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Cymbalta
Cymbalta
Information
Cymbalta is an antidepressant
medication. It affects chemicals in the brain that may become unbalanced and
cause depression. Cymbalta is used to treat major depressive disorder (MDD) and
for the management of pain associated with diabetic peripheral neuropathy.
Cymbalta Warnings
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 used 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
asamitriptyline (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 this medication
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.
Cymbalta Side
effects
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 this medication unless otherwise directed by your doctor.
Cymbalta Usage
Guidelines
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.
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In some countries CYMBALTA may
also be known as: Duxetin, Yentreve, Delok, Ariclaim, Xeristar, Ariclaim
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