Cymbalta (Duloxetine Hydrochloride)
20mg Capsule (Delayed Release)
30mg Capsule (Delayed Release)
60mg Capsule (Delayed Release)
Generic equivalents for Cymbalta...What are generics?
20mg Capsule (Delayed Release)
30mg Capsule (Delayed Release)
40mg Capsule (Delayed Release)
60mg Capsule (Delayed Release)
(Rx) - indicates only available by prescription
To comply with Canadian International Pharmacy Association regulations you are permitted to order a 3-month supply or the closest package size available based on your personal prescription. read more
Duloxetine Hydrochloride Information
DULOXETINE (doo LOX e teen) is used to treat depression, anxiety, and different types of chronic pain.
This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.Read more...
Cymbalta® works by improving pathways in the brain that send and receive messages about mood, anxiety, nerve pain in people with diabetes, and chronic pain conditions like fibromyalgia.
Cymbalta® is classed as an SNRI medicine. That stands for serotonin-norepinephrine reuptake inhibitor. Serotonin and norepinephrine are the two primary chemicals in the brain affected by Cymbalta®. Cymbalta® affects other chemicals in the brain to a lesser degree.
Cymbalta® increases levels of both serotonin and norepinephrine in parts of the brain that send messages through a complex communication pathway. Those message work to improve depressed feelings, feelings of anxiety, and pain.
Be aware that Cymbalta® can cause unwanted side effects, especially when combined with other drugs that work in a similar manner. Many drugs, other than antidepressants, can also affect the same chemicals.
In some people, taking a medicine like Cymbalta® can cause an increase in depression, including suicidal thoughts and actions. This most often happens during the first few months of treatment, when the dose is changed, and in children, teenagers, and young adults.
A possible serious side effect that can be caused by Cymbalta® is called serotonin syndrome. People that take Cymbalta® along with medicines called monoamine oxidase inhibitors, or MAOIs, are at the greatest risk of developing serotonin syndrome.
Taking other drugs that cause changes in serotonin can also cause this syndrome to occur. See the sections on "What should I watch for" and "What side effects might be noticed" to see a list of the symptoms for serotonin syndrome.
Medicines like Cymbalta® should never be stopped suddenly. Your body adjusts to the effects of the medicine. Stopping the medicine suddenly can cause unwanted symptoms. If you feel this medicine is not right for you, work with your doctor to gradually reduce the dose to avoid problems.
Sexual side effects are possible with Cymbalta®. Sexual side effects may cause people to consider stopping the medicine on their own. Talk to your doctor if you experience a decrease in sex drive or other problems with sexual activity. Options to help are available.
Be patient. It may take several weeks for the medicine to help with your symptoms. Keep in touch with your doctor during this time. After several weeks, your doctor may adjust your dose to provide the best results for your condition.
Take your dose of Cymbalta® exactly as prescribed and at about the same time each day. Swallow the capsule whole without opening, chewing, or crushing it. You can take your Cymbalta® dose with food or on an empty stomach.
Each Cymbalta® prescription ordered from an online Canadian Pharmacy Referral Service comes with a printed medication guide. Always take time to read the medication information in the guide to be sure you are reviewing the most recent information about your medicine.
Cymbalta contains the active ingredient Duloxetine. There may be options available for you to save on your prescription by buying generic Duloxetine from our licensed international pharmacies. By using a prescription referral service, we will connect you with a Canadian pharmacy or an International pharmacy to provide you with the best savings possible. To verify a legitimate Canadian pharmacy or Canadian prescription referral service, we recommend only purchasing from a member of the Canadian International Pharmacy Association and a website verified by PharmacyChecker.
A less expensive and safe generic alternative to Cymbalta, known as duloxetine, may be available. By using a Canadian Prescription Referral Service, we can help you find a licensed Canadian or international pharmacy that can provide you with safe generic products and the best possible dollar savings. As an added safety measure, we recommend purchasing your medicines from a pharmacy that is a member of the Canadian International Pharmacy Association. Visit a website called PharmacyChecker to locate licensed and credible pharmacies.
They need to know if you have any of these conditions: -bipolar disorder or a family history of bipolar disorder -glaucoma -kidney disease -liver disease -suicidal thoughts or a previous suicide attempt -taken medicines called MAOIs like Carbex, Eldepryl, Marplan, Nardil, and Parnate within 14 days -an unusual reaction to duloxetine, other medicines, foods, dyes, or preservatives -pregnant or trying to get pregnant -breast-feedingRead more...
- heart problems of any kind
- high blood pressure
- history of low sodium levels
- problems with delayed stomach emptying
- bleeding or bruising problems
Medical problems may affect the way Cymbalta® works in your body. Your doctor needs to know about every medical condition or problem you have to determine the best treatment for you. Talk to your doctor about all your medical conditions even if you think they are not related to the reason you are taking Cymbalta®.
Tell your doctor if you have ever had problems with any of the conditions mentioned in the above list. Your doctor may want to adjust your dose or monitor your condition differently.
As with most medicines, interactions with other substances, including medicines prescribed by other doctors, over-the-counter products, vitamins, herbal supplements, alcohol use, and smoking, can be dangerous. Give your doctor a complete list of everything you take.
Before ordering Cymbalta® online, be sure all your doctors and healthcare providers know that you are taking Cymbalta®. Your doctors need to know in order to prevent possible serious interactions with other medicines and medical conditions.
Take this medicine by mouth with a glass of water. Follow the directions on the prescription label. Do not cut, crush or chew this medicine. You can take this medicine with or without food. Take your medicine at regular intervals. Do not take your medicine more often than directed. Do not stop taking this medicine suddenly except upon the advice of your doctor. Stopping this medicine too quickly may cause serious side effects or your condition may worsen. A special MedGuide will be given to you by the pharmacist with each prescription and refill. Be sure to read this information carefully each time. Talk to your pediatrician regarding the use of this medicine in children. While this drug may be prescribed for children as young as 7 years of age for selected conditions, precautions do apply.
Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once. NOTE: This medicine is only for you. Do not share this medicine with others.
If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.
Do not take this medicine with any of the following medications: -certain diet drugs like dexfenfluramine, fenfluramine -desvenlafaxine -linezolid -MAOIs like Azilect, Carbex, Eldepryl, Marplan, Nardil, and Parnate -methylene blue (intravenous) -milnacipran -thioridazine -venlafaxine This medicine may also interact with the following medications: -alcohol -aspirin and aspirin-like medicines -certain antibiotics like ciprofloxacin and enoxacin -certain medicines for blood pressure, heart disease, irregular heart beat -certain medicines for depression, anxiety, or psychotic disturbances -certain medicines for migraine headache like almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, sumatriptan, zolmitriptan -certain medicines that treat or prevent blood clots like warfarin, enoxaparin, and dalteparin -cimetidine -fentanyl -lithium -NSAIDS, medicines for pain and inflammation, like ibuprofen or naproxen -phentermine -procarbazine -sibutramine -St. John's wort -theophylline -tramadol -tryptophan
This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.Read more...
Combining Cymbalta® with drugs that act as MAOIs can cause serious and life-threatening conditions. Medicines that interact with Cymbalta® in other ways can also lead to serious problems. More information about some of the medicines mentioned in the above list is provided here. This is not a complete list.
- Zyvox (linezolid)
- Azilect (rasagiline mesylate)
- Zelapar (selegiline hydrochloride)
- Nardil (phenelzine sulfate)
- Parnate (tranylcypromine sulfate)
- Effexor (venlafaxine hydrochloride)
- Pristiq (desvenlafaxine succinate)
- Mellaril (thioridazine hydrochloride)
Combining Cymbalta® with medicines that increase levels of serotonin in the brain can cause serious and life-threatening problems, including serotonin syndrome. In some cases, your doctor may prescribe a medicine listed here in addition to your Cymbalta®.
Be sure your doctor is aware that you are taking Cymbalta®. Your doctor may adjust the dose of one, or both, medicines.
This is not a complete list of all drugs that increase serotonin. If you are taking a medicine that you think is similar to the medicines listed here, talk to your doctor about the combination.
- Matulane (procarbazine hydrochloride)
- Metozolv, (metoclopramide hydrochloride)
- Flexeril (cyclobenzaprine hydrochloride)
- BuSpar (buspirone hydrochloride)
- Eskalith (lithium carbonate)
- Savella (milnacipranhydrochloride)
Antidepressant medicines, including selective serotonin reuptake inhibitors, or SSRIs, tricyclic antidepressants, and others, can cause serotonin syndrome when combined with Cymbalta®. Do not take medicines like these along with your Cymbalta®. Many drugs fall within the group of antidepressant medicines. Only a few are listed here. Talk to your doctor if you think you are taking a medicine similar to those listed here.
- Prozac (fluoxetine hydrochloride)
- Lexapro (escitalopram oxylate)
- Zoloft (sertraline hydrochloride)
- Paxil (paroxetine hydrochloride)
- Luvox (fluvoxamine maleate)
- Brintellix (vortioxetine)
- Elavil (amitriptyline hydrochloride)
- Tofranil (imipramine hydrochloride)
- Anafranil (clomipramine hydrochloride)
- Sinequan (doxepin hydrochloride)
- Desyrel (trazodone hydrochloride)
- Remeron (mirtazapine)
Medicines commonly used to treat migraine headaches, called triptans, also have an effect on serotonin levels. Combining triptans with Cymbalta® can increase serotonin levels too much in some people and cause serotonin syndrome. Talk to your doctor about taking both medicines together if you are prescribed a triptan for migraine headaches. Some examples of triptans are listed here.
- Axert (almotriptan maleate)
- Imitrex (sumatriptan succinate)
- Zomig (zolmitriptan)>
- Amerge (naratriptan hydrochloride)
- Frova (frovatriptan succinate)
Some drug interactions can be life-threatening. Other interactions can cause unwanted side effects or make the medicines more or less effective. Sometimes drug interactions can cause a medicine to exceed safe levels in the blood, similar to taking an overdose. This can happen all at once or gradually over time. A drug interaction happens when one drug causes another drug to change how it works in the body.
Many processes are at work in your body that handle drugs. Interactions can happen at different places and for different reasons. Some processes involve how your gut absorbs the medicine, others involve the way your liver works to alter medicines. Some interactions occur at the exact place in your body where the drugs connect to do their job, and others involve changes with the way the drug is eliminated from your body.
Cymbalta® is no exception. There are many medicines that interact with the active ingredient found in Cymbalta®. Always check with your doctor or pharmacist to be sure you are not taking drugs that interact.
Each time you have a new low cost generic drug or expensive brand name drug added to your existing list of medications, be sure to ask your pharmacist to check it against all your other medicines.
The pharmacists that fill your prescriptions at an online Canadian Pharmacy Referral Service need a complete list of all your medicines, including prescription drugs, over-the-counter items, vitamins, supplements, and herbal products. For your safety, your online pharmacists will screen your current medicines and new drugs added for possible drug interactions.
Tell your doctor if your symptoms do not get better or if they get worse. Visit your doctor or health care professional for regular checks on your progress. Because it may take several weeks to see the full effects of this medicine, it is important to continue your treatment as prescribed by your doctor. Patients and their families should watch out for new or worsening thoughts of suicide or depression. Also watch out for sudden changes in feelings such as feeling anxious, agitated, panicky, irritable, hostile, aggressive, impulsive, severely restless, overly excited and hyperactive, or not being able to sleep. If this happens, especially at the beginning of treatment or after a change in dose, call your health care professional. You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this medicine affects you. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells. Alcohol may interfere with the effect of this medicine. Avoid alcoholic drinks. This medicine can cause an increase in blood pressure. This medicine can also cause a sudden drop in your blood pressure, which may make you feel faint and increase the chance of a fall. These effects are most common when you first start the medicine or when the dose is increased, or during use of other medicines that can cause a sudden drop in blood pressure. Check with your doctor for instructions on monitoring your blood pressure while taking this medicine. Your mouth may get dry. Chewing sugarless gum or sucking hard candy, and drinking plenty of water may help. Contact your doctor if the problem does not go away or is severe.Read more...
As with any new medicine, watch for signs of an allergic reaction. Symptoms can include swelling of the face, lips, tongue, or throat, difficulty breathing, tightening of the chest, and a skin rash, itching, or hives.
Serotonin syndrome is a serious and life-threatening condition that is possible when taking Cymbalta®, especially when combined with another medicine that works in a similar way.
Symptoms of serotonin syndrome usually begin within a few hours of taking a new medicine, taking a higher dose of your medicine, or adding a medicine to your existing drugs. Watch for the symptoms listed here. Severe cases of serotonin syndrome can be life-threatening. Seek emergency medical care if you experience any of the following:
- high fever
- irregular pulse or heartbeat
- loss of consciousness
Less severe cases still warrant immediate medical attention. Symptoms can include the following:
- agitation or a feeling of restlessness
- confusion or hallucinations
- rapid pulse rate
- an increase or decrease in blood pressure
- dilated pupils
- difficulty with muscle movements, muscle twitching, tremor, or very stiff muscles
- sweating, shivering, fever, or goose bumps
- diarrhea, nausea, or vomiting
- headache or dizziness
Watch for changes in your mood that may be a warning sign of mania. Let your doctor know if you feel more anxious, agitated, jittery or restless, have trouble sleeping, become more talkative, or experience a noticeable increase in energy level.
Cymbalta® can cause you to bruise or bleed more easily. Let your doctor know if this happens.
Also watch for yellowing of the skin or eyes, itching, pain on your right side, and changes in your urine, bladder, and kidney function. Let your doctor know if you develop these symptoms.
Side effects that you should report to your doctor or health care professional as soon as possible: -allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue -changes in blood pressure -confusion -dark urine -dizziness -fast talking and excited feelings or actions that are out of control -fast, irregular heartbeat -fever -general ill feeling or flu-like symptoms -hallucination, loss of contact with reality -light-colored stools -loss of balance or coordination -redness, blistering, peeling or loosening of the skin, including inside the mouth -right upper belly pain -seizures -suicidal thoughts or other mood changes -trouble concentrating -trouble passing urine or change in the amount of urine -unusual bleeding or bruising -unusually weak or tired -yellowing of the eyes or skin Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome): -blurred vision -change in appetite -change in sex drive or performance -headache -increased sweating -nausea
This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.Read more...
- dry mouth
Keep out of the reach of children. Store at room temperature between 20 and 25 degrees C (68 to 77 degrees F). Throw away any unused medicine after the expiration date.
NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.
Duloxetine Oral capsule, gastro-resistant pellets