Duloxetine 60mg

Antidepressant, Serotonin/Norepinephrine Reuptake Inhibitor

“ALERT: US Boxed Warning

Suicidal thoughts and behavior:

Antidepressants increased the risk of suicidal thoughts and behavior in pediatric and young adult patients in short-term studies. Closely monitor all antidepressant-treated patients for clinical worsening, and for emergence of suicidal thoughts and behaviors.”

CSA NA – FDA Approved – REMS (N) – Can Ship

Duloxetine/Cymbalta/Drizalma is a strong inhibitor of serotonin and norepinephrine reuptake and a weak inhibitor of dopamine reuptake within the neuron.  It does not affect muscarinic, histamine 1, or alpha 2 adrenergic receptors or MAO.

Duloxetine/Cymbalta/Drizalma is officially indicated for fibromyalgia, generalized anxiety disorder, major depressive disorder, chronic musculoskeletal pain, and diabetic neuropathy.  It is also prescribed off-label for chemotherapy induced peripheral neuropathy and stress urinary incontinence. (may be used for conditions not listed)

Before starting Duloxetine/Cymbalta/Drizalma make sure your physician is aware of any allergies or medications you currently take, if you have liver disease, gastroparesis, if you have bipolar disorder, kidney disease, a seizure disorder, cardiovascular disease, or are pregnant or breastfeeding.  This medication has risk of causing serotonin syndrome especially if combined with other serotonergic drugs.  It can cause suicidal ideation, usually in young patients, with major depressive disorder so must be used with caution and any major changes in personality or mood should be reported to physician immediately.

30-120mg once daily

How to Take: Follow instructions provided by physician/pharmacy label, swallow whole, take consistently at same time each day unless otherwise directed, store at room temperature.

You Need to Avoid: This medication can increase the psychomotor impairment from alcohol consumption so extra care should be taken if choosing to consume alcohol.  Do not stop this medication without tapering dose down over time to prevent withdrawal symptoms (nausea, diarrhea, sweating, headaches, agitation, insomnia, anxiety, tremor, vertigo, dizziness).

Headache, drowsiness, fatigue, nausea, xerostomia (dry mouth), abdominal pain, weight loss, weakness, insomnia, dizziness, constipation, diarrhea

Note this is not a complete list of side effects, only common ones

1. What do I do if side effects are intolerable?
   If you are just starting this medication or just had a dosage increase, then it is common to have more prominent side effects for 2 weeks or so and if any remain at that point they will likely remain.  If the symptoms are causing a lot of distress speak to your physician as soon as possible to discuss how to come off the medication.
2. What do I do if my mood worsens on this medication and I feel much worse?
   Contact your physician immediately, it is rare however antidepressant medications can cause suicidal ideation, generally in those under the age of 24.
3. What is serotonin syndrome?
   Serotonin syndrome is a rare, but potentially life-threatening condition of serotonin toxicity from too much of it in your system generally from the use of certain medications and supplements.  Usually multiple agents are at play or exceedingly high doses are involved.  The signs and symptoms include agitation, hallucinations, delirium, coma, tachycardia (rapid heart rate), diaphoresis (excessive sweating), tremor, muscle rigidity, nausea, vomiting, diarrhea, and/or seizures.  If serotonin syndrome is suspected, discontinue any serotonergic medications, and seek immediate medical attention.