, do not take Cymbalta if you are taking thioridazine (Mellaril). Dangerous, even fatal irregular heartbeats may occur if these medicines are taken together. Before taking Cymbalta, tell your doctor if you are taking any of the following medicines: -an antiarrhythmic such as flecainide (Tambocor) or propafenone (Rythmol), and others; -a tricyclic antidepressant such as amitriptyline (Elavil), imipramine (Tofranil), doxepin (Sinequan), nortriptyline (Pamelor), and others; -venlafaxine (Effexor); -a phenothiazine such as chlorpromazine (Thorazine), fluphenazine (Prolixin), mesoridazine (Serentil), perphenazine (Trilafon), prochlorperazine (Compazine), and others; -a quinolone antibiotic such as trovafloxacin (Trovan), ciprofloxacin (Cipro), ofloxacin (Floxin), and others; -quinidine; or -a selective serotonin reuptake inhibitor (SSRI) such as fluoxetine (Prozac, Sarafem), paroxetine (Paxil, Pexeva), fluvoxamine (Luvox), and others.
Cymbalta is in the FDA pregnancy category C. Babies exposed to Cymbalta and/or other drugs of the same class during the third trimester of pregnancy may develop medical complications. Discuss the risks with your doctor. Do not take Cymbalta without first talking to your doctor if you are pregnant or could become pregnant during treatment. Cymbalta passes into breast milk and may affect a nursing infant. Do not take Cymbalta without first talking to your doctor if you are breast-feeding a baby. Safety and efficacy in pediatric patients have not been established.
If you experience any of the following serious side effects, stop taking Cymbalta and contact your doctor immediately or seek emergency medical treatment: -an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives); -an irregular heartbeat or pulse; -low blood pressure (dizziness, weakness); -high blood pressure (severe headache, blurred vision); -chills or fever; -unusual bleeding or bruising; -a rash or hives.
In case of any of the following less serious side effects, continue taking Cymbalta and talk to your doctor: -headache, tremor, nervousness, or anxiety; -difficulty concentrating; -constipation; -nausea, diarrhea, dry mouth, or changes in appetite or weight; -weakness; -increased sweating; -sleepiness or insomnia; or -decreased sex drive, impotence, or difficulty having an orgasm.
Seek emergency medical attention if an overdose is suspected. Symptoms of a Cymbalta overdose may include nausea, vomiting, tremor, agitation, seizures, drowsiness, hyperactivity, and enlarged pupils. In case of a missed a dose, take it as soon as you remember. However, if it is almost time for the next regularly scheduled dose, skip the missed dose and take the next one as directed. Do not take a double dose of Cymbalta unless otherwise directed by your doctor.
Take each dose with water. Cymbalta capsules should be swallowed whole and should not be chewed or crushed, nor should the contents be sprinkled on food or mixed with liquids. Cymbalta may be taken with or without food. Try to take Cymbalta at the same time each day. Do not stop taking Cymbalta without first talking to your doctor. Store Cymbalta at room temperature away from moisture and heat.
Other Brand Names
In some countries Cymbalta may also be known as: