Cymbalta

Cymbalta

duloxetine

Manufacturer:

Eli Lilly

Distributor:

Zuellig Pharma
Concise Prescribing Info
Contents
Duloxetine HCl
Indications/Uses
Major depressive disorder, generalized anxiety disorder. Management of diabetic peripheral neuropathic pain.
Dosage/Direction for Use
Major depressive disorder Initial & maintenance dose: 60 mg once daily. Max: 120 mg daily. Diabetic peripheral neuropathic pain 60 mg once daily. Max: 120 mg daily in divided doses. Generalized anxiety disorder 30 mg once daily, may be increased up to 60 mg. Patient w/ co-morbid major depressive disorder 60 mg once daily, may be increased up to 90-120 mg.
Administration
May be taken with or without food: Swallow whole, do not chew/crush.
Contraindications
Hypersensitivity. Uncontrolled HTN. Concomitant use w/ MAOIs & potent CYP1A2 inhibitors (eg, fluvoxamine, ciprofloxacin or enoxacin). Hepatic & severe renal impairment.
Special Precautions
Mania, bipolar disorders &/or seizures. Patients w/ increased IOP & risk of narrow-angle glaucoma. Monitor BP in patients w/ known HTN & heart disease. Monitor for suicidal ideation/behavior especially w/ patients <25 yr. Haemorrhage, known bleeding tendencies. Hyponatraemia. W/drawal symptoms on treatment discontinuation. Akathisia/psychomotor restlessness. Concomitant use w/ SSRIs, SNRIs, TCAs, triptans, St. John's wort, anticoagulants, NSAIDs, acetylsalicylic acid. Fructose intolerance, glucose-galactose malabsorption or sucrose-isomaltose insufficiency. May affect ability to drive & use machines. Renal impairment. Hepatitis/increased hepatic enzyme. Pregnancy. Not recommended during lactation. Not to be used in childn & adolescents <18 yr. Elderly.
Adverse Reactions
Headache, somnolence; nausea, dry mouth. Decreased appetite; insomnia, agitation, decreased libido, anxiety, abnormal orgasm & dreams; dizziness, lethargy, tremor, paraesthesia; blurred vision; tinnitus; palpitations; increased BP, flushing; yawning; constipation, diarrhoea, abdominal pain, vomiting, dyspepsia, flatulence; increased sweating, rash; musculoskeletal pain, muscle spasm; dysuria, pollakiuria; erectile dysfunction, ejaculation disorder; falls, fatigue; decreased wt.
Drug Interactions
CNS medicinal products. Serotonin syndrome w/ MAOIs, SSRIs, SNRIs, TCAs, St. John's wort, triptans, tramadol, pethidine, tryptophan. Increased AUC of desipramine, tolterodine. Drugs metabolised by CYP2D6 eg, risperidone, flecainide, propafenone, metoprolol. Increased risk of bleeding w/ oral anticoagulant or antiplatelet agents.
ATC Classification
N06AX21 - duloxetine ; Belongs to the class of other antidepressants.
Presentation/Packing
Form
Cymbalta gastro-resistant cap 60 mg
Packing/Price
28's
Form
Cymbalta gastro-resistant cap 30 mg
Packing/Price
28's
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