Patient handout
Duloxetine (Cymbalta)
You have been prescribed duloxetine. This page explains what it is, what to expect, and when to call.
What it is
Duloxetine is an SNRI antidepressant that raises serotonin and norepinephrine. It is used for depression and generalized anxiety, and it also treats nerve pain, fibromyalgia, and chronic muscle and joint pain, which makes it a good fit when mood and pain go together.
How to take it
- Take it once a day at the same time, with food to reduce nausea.
- Swallow the capsule whole. Do not crush, chew, or open it.
- If you miss a dose, take it when you remember the same day. If it is the next day, skip it. Do not double up.
- A dose increase after a few weeks is common and planned.
What to expect, and when
- Week 1 to 2: nausea, dry mouth, and sleepiness or trouble sleeping are the common early effects and usually fade.
- Week 2 to 4: mood, worry, and pain often begin to ease.
- Week 4 to 8: full benefit at the right dose.
- Plan to stay on it for at least six to twelve months after you feel well.
Common side effects
Nausea, dry mouth, constipation, reduced appetite, sweating, dizziness, fatigue or trouble sleeping, and sexual side effects. Blood pressure can rise a little.
Call the office the same day if
- New or worsening thoughts of hurting yourself, especially early on or after a dose change (particularly under age 25)
- Yellowing of the skin or eyes, dark urine, or pain in the upper right belly (possible liver problem)
- Fever with agitation, fast heartbeat, muscle twitching, or confusion (possible serotonin syndrome)
- Unusual bruising or bleeding, especially with ibuprofen, naproxen, aspirin, or a blood thinner
- Rash, swelling, or trouble breathing (call 911)
Stopping
Stopping duloxetine suddenly can cause dizziness, nausea, irritability, headache, and electric-shock sensations. Keep refills ahead of time, and do not stop on your own. We taper gradually together.
Good to know
- Avoid heavy alcohol use with duloxetine; the combination can strain the liver. Tell us if you have liver disease or drink regularly.
- Tell other prescribers and your pharmacist. Check before adding tramadol, triptans, St. John's wort, or other antidepressants.
- If you are pregnant, planning pregnancy, or breastfeeding, tell us.
Questions about this medication?
Alice Tran Psychiatric Care · 3060 Williams Drive, Suite 300, Fairfax, VA 22031
Call: (703) 791-9099 · Text: (703) 791-9031 · info@alicetrannp.com · alicetrannp.com
This handout is for education and is not a substitute for the instructions you received at your visit. Follow the dose on your prescription label. If anything here differs from what you were told, call the office. In an emergency, call 911. If you are in crisis, call or text 988.