Cymbalta (Duloxetine) Prescription

• Generic name: Duloxetine hcl
• Brand name: Cymbalta, Yentreve
• Class: Antidepressant, Serotonin and norepinephrine reuptake inhibitor (SNRIs)

Cymbalta (duloxetine) is an antidepressant with some analgesic properties. It is used to treat depression, anxiety disorder, fibromyalgia symptoms, and pain caused by nerve damage in people with diabetes (diabetic neuropathy).

Sometimes it is prescribed for bipolar depression, stress urinary incontinence, and chronic fatigue syndrome.

Cymbalta may be preferred prescription choice for people who have pain syndromes along with their depression.

Cymbalta vs Effexor

Cymbalta differs from Effexor (venlafaxine) in that it is comparatively more noradrenergic. Cymbalta blocks serotonin and norepinephrine transporters more effectively than Effexor.

Effectiveness perspective: Duloxetine and venlafaxine are similarly effective for depression. Duloxetine is at least as effective as venlafaxine in the treatment of anxiety3.

Safety perspective: Nausea is the leading adverse effect for both antidepressants, but is significantly higher with duloxetine compared to venlafaxine2. Sustained elevations of systolic blood pressure occurs more frequently in patients taking venlafaxine.

Cymbalta has some advantages: an easier titration schedule and somewhat less severe discontinuation symptoms.

Generic Cymbalta (International)

Description	Quantity	Pharmacy	Price	Buy
Duloxetine 20 mg	90 capsules	4RX	$45
Duloxetine 20 mg	180 capsules	4RX	$81
Duloxetine 20 mg	360 capsules	4RX	$149
Duloxetine 30 mg	60 capsules	4RX	$42
Duloxetine 30 mg	90 capsules	4RX	$58
Duloxetine 30 mg	180 capsules	4RX	$106
Duloxetine 40 mg	60 capsules	4RX	$52
Duloxetine 40 mg	90 capsules	4RX	$77
Duloxetine 40 mg	180 capsules	4RX	$139
Duloxetine 60 mg	60 capsules	4RX	$74
Duloxetine 60 mg	90 capsules	4RX	$104
Duloxetine 60 mg	180 capsules	4RX	$199

How does Cymbalta work?

Duloxetine is a balanced and potent reuptake inhibitor of serotonin and norepinephrine. Scientists believe its effects on depression and anxiety symptoms, and on pain perception, may be due to increasing the activity of serotonin and norepinephrine in the central nervous system.

Duloxetine takes 2–3 weeks before you notice any improvement in your mood. If antidepressant has not started to work after about six weeks, it is unlikely to be effective.

Side effects

The most frequent side effects with duloxetine are nausea, dry mouth, constipation, diarrhea, fatigue, somnolence, dizziness, hyperhidrosis or increased sweating, and sexual troubles1.

Duloxetine is less likely to cause sexual troubles than the SSRIs. However, unlike SSRIs, it may cause an elevation in blood pressure.

Duloxetine may affect urethral resistance and cause urinary retention.

Cymbalta dosage

Swallow Cymbalta capsule whole without chewing or breaking. Take at about the same time each day.

Major Depression:
The total daily dose ranges from 40 mg (taken as one 20 mg capsule twice a day) to 60 mg (taken as a 60 mg capsule once a day or as a 30 mg capsule twice a day).

Diabetic Peripheral Neuropathy:
The recommended dose is 60 mg once daily.

Contraindications

Before you buy or ask the doctor for a prescription you should know that Cymbalta is contraindicated or not recommended for people with:

• uncontrolled narrow-angle glaucoma
• severe kidney function impairment
• liver function impairment

Never combine Cymbalta with MAO inhibitors (e.g. Marplan, Nardil and Parnate), and wait at least 14 days after stopping an MAO inhibitor before starting it.

Duloxetine has the potential to interact with tricyclics, triptans, and SSRIs. Check for possible interactions with your doctor of pharmacist.

Withdrawal and Discontinuation

Do not change the dosage or stop taking Cymbalta or Duloxetine without your doctor's approval. Abrupt discontinuation may cause withdrawal symptoms such as dizziness, nausea, headache, paresthesia, vomiting, irritability, and nightmare. Withdrawal symptoms are temporary and are not the same as addiction.

A gradual tapering off rather than abrupt cessation is recommended whenever possible. If intolerable symptoms occur following a decrease in the dose or upon discontinuation, then resuming the previous dose may be considered. Subsequently, you may continue tapering duloxetine more gradually.

• 1. Duloxetine Monograph by American Society of Health-System Pharmacists.
• 2. Schueler YB, Koesters M, Wieseler B, Grouven U, Kromp M, Kerekes MF, Kreis J, Kaiser T, Becker T, Weinmann S. A randomized, double-blind comparison of duloxetine versus venlafaxine in major depressive disorder. J Psychiatr Res. 2008 Jan;42(1):22-34.
• 3. Allgulander C, Nutt D, Detke M, Erickson J, Spann M, Walker D, Ball SG, Russell JM. A non-inferiority comparison of duloxetine versus venlafaxine in generalized anxiety disorder. J Psychopharmacol. 2008 Jun;22(4):417-25.