* The product images are for reference only. Generic equivalents may also be supplied by alternate manufacturers.
Ordering Cymbalta (Duloxetine)
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What is Cymbalta?
This medication is used to treat depression and anxiety. It is also used to manage fibromyalgia and to relieve nerve pain in people with diabetes (diabetic peripheral neuropathy), as well as chronic musculoskeletal pain, such as chronic lower back pain and osteoarthritis-related pain. Duloxetine is a serotonin and norepinephrine reuptake inhibitor (SNRI) antidepressant. It works by helping restore the balance of certain natural substances (serotonin and norepinephrine) in the brain. Cymbalta may improve your mood, sleep, appetite, and energy level, and decrease your nervousness. It may also reduce pain caused by other medical conditions.
Brand-name Cymbalta is manufactured in Turkey, the European Union, and Australia by Eli Lilly. Generic versions are produced by various manufacturers in Canada, India, and the United Kingdom. Common generic equivalents include Duzela (manufactured by Sun Pharma) and Duvanta (manufactured by Intas).
Available Strengths and Sizes
Brand-name Cymbalta is available in 30 mg and 60 mg capsule strengths. The generic version is also available as delayed-release capsules or tablets in 20 mg, 30mg, 40 mg, and 60 mg strengths.
Adverse Reactions & Side Effects
Common Side Effects – If these persist or become a concern, please reach out to your healthcare provider:
• Constipation
• Dizziness
• Dry mouth
• Fatigue
• Headache
• Insomnia
• Nausea
• Sweating increased
Other Potential Side Effects (less common) - The following list includes side effects that are reported less frequently by individuals:
• Blurred vision
• Decreased appetite
• Diarrhea
• Erectile dysfunction
• Hot flashes
• Muscle cramps
• Paresthesia (a "pins and needles" sensation)
• Weight loss
Serious Side Effects – These reactions are rare but require immediate medical attention. Stop using the medication and call your doctor or emergency services if you experience:
• Gastrointestinal Bleeding
• Hepatic Failure (liver damage)
• Hypertensive Crisis
• Serotonin Syndrome
• Stevens-Johnson Syndrome
Contraindications
Do NOT take this medication if any of the following conditions exist:
• Hypersensitivity: A known allergy or hypersensitivity to duloxetine or any of the inactive ingredients in the capsule.
• MAO Inhibitor Use: If you have taken a Monoamine Oxidase Inhibitor (MAOI) within the last 14 days, this can cause a life-threatening interaction.
• Severe Renal Impairment: End-stage renal disease or severe renal impairment.
• Uncontrolled Narrow-Angle Glaucoma: Narrow-angle glaucoma that is inadequately managed.
Precautions and Warnings
The following conditions warrant a detailed discussion with a healthcare provider before starting this medication, as they may need to be adjusted or avoided to ensure patient safety:
• Alcohol Use Heavy alcohol use or chronic liver disease, as Cymbalta increases the risk of severe liver injury.
• Bipolar Disorder: History of mania or bipolar disorder, as antidepressants can trigger manic episodes.
• Bleeding Disorders Conditions that increase bleeding risk, such as the use of anticoagulants (NSAIDs, warfarin).
• Heart Problems: History of heart disease or high blood pressure.
• Seizures: History of a seizure disorder or epilepsy
Drug Interactions
Understanding how Cymbalta interacts with other substances is crucial for safe and effective treatment. The following medications may need close monitoring or dosage adjustments when taken together.
• CYP1A2 Inhibitors: Medications that inhibit this enzyme, such as fluvoxamine or certain quinolone antibiotics like ciprofloxacin, can significantly increase duloxetine blood levels. This elevation increases the likelihood of side effects and may require dosage adjustments.
• CYP2D6 Inhibitors: Because duloxetine is both a substrate and a moderate inhibitor of CYP2D6, medications such as paroxetine, fluoxetine, or quinidine can increase duloxetine levels. Conversely, Cymbalta may increase the levels of other drugs metabolized by this enzyme, including tricyclic antidepressants and certain antiarrhythmics.
• Serotonergic Drugs: Medications that increase serotonin—including SSRIs, other SNRIs, triptans, buspirone, or St. John's Wort—may have an additive effect when taken with duloxetine. This combination can cause dangerously high serotonin levels, leading to Serotonin Syndrome.
• Thioridazine: Cymbalta should not be administered with thioridazine because it can increase thioridazine concentrations and raise the risk of serious ventricular arrhythmias and sudden death.
• Triptans: Used to treat migraine, these may interact with Cymbalta, causing symptoms such as agitation, hallucinations, and rapid heart rate. Patients should be closely monitored when starting or adjusting these medications together.
Other Notable Interactions• Anticoagulants and Antiplatelets: Medications such as warfarin, aspirin, and nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen may increase the risk of bleeding. Duloxetine may interfere with platelet aggregation, and its coadministration increases the risk of gastrointestinal or other bleeding events.
• CNS-Acting Drugs: Other medications that affect the central nervous system, such as benzodiazepines or opioids, should be used cautiously because of the risk of increased sedation or cognitive impairment.
Safety & Storage Information
Cymbalta should be stored at room temperature, away from light and moisture, and out of reach of children and pets. This medication should not be stored in the bathroom.
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The drug information provided here is only a summary and does not contain all the list of possible side effects and drug interactions regarding this medication. Be sure to contact your doctor or pharmacist if you have any specific question or concern. If you require any advice or information about the drugs on this page, a medical condition or treatment advice, you should always speak to a healthcare professional.
Please note that not all products, including any referenced in this page, are shipped by our affiliated Canadian Pharmacy. We are affiliated with other dispensaries that ship product to our customers from the following jurisdictions: Canada, Singapore, New Zealand, Turkey, Mauritius, India, and United Kingdom. The items in your order maybe shipped from any of the above jurisdictions. The products are sourced from various countries as well as those listed above. Rest assured, we only affiliate with our authorized dispensaries that procure product through reliable sources.