Cymbalta (Duloxetine)
Class and Category of Drug
Before you buy Cymbalta (Duloxetine) online, read common information about the medication.
Chemical: Selective serotonin and norepinephrine reuptake inhibitor Therapeutic: Antidepressant, neuropathic pain reliever
Pregnancy category: C
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Drug Indications and Dosages
Before purchase Cymbalta (Duloxetine) online , you must read how it works.
To treat major depressive disorder
E.R. Capsules
Adults. 20 mg b.i.d. Alternatively, 60 mg once daily or 30 mg b.i.d.
To relieve neuropathic pain associated with diabetic peripheral neuropathy
E.R. Capsules
Adults. 60 mg daily.
To treat generalized anxiety disorder
E.R. Capsules
Adults. Initial: 30 or 60 mg once daily, increased in 30-mg increments weekly, as needed. Maximum: 120 mg once daily.
To treat fihromyalgia
E.R. Capsules
Adults. Initial: 30 mg daily for 1 wk; then increased to 60 mg daily.
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Contraindications of Drug
Read contraindications if you want cheap Cymbalta (Duloxetine) online.
Hepatic insufficiency, hypersensitivity to duloxetine or its components, uncontrolled angle-closure glaucoma, use within 14 days of MAO inhibitor therapy
Generic Drug Interactions
Drugs
amiodarone, celecoxib, cimetidine, erythromycin, fluoxetine, fluvoxamine, haloperidol, ketoconazole, methadone, paroxetine, quinidine, quinolones, ritonavir: Increased blood duloxetine level
amiodarone, amitriptyline, desipmmine, flecainide, haloperidol, imipramine, methadone, nortriptyline, phenothiazines, propafenone, ritonavir, thioridazine: Increased blood levels of these drugs
aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), warfarin: Possibly increased risk of bleeding
CNS drugs: Increased effect of duloxetine
MAO inhibitors: Serious, sometimes fatal, autonomic instability, hyperthermia, myoclonus, rigidity
plasma protein binders (warfarin, phenytoin): Increased free concentration of these drugs and increased risk of adverse reactions
serotonergic drugs: Increased risk of serotonin syndrome
Activities
alcohol use: Increased risk of hepatotoxicity
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Drugs Adverse Reactions
Central Nervous System: Abnormal dreams, aggression, agitation, anger, anxiety, asthenia, chills, dizziness, extrapyramidal disorder, fatigue, fever, hallucinations, headache, insomnia, migraine, nervousness, neuroleptic malignant syndrome, parasthesia, restless legs syndrome, serotonin syndrome, somnolence, suicidal ideation, syncope, tremor, vertigo
Cardiovascular: Hypertension, hypertensive crisis, orthostatic hypotension, palpitations, paresthesia, peripheral edema, supraventricular arrhythmia
Eyes, Ears, Nose, And Throat: Blurred vision, dry mouth, glaucoma, nasopharyngitis, pharyngitis, taste alteration
Endocrine: Hot flashes, hyperglycemia
Gastrointestinal: Abdominal pain, anorexia, cholestatic jaundice, constipation, diarrhea, elevated liver enzymes, flatulence, hepatitis, hepatotoxicity, indigestion, jaundice, nausea, upper abdominal pain, vomiting
Genitourinary: Abnormal orgasm, decreased libido, erectile or ejaculatory dysfunction, urinary frequency, urinary tract infection
Hematologic: Bleeding episodes, leukopenia, thrombocytopenia
Musculoskeletal: Arthralgia, back pain, extremity pain, muscle cramp, myalgia
Respiratory: Cough, upper respiratory tract infection
Skin: Diaphoresis, erythema multiforme, pruritus, rash, Stevens-Johnson syndrome, urticaria
Other: Anaphylaxis, angioedema, hyponatremia, weight loss
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Nursing Considerations for Generic Drugs
• Avoid giving duloxetine to patients with severe renal impairment or end-stage renal disease that requires hemodialysis because blood drug levels increase significantly in these patients. Also avoid duloxetine in patients with hepatic insufficiency because drug is metabolized by the liver.
• Use duloxetine cautiously in patients with delayed gastric emptying because drug's enteric coating resists dissolution until it reaches an area where pH exceeds 5.5.
• Give duloxetine cautiously to patients with a history of mania, which it may activate. Also give cautiously to patients with a seizure disorder because drug effects aren't known in these patients.
• Obtain patient's baseline blood pressure before duloxetine therapy starts, and assess it periodically thereafter for changes. If orthostatic hypotension occurs during therapy, notify prescriber and anticipate that drug may need to be discontinued.
• Monitor patient's serum sodium level, especially if patient is elderly, is taking a diuretic, or has volume depletion, because drug may lower serum sodium level.
• Monitor patient's hepatic function, as ordered, because drug may increase the risk of hepatotoxicity.
• If patient takes duloxetine for depression (especially if he's a child or an adolescent), watch closely for evidence of suicidal thinking or behavior, especially when therapy starts or dosage changes.
• Avoid stopping duloxetine therapy abruptly, if possible, because withdrawal symptoms such as dizziness, nausea, headacle, fatigue, paresthesia, vomiting, irritability, nightmares, insomnia, diarrhea, anxiety, hyperhidrosis, and vertigo may occur. Taper dosage gradually, as ordered.
WARNING Monitor patient for serotonin syndrome, characterized by agitation, chills, confusion, diaphoresis, diarrhea, fever, hyperactive reflexes, poor coordination, restlessness, shaking, talking or acting with uncontrolled excitement, tremor, and twitching. In its most severe form, serotonin syndrome can resemble neuroleptic malignant syndrome, which includes a high fever, muscle rigidity, autonomic instability with possible fluctuations in vital signs, and mental status changes.
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Duloxetine
Preparations
International Brand Drug Names
The information about drugs (tablets, pills, capsules, creams, solution, nasal spray, inhaler) around the world.
Proprietary Preparations
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