WHAT IS Cymbalta/Duloxetine?

DULOXETINE/Cymbalta is an antidepressant. It is used to treat depression. It is also used to treat pain caused by complications of diabetes or pain caused by fibromyalgia. This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

WHERE SHOULD I KEEP Cymbalta/Duloxetine?

Keep out of the reach of children.

HOW SHOULD I USE Cymbalta/Duloxetine?

Take this medicine by mouth with a glass of water. Follow the directions on the prescription label. Do not cut, crush or chew this medicine. You can take this medicine with or without food. Take your medicine at regular intervals. Do not take your medicine more often than directed. If you have been taking this medicine regularly for some time, do not suddenly stop taking it. You must gradually reduce the dose, or your symptoms may get worse. Ask your doctor or health care professional for advice.

A special MedGuide will be given to you by the pharmacist with each prescription and refill. Be sure to read this information carefully each time.

Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

Note: This medicine is only for you. Do not share this medicine with others.

WHAT IF I MISS A DOSE?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

WHAT SHOULD I WATCH FOR WHILE USING Cymbalta/Duloxetine?

Visit your doctor or health care professional for regular checks on your progress. Continue to take your medicine even if you do not feel better right away. It can take about 4 weeks before you feel the full effect of this medicine.

Patients and their families should watch out for worsening depression or thoughts of suicide. Also watch out for sudden or severe changes in feelings such as feeling anxious, agitated, panicky, irritable, hostile, aggressive, impulsive, severely restless, overly excited and hyperactive, or not being able to sleep. If this happens, especially at the beginning of treatment or after a change in dose, call your health care professional.

You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this medicine affects you. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells. Alcohol may interfere with the effect of this medicine. Avoid alcoholic drinks.

Do not treat yourself for coughs, colds, or allergies without asking your doctor or health care professional for advice. Some ingredients can increase possible side effects.

Your mouth may get dry. Chewing sugarless gum or sucking hard candy, and drinking plenty of water may help. Contact your doctor if the problem does not go away or is severe.

This medicine may cause an increase in blood pressure. Check with your doctor or health care professional, you may be able to measure your own blood pressure and pulse. Find out what your blood pressure and heart rate should be and when you should contact him or her.

WHAT MAY INTERACT WITH Cymbalta/Duloxetine?

Do not take this medicine with any of the following:

• MAOIs like Carbex, Eldepryl , Marplan, Nardil, and Parnate
• tryptophan
• procarbazine
• thioridazine/Mellaril
• venlafaxine/Effexor
• nefazodone
• certain diet drugs like dexfenfluramine, fenfluramine, phentermine, sibutramine
• SSRIs like citalopram/Celexa, escitalopram/Lexapro, fluoxetine/Prozac, fluvoxamine/Luvox, paroxetine/Paxil cr, sertraline/Zoloft
• St. John's Wort

This medicine may also interact with the following:

• cimetidine
• certain antibiotics like ciprofloxacin/Cipro and enoxacin
• medicines for heart rhythm or blood pressure
• other medicines for mental depression, mania, psychosis, or anxiety

This list may not describe all possible interactions. Give your health care providers a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

WHAT SIDE EFFECTS MAY I NOTICE FROM Cymbalta/Duloxetine?

Side effects that you should report to your doctor or health care professional as soon as possible:

• fever
• dizziness
• stomach flu-like symptoms of diarrhea, vomiting
• allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
• hallucination, loss of contact with reality
• suicidal thoughts or other mood changes
• confusion
• fast, irregular heartbeat
• changes in blood pressure
• fast talking and excited feelings or actions that are out of control
• seizures

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

• headache
• nausea
• change in appetite
• change in sex drive or performance
• blurred vision
• increased sweating

This list may not describe all possible side effects.

WHAT SHOULD I TELL MY HEALTH CARE PROVIDERS BEFORE I TAKE Cymbalta/Duloxetine?

They need to know if you have any of these conditions:

• an unusual reaction to duloxetine/Cymbalta , other medicines, foods, dyes, or preservatives
• kidney or liver disease
• breast-feeding
• narrow- angle glaucoma
• pregnant or trying to get pregnant
• bipolar disorder or a family history of bipolar disorder
• taken medicines called MAOIs like Carbex, Eldepryl , Marplan, Nardil, and Parnate within 14 days
• suicidal thoughts or a previous suicide attempt

What is the shelf life of the pills?

• The expiry date is mentioned on each blister. It is different for different batches. The shelf life is 2 years from the date of manufacture and would differ from batch to batch depending on when they were manufactured.