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Question
Posted by: Rob | 2004/12/01

Cymbalta 60mg

Hi there,

I have recently been put on Cymbalta 60mg for depression. I was previously on Cipralex 10mg, but found the sexual sides affects a little too daunting.

Is there anyone that has been on this medication or knows about it. I am trying to find out side effects etc.

Thanks

Rob

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Our expert says:
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Cumbalta is a very new antidepressant, and the extremely bad-mannered company marketing it hasn't bothered to provide me with any information about it at all. Frankly, I am bothered about doctors, especialylGP's who leap on each and every new drug ( Cipralex, now Cymbalta) and prescribe it wildly when it is first released. It is far wiser and safer for a doctor to stick to the drugs he is already familiar with, and using the newer drugs only when the regular reliable meds are not working, or where there is a special indication for their use --- otherwise the gtreatment is needlessly expensive, driving up the cost of health care and of Medical Aid, with no real benefits. I am wary of a doctor who is always prescribing what the last pretty drug rep was talking to him about.
And NO doctor should EVER EVER EVER prescribe ANY drug, let alone a new one, without fully explaining the side-effects to their patient. It's just lousy and lazy practice not to do so. Similarly, with any new drug INSIST that the pharmacost filling the prescription (a) provide you with a copy of the package insert with the most relevant information, and that they discuss the side-effects, precautions, etcd. with you in full --- they need to earn the high fees / profits they want to charge !
On a quick web search ( as I said, the company couldn'tbe bothered to inform me properly ) this is what I found about side-effects, etc., from the Drugs.com database ---. Cymbalta is Duloxetine.
" What is the most important information I should know about Cymbalta?
• While you are taking Cymbalta you may need to be monitored for worsening symptoms of depression and/or suicidal thoughts especially at the start of therapy or when doses are changed. Your doctor may want you to monitor for the following symptoms: anxiety, panic attacks, difficulty sleeping, irritability, hostility, impulsivity, severe restlessness, and mania (mental and/or physical hyperactivity). These symptoms may be associated with development of worsening symptoms of depression and/or suicidal thoughts or actions. Contact your healthcare provider if you develop any new or worsening mental health symptoms during treatment with Cymbalta. Do not stop taking Cymbalta without first talking to your healthcare provider.
• Do not stop taking Cymbalta without first talking to your doctor. It may take several weeks before you start feeling better.
What should I discuss with my healthcare provider before taking Cymbalta?
• While you are taking Cymbalta you may need to be monitored for worsening symptoms of depression and/or suicidal thoughts especially at the start of therapy or when doses are changed. Your doctor may want you to monitor for the following symptoms: anxiety, panic attacks, difficulty sleeping, irritability, hostility, impulsivity, severe restlessness, and mania (mental and/or physical hyperactivity). These symptoms may be associated with development of worsening symptoms of depression and/or suicidal thoughts or actions. Contact your healthcare provider if you develop any new or worsening mental health symptoms during treatment with Cymbalta. Do not stop taking Cymbalta without first talking to your healthcare provider.
• 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. You must wait 5 weeks after stopping Cymbalta before taking thioridazine (Mellaril).
• Tell your doctor about any medications you have been taking, even if you have stopped taking them, before you take Cymbalta.
• Talk to your doctor before taking any other medications after you stop taking Cymbalta.
• Before taking Cymbalta, tell your doctor if you
· have liver disease;
· have kidney disease;
· narrow angle glaucoma;
· have diabetes;
· drink alcohol regularly;
· have high blood pressure;
· suffer from seizures; or
· suffer from mania or have suicidal thoughts.
• You may not be able to take Cymbalta, or you may need a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.
• 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.
How should I take Cymbalta?
• Take Cymbalta exactly as directed by your doctor. If you do not understand these instructions, ask your pharmacist, nurse, or doctor to explain them to you.
• 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. It may take several weeks before you start feeling better.
• It is important to take Cymbalta regularly to get the most benefit.
• Your doctor may want to perform tests or schedule appointments to monitor your treatment with Cymbalta.
• Store Cymbalta at room temperature away from moisture and heat.
What happens if I miss a dose?
• Take the missed dose 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.
What should I avoid while taking Cymbalta?
• Use caution when driving, operating machinery, or performing other hazardous activities. Cymbalta may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities.




What are the possible side effects of Cymbalta?
• 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.
• If you experience 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.
• Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.
What other drugs will affect Cymbalta?
• 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. You must wait 5 weeks after stopping Cymbalta before taking thioridazine (Mellaril).
• 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 as amitriptyline (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.
• You may not be able to take Cymbalta, or you may require a dosage adjustment or special monitoring during treatment if you are taking any of the medicines listed above.
• Drugs other than those listed here may also interact with Cymbalta. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including vitamins, minerals, and herbal products.

The information provided does not constitute a diagnosis of your condition. You should consult a medical practitioner or other appropriate health care professional for a physical exmanication, diagnosis and formal advice. Health24 and the expert accept no responsibility or liability for any damage or personal harm you may suffer resulting from making use of this content.

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