Drug Name
Cymbalta (Duloxetine)

Drug Uses
Cymbalta is used for treating depression and generalized anxiety disorder. It is used for managing pain caused by diabetic peripheral neuropathy (DPNP). It may also be used for other conditions as determined by your doctor.

How to use
Use Cymbalta as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Take Cymbalta by mouth with or without food.
• Swallow Cymbalta whole. Do not break, crush, or chew before swallowing. Do not open the capsule and sprinkle the contents on food or in liquid.
• Take Cymbalta on a regular schedule to get the most benefit from it. Taking Cymbalta at the same time each day will help you remember to take it.
• Continue to take Cymbalta even if you feel well. Do not miss any doses.

Drug Class and Mechanism
Cymbalta is a serotonin and norepinephrine reuptake inhibitor (SNRI). It works by restoring the balance of certain natural substances in the brain (serotonin and norepinephrine), which helps to improve certain mood problems.

Missed Dose
If you miss a dose of Cymbalta, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Storage
Store Cymbalta at 77 degrees F (25 degrees C). Brief storage between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Cymbalta out of the reach of children and away from pets.

Warnings/Precautions
Do not use Cymbalta if:

• you are allergic to any ingredient in Cymbalta;
• you have uncontrolled narrow-angle glaucoma;
• you have liver problems or severe kidney problems, or are having dialysis;
• you are taking or have taken a monoamine oxidase inhibitor (MAOI) (eg, phenelzine) within the last 14 days;
• you are taking a quinolone antibiotic (e.g., ciprofloxacin), a selective serotonin reuptake inhibitor (SSRI) (e.g., fluoxetine, fluvoxamine), a SNRI (e.g., venlafaxine), thioridazine, or tryptophan.

Contact your doctor or health care provider right away if any of these apply to you.

Some medical conditions may interact with Cymbalta Delayed-Release Capsules. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding
• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
• if you have allergies to medicines, foods, or other substances
• if you or a family member has a history of bipolar disorder (manic-depression), other mental or mood problems, suicidal thoughts or attempts, or alcohol or substance abuse
• if you have a history of seizures, heart problems (eg, heart failure, irregular heartbeat), recent heart attack, high blood pressure, kidney problems, diabetes, stomach or bowel problems (eg, slowed emptying), or increased eye pressure (eg, glaucoma)
• if you are dehydrated, have low blood sodium levels, or drink alcohol

Some MEDICINES MAY INTERACT with Cymbalta Delayed-Release Capsules. Tell your health care provider if you are taking any other medicines, especially any of the following:

• 5-HT1 receptor agonists (eg, sumatriptan), linezolid, lithium, MAOIs (eg, phenelzine), quinidine, rasagiline, SNRIs (eg, venlafaxine), SSRIs (eg, fluoxetine, fluvoxamine), St. John's wort, tramadol, or tryptophan because severe side effects, such as a reaction that may include fever, rigid muscles, blood pressure changes, mental changes, confusion, irritability, agitation, delirium, and coma, may occur
• Diuretics (eg, furosemide, hydrochlorothiazide) because the risk of low blood sodium levels may be increased
• Cimetidine, medicines for high blood pressure, or quinolone antibiotics (eg, ciprofloxacin) because they may increase the risk of Cymbalta Delayed-Release Capsules's side effects
• Certain antiarrhythmics (eg, flecainide, propafenone), phenothiazines (eg, chlorpromazine, thioridazine), or tricyclic antidepressants (eg, amitriptyline) because the risk of their side effects may be increased by Cymbalta Delayed-Release Capsules

Possible Side Effects
Check with your doctor if any of these most common side effects persist or become bothersome:

• blurred vision; constipation; decreased sexual desire or ability; diarrhea; dizziness; drowsiness; dry mouth; headache; increased sweating; loss of appetite; muscle aches; nausea; sore throat; tiredness; trouble sleeping; vomiting.

Seek medical attention right away if any of these severe side effects occur:

• severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); bizarre behavior; confusion; excessive sweating; dark urine; fainting; fast or irregular heartbeat; fever or chills; hallucinations; loss of coordination; new or worsening agitation, anxiety, panic attacks, aggressiveness, impulsiveness, irritability, hostility, restlessness, or inability to sit still; red, swollen, blistered, or peeling skin; seizures; severe or persistent nausea, vomiting, or diarrhea; severe or persistent trouble sleeping; suicidal thoughts or attempts; tremor; trouble urinating; unusual or severe mental or mood changes; worsening of depression; yellowing of the skin or eyes.

More Information
Cymbalta is to be used only by the patient for whom it is prescribed. Do not share it with other people.