Buy Cymbalta
(Duloxetine)
Duloxetine (Generic Cymbalta) is a selective serotonin and norepinephrine
reuptake inhibitor (SNRI) used to treat depression and generalized anxiety disorder.
It may also be used to treat certain types of nerve pain and other conditions
as determined by your doctor.
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Cymbalta
GENERIC NAME: Duloxetine
BRAND NAME: Cymbalta
IMPORTANT WARNING:
A small number of children, teenagers, and young adults (up to 24 years of
age) who took antidepressants ('mood elevators') such as Cymbalta during
clinical studies became suicidal (thinking about harming or killing oneself
or planning or trying to do so). Children, teenagers, and young adults who
take antidepressants to treat depression or other mental illnesses may be
more likely to become suicidal than children, teenagers, and young adults
who do not take antidepressants to treat these conditions. However, experts
are not sure about how great this risk is and how much it should be considered
in deciding whether a child or teenager should take an antidepressant. Children
younger than 18 years of age should not normally take Cymbalta, but in some
cases, a doctor may decide that Cymbalta is the best medication to treat
a child's condition.
You should know that your mental health may change in unexpected ways when
you take Cymbalta or other antidepressants even if you are an adult over
age 24. These changes may occur even if you do not have a mental illness and
you are taking Cymbalta to treat a different type of condition. You may
become suicidal, especially at the beginning of your treatment and any time
that your dose is increased or decreased. You, your family, or caregiver should
call your doctor right away if you experience any of the following symptoms:
new or worsening depression; thinking about harming or killing yourself, or
planning or trying to do so; extreme worry; agitation; panic attacks; difficulty
falling asleep or staying asleep; aggressive behavior; irritability; acting
without thinking; severe restlessness; and frenzied abnormal excitement. Be
sure that your family or caregiver knows which symptoms may be serious so
they can call the doctor when you are unable to seek treatment on your own.
Your healthcare provider will want to see you often while you are taking
Cymbalta, especially at the beginning of your treatment. Be sure to keep
all appointments for office visits with your doctor.
The doctor or pharmacist will give you the manufacturer's patient information
sheet (Medication Guide) when you begin treatment with Cymbalta. Read the
information carefully and ask your doctor or pharmacist if you have any questions.
You also can obtain the Medication Guide from the FDA website: http://www.fda.gov/cder/drug/antidepressants/antidepressants_MG_2007.pdf.
No matter your age, before you take an antidepressant, you, your parent,
or your caregiver should talk to your doctor about the risks and benefits
of treating your condition with an antidepressant or with other treatments.
You should also talk about the risks and benefits of not treating your condition.
You should know that having depression or another mental illness greatly increases
the risk that you will become suicidal. This risk is higher if you or anyone
in your family has or has ever had bipolar disorder (mood that changes from
depressed to abnormally excited) or mania (frenzied, abnormally excited mood)
or has thought about or attempted suicide. Talk to your doctor about your
condition, symptoms, and personal and family medical history. You and your
doctor will decide what type of treatment is right for you.
Why is Cymbalta prescribed?
Cymbalta is used to treat depression and generalized anxiety disorder (GAD;
excessive worry and tension that disrupts daily life and lasts for 6 months
or longer). Cymbalta is also used to treat pain and tingling caused by diabetic
neuropathy (damage to nerves that can develop in people who have diabetes).
Cymbalta is in a class of medications called selective serotonin and norepinephrine
reuptake inhibitors (SSNRIs). It works by increasing the amounts of serotonin
and norepinephrine, natural substances in the brain that help maintain mental
balance and stop the movement of pain signals in the brain.
How should Cymbalta be used?
Cymbalta comes as a delayed release (long-acting) capsule to take by mouth.
When Cymbalta is used to treat depression, it is usually taken once or twice
a day with or without food. When Cymbalta is used to treat generalized anxiety
disorder or the pain of diabetic neuropathy, it is usually taken once a day
with or without food. Take Cymbalta at around the same time(s) every day.
Follow the directions on your prescription label carefully, and ask your doctor
or pharmacist to explain any part you do not understand. Take Cymbalta exactly
as directed. Do not take more or less of it, take it more often, or take it
for a longer time than prescribed by your doctor.
Swallow the capsules whole; do not split, chew, or crush them. Do not open
the capsules and mix the contents with liquids or sprinkle the contents on
food.
If you are taking Cymbalta to treat generalized anxiety disorder or the
pain of diabetic neuropathy, your doctor may start you on a low dose of medication
and gradually increase your dose.
Cymbalta may help control your symptoms but will not cure your condition.
It may take 1 to 4 weeks or longer before you feel the full benefit of Cymbalta.
Continue to take Cymbalta even if you feel well. Do not stop taking Cymbalta
without talking to your doctor. Your doctor will probably decrease your dose
gradually. If you suddenly stop taking Cymbalta, you may experience withdrawal
symptoms such as dizziness, nausea, vomiting, headache, pain, burning or tingling
in the hands or feet, irritability, and nightmares.Tell your doctor if you
experience any of these symptoms when your dose of Cymbalta is decreased.
Other uses for Cymbalta
Cymbalta is also sometimes used to treat stress urinary incontinence (leakage
of urine during physical activity such as coughing, sneezing, laughing, and
exercise) in women. Talk to your doctor about using Cymbalta to treat your
condition.
Cymbalta may be prescribed for other uses; ask your doctor or pharmacist
for more information.
What special precautions should I follow?
Before taking Cymbalta,
tell your doctor and pharmacist if you are allergic to Cymbalta or any
other medications.
tell your doctor if you are taking thioridazine or a monoamine oxidase (MAO)
inhibitor, such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline
(Eldepryl, Emsam, Zelapar), and tranylcypromine (Parnate), or if you have
stopped taking an MAO inhibitor within the past 14 days. Your doctor will
probably tell you not to take Cymbalta. If you stop taking Cymbalta, you
should wait at least 5 days before you start to take an MAO inhibitor.
tell your doctor and pharmacist what other prescription and nonprescription
medications, vitamins, and nutritional supplements you are taking or plan
to take. Be sure to mention any of the following: anticoagulants ('blood thinners')
such as warfarin (Coumadin); antidepressants such as amitriptyline (Elavil),
amoxapine (Asendin), clomipramine (Anafranil), desipramine (Norpramin), doxepin
(Adapin, Sinequan), imipramine (Tofranil), nortriptyline (Aventyl, Pamelor),
protriptyline (Vivactil), and trimipramine (Surmontil); antihistamines; cimetidine
(Tagamet); diuretics ('water pills'); linezolid (Zyvox); medications for irregular
heartbeat such as amiodarone (Cordarone), flecainide (Tambocor), moricizine
(Ethmozine), quinidine (Quinidex) and propafenone (Rythmol); medications for
anxiety, high blood pressure, mental illness, pain, and nausea; propranolol
(Inderal); medications for migraine headaches such as almotriptan (Axert),
eletriptan (Relpax), frovatriptan (Frova), naratriptan (Amerge), rizatriptan
(Maxalt), sumatriptan (Imitrex), and zolmitriptan (Zomig); lithium (Eskalith,
Lithobid); proton pump inhibitors such as lansoprazole (Prevacid), omeprazole
(Prilosec), pantoprazole (Protonix), and rabeprazole (Aciphex); quinolone
antibiotics such as ciprofloxacin (Cipro) and enoxacin (Penetrex); sedatives;
certain selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine
(Prozac, Sarafem), fluvoxamine (Luvox) and paroxetine (Paxil); sibutramine
(Meridia); sleeping pills; theophylline (Theochron, Theolair); tramadol (Ultram);
and tranquilizers. Many other medications may interact with Cymbalta, so
be sure to tell your doctor about all the medications you are taking, even
those that do not appear on this list. Your doctor may need to change the
doses of your medications or monitor you carefully for side effects.
tell your doctor what herbal products you are taking, especially products
containing St. John's wort or tryptophan.
tell your doctor if you have or have ever had glaucoma (an eye condition).
Your doctor may tell you that you should not take Cymbalta.
tell your doctor if you drink or have ever drunk large amounts of alcohol
or if you use or have ever used street drugs or have ever overused prescription
medications. Also tell your doctor if you have or have ever had a heart attack;
high blood pressure; seizures; coronary artery disease (blockage or narrowing
of the blood vessels that lead to the heart; or heart, liver, or kidney disease.
If you have diabetes, be sure to talk to your doctor about how serious your
condition is so your doctor can decide if Cymbalta is right for you.
tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding.
If you become pregnant while taking Cymbalta, call your doctor.
if you are having surgery, including dental surgery, tell the doctor or dentist
that you are taking Cymbalta.
you should know that Cymbalta may make you drowsy or dizzy. Do not drive
a car or operate machinery until you know how Cymbalta affects you.
ask your doctor about the safe use of alcoholic beverages while you are taking
Cymbalta..Alcohol can increase the risk of serious side effects from Cymbalta.
you should know that Cymbalta may cause dizziness, lightheadedness, and
fainting when you get up too quickly from a lying position. This is more common
when you first start taking Cymbalta. To avoid this problem, get out of
bed slowly, resting your feet on the floor for a few minutes before standing
up.
What special dietary instructions should I follow?
Unless your doctor tells you otherwise, continue your normal diet.
What should I do if I forget a dose?
Take the missed dose as soon as you remember it. However, if it is almost
time for the next dose, skip the missed dose and continue your regular dosing
schedule. Do not take a double dose to make up for a missed one.
What side effects can Cymbalta cause?
Cymbalta may cause side effects. Tell your doctor if any of these symptoms
are severe or do not go away:
nausea
vomiting
constipation
diarrhea
heartburn
stomach pain
decreased appetite
dry mouth
increased urination
difficulty urinating
sweating or night sweats
dizziness
headache
extreme tiredness
weakness
muscle pain or cramps
changes in sexual desire or ability
uncontrollable shaking of a part of the body
Some side effects can be serious. If you experience any of the following
side effects, or those mentioned in the IMPORTANT WARNING section, call your
doctor immediately:
unusual bruising or bleeding
pain in the upper right part of the stomach
itching
yellowing of the skin or eyes
dark colored urine
flu-like symptoms
blurred vision
fever
blisters
rash
hives
swelling of the eyes, face, lips, tongue, throat, hands, arms, feet, ankles,
or lower legs
difficulty breathing or swallowing
Cymbalta may cause other side effects. Call your doctor if you have any
unusual problems while taking Cymbalta.
If you experience a serious side effect, you or your doctor may send a report
to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting
program online [at http://www.fda.gov/MedWatch/index.html] or by phone [1-800-332-1088].
What storage conditions are needed for Cymbalta?
Keep Cymbalta in the container it came in, tightly closed, and out of reach
of children. Store Cymbalta at room temperature and away from excess heat
and moisture (not in the bathroom).Throw away any medication that is outdated
or no longer needed. Talk to your pharmacist about the proper disposal of
your medication.
In case of emergency/overdose
In case of overdose, call your local poison control center at 1-800-222-1222.
If the victim has collapsed or is not breathing, call local emergency services
at 911.
Symptoms of overdose may include:
agitation
hallucinating (seeing things or hearing voices that do not exist)
fast heartbeat
fever
loss of coordination
nausea
vomiting
diarrhea
drowsiness
seizures
What other information should I know?
Keep all appointments with your doctor.
Do not let anyone else take your medication. Ask your pharmacist any questions
you have about refilling your prescription.
It is important for you to keep a written list of all of the prescription
and nonprescription (over-the-counter) medicines you are taking, as well as
any products such as vitamins, minerals, or other dietary supplements. You
should bring this list with you each time you visit a doctor or if you are
admitted to a hospital. It is also important information to carry with you
in case of emergencies.
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