Cymbalta Dosage, forms & strengths
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Get started todayCymbalta is the brand name for the prescription drug duloxetine hydrochloride. It is classed as a serotonin and norepinephrine reuptake inhibitor (SNRIs). SNRIs increase serotonin and norepinephrine levels in your brain, which increases nerve activity and helps to regulate your mood.
Cymbalta is used to treat depression and other mental health conditions such as major depressive disorder (MDD), generalized anxiety disorder, fibromyalgia, diabetic peripheral neuropathy (nerve pain due to diabetes), and chronic musculoskeletal pain such as back pain or arthritic pain.
Cymbalta has a boxed warning about suicidal thoughts and behaviors. This is a serious warning from the Food and Drug Administration (FDA).
Cymbalta forms and strengths
Cymbalta is available as a delayed-release capsule in the following dose: 20 mg, 30 mg, 60 mg.
Cymbalta dosage for adults table
| Indication | Initial dosage | Maintenance dosage | Maximum dosage |
|---|---|---|---|
| Major depressive disorder | 40 - 60 mg daily | 20 mg taken twice daily or 60 mg taken daily in 1 or 2 divided doses | 120 mg daily |
| Generalized anxiety disorder | 60 mg taken once daily | 60 mg taken once daily | 120 mg daily |
| Fibromyalgia | 30 mg taken once daily | 60 mg taken once daily | 60 mg daily |
| Diabetic peripheral neuropathy | 30 mg taken once daily | 60 mg taken once daily | 60mg daily |
| Chronic musculoskeletal pain | 30 mg taken once daily | 60 mg taken once daily | 60mg daily |
For patients for whom tolerability is a concern, a lower starting dose may be considered.
Cymbalta dosage for major depressive disorder
Major depressive disorder has symptoms of depression such as sadness, lack of enjoyment, and suicidal thoughts, persisting for two or more weeks. It takes a few weeks of treatment to start improving the symptoms of depression.
- Standard adult dose for major depressive disorder: 20 mg twice daily or 60 mg taken once daily or in two divided doses of 30 mg each
- Maximum adult dose for major depressive disorder: 120 mg daily
Cymbalta dosage for generalized anxiety disorder
Generalized anxiety disorder symptoms include excessive worry and distress throughout the day that can cause significant impairment in your daily life as well as physical problems such as trouble sleeping, chronic headaches, and digestive system problems.
- Standard adult dose for generalized anxiety disorder: 60 mg taken once daily
- Maximum adult dose for generalized anxiety disorder: 120 mg daily
Cymbalta dosage for fibromyalgia
Fibromyalgia is a chronic condition with symptoms that include muscle pain, tiredness, and problems sleeping. The mechanism of action for how duloxetine helps manage fibromyalgia pain is not fully understood. It may take a few weeks for duloxetine to improve pain symptoms in fibromyalgia or other pain conditions.
- Standard adult dosage for fibromyalgia: 60 mg taken once daily
- Maximum adult dosage for fibromyalgia: 60 mg per daily
Cymbalta dosage for diabetic peripheral neuropathy
Nerves located in extremities such as your hands, arms, feet, and legs can be damaged by chronic high blood sugar. Cymbalta is effective at reducing this diabetic peripheral neuropathy. It will take a few weeks to improve DBNP pain symptoms when treated with Cymbalta.
- Standard adult dosage for diabetic peripheral neuropathy: 60 mg taken once daily
- Maximum adult dosage for diabetic peripheral neuropathy: 60 mg daily
Cymbalta dosage for chronic musculoskeletal pain
Chronic musculoskeletal pain includes back pain and osteoarthritis pain. It takes a few weeks of treatment with Cymbalta to improve symptoms.
- Standard adult dosage for chronic musculoskeletal pain: 60 mg taken once daily
- Maximum adult dosage for chronic musculoskeletal pain: 60 mg daily
Cymbalta dosage for children
Cymbalta is FDA approved for the treatment of generalized anxiety disorder in children aged 7 years and older and to treat fibromyalgia in children aged 13 years and older. Cymbalta may also be prescribed off-label in children 7 years of age to treat major depressive disorder.
Cymbalta pediatric dosage chart
| Indication | Age | Initial dosage | Maintenance dosage | Maximum dosage |
|---|---|---|---|---|
| Generalized anxiety disorder | 7-17 years | 30 mg taken once daily | 30 - 60 mg taken once daily | 120 mg daily |
| Fibromyalgia | 13 - 17 years | 30 mg taken once daily | 60 mg taken once daily | 60 mg daily |
Cymbalta dosage restrictions
Some people with physical or medical conditions may have difficulties taking Cymbalta. Cymbalta is contraindicated if you have a history of allergic reactions to duloxetine, severe renal impairment, liver disease, or cirrhosis. Other medical conditions require a dose reduction or closer monitoring when treated with Cymbalta.
- Cymbalta should be used with caution if you have a history of mania or a diagnosis of bipolar disorder, and/or seizures
- Older patients should be started on a daily dose of 30 mg per day for the treatment of major depressive disorder or generalized anxiety disorder
- You will need to discuss treatment with your prescriber if you have a renal impairment (kidney disease)
- Dose reduction is required if you have hepatic impairment (liver problems). Treatment is not recommended with Cymbalta if you have severe hepatic disease or cirrhosis
- Discuss treatment with your healthcare provider if you have any eye problems, including any kinds of glaucoma
How to take Cymbalta
Cymbalta is a delayed-release capsule taken once or twice a day with or without food, depending on your condition. The capsule should be swallowed whole. Do not open the capsule and sprinkle the contents on food or mix in liquids. Your dose may need to be changed a few times to find what works best for you. Please read the medication guide before taking the medication.
Cymbalta dosage FAQs
What are the side effects of Cymbalta?
Common side effects of duloxetine that occur most regularly include headaches, increased heart rate, high blood pressure, drowsiness, nausea, a dry mouth, a lack of appetite, constipation, trouble sleeping, sexual dysfunction in both male and female patients, a reduced sex drive, and problems orgasming.
In rarer cases, Cymbalta can cause more serious side effects requiring hospitalization. These can include worsening suicidal thoughts and behaviors in children, adolescents, and young adults, allergic reactions to the medication, and liver failure. Your physician will assess your risk of side effects versus the benefits of Cymbalta.
What drug interactions are there with Cymbalta?
- Other medications that can increase serotonin levels, such as SSRIs and SNRI (selective serotonin and norepinephrine reuptake inhibitor) antidepressants, triptans, tramadol, tryptophan, or St John’s Wort
- Monoamine oxidase inhibitors (MAOIs), used as antidepressants such as linezolid and methylene blue can cause an increased risk of serotonin syndrome. At least 14 days should elapse between discontinuation of an MAOI intended to treat psychiatric disorders and initiation of therapy with Cymbalta
- Fluoxetine and paroxetine will increase the level or effect of duloxetine by blocking the action of the hepatic enzyme CYP2D6
- Treatments that cause drowsiness such as strong painkillers, benzodiazepines, antipsychotics, phenobarbital, and antihistamines
- Blood thinners such as warfarin that prevent blood from clotting, anticoagulants antiplatelet agents, and NSAIDs
Make sure you tell your healthcare professional about all the prescription drugs you’re taking, as well as those mentioned above, including any vitamins, minerals, over-the-counter or dietary supplements.
How long does it take Cymbalta to work?
You will need to take Cymbalta daily for one to two weeks before you notice any improvement in your symptoms. It may take longer to improve any pain symptoms.
How long does Cymbalta stay in your system?
It takes your body about two days to completely clear Cymbalta from your system, but this will vary from person to person.
What happens if I miss a dose of Cymbalta?
If you miss a dose take it as soon as you remember. If it is nearly time for your next dose, skip the missed dose and take your next dose at the regular time.
How long can you take Cymbalta?
There are no known problems associated with long-term use of duloxetine, so treatments using duloxetine can last indefinitely. You are advised to speak to your healthcare provider before you stop taking this medication.
Is it safe to take Cymbalta during pregnancy?
The risk of harming the fetus is small, but when given in the third trimester, there is a risk that the baby will be born with withdrawal symptoms or serotonin syndrome.
Duloxetine is found in breast milk and can affect the baby. If you are a breastfeeding mother seek medical advice from your caregivers if your baby is sleepy, has poor feeding, or has poor weight gain.
