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The eMC  

Last Updated 20 Nov 2013

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Cymbalta 30mg gastro-resistant capsules

Cymbalta (Sim-bal-ta) is a medicine which is used in anxiety disorder, depression and relief of diabetic peripheral neuropathic pain in adults. Cymbalta contains duloxetine hydrochloride. It is supplied by Eli Lilly and Company Limited.

The information in this Medicine Guide for Cymbalta varies according to the condition being treated and the particular preparation used.

There are 2 preparations of Cymbalta available. If Cymbalta 30mg gastro-resistant capsules is not the preparation you are looking for, please select from the drop down list below.

Select your preparation (type) of Cymbalta

Cymbalta 30mg gastro-resistant capsules

Information specific to Cymbalta 30mg gastro-resistant capsules when used in relief of diabetic peripheral neuropathic pain in adults

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Your medicine

Cymbalta is used to treat depression. It is thought that Cymbalta increases the activity and levels of certain chemicals in the brain. This can improve symptoms of depression. In the early stages of taking Cymbalta, suicidal thoughts and behaviour may be seen in some people. These people have an increased risk of self-harm or suicide in the early stages of taking Cymbalta. As Cymbalta starts to work these risks decrease.

Cymbalta is also used to treat neuropathic pain in diabetics. Some people who are taking Cymbalta for neuropathic pain may also have an increased risk of self-harm or suicide in the early stages of taking Cymbalta. As Cymbalta starts to work these risks decrease.

If you are taking Cymbalta, or you care for someone who is taking Cymbalta, you need to look out for changes in thoughts or behaviour that could be linked to self-harm or suicide.

If you notice any of these changes or are worried about how Cymbalta is affecting you or someone you care for, you should contact your prescriber, a mental health professional or call 111 as soon as possible.

It is important that you discuss with your prescriber how long it will take before you can expect to feel any benefits from taking Cymbalta.

Do not share your medicine with other people. It may not be suitable for them and may harm them.

The pharmacy label on your medicine tells you how much medicine you should take. It also tells you how often you should take your medicine. This is the dose that you and your prescriber have agreed you should take. You should not change the dose of your medicine unless you are told to do so by your prescriber.

If you feel that the medicine is making you unwell or you do not think it is working, then talk to your prescriber.

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When to take your medicine

Some medicines work best if they are taken at a specific time of day. Getting the most from your medicine can also be affected by what you eat, when you eat and the times at which you take other medicines. Make sure you follow any specific instructions given to you by your prescriber or that are in the Patient Information Leaflet that comes with this medicine.

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How to take your medicine

Some medicines have specific instructions about how to take them. This is because they work better when taken correctly. These instructions can include getting the right dose and special instructions for preparing the medicine.

In the case of Cymbalta:

  • swallow the medicine whole with a glass of water
  • this medicine can be taken with or without food

If you are having problems taking this form of Cymbalta, you should talk to your prescriber or pharmacist. They may be able to give you advice on other ways to take your medicine or other preparations that are easier for you to take.

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Taking too much of your medicine

Taking extra doses of some medicines can be harmful. In some cases even one extra dose can cause you problems. If you take extra doses of your medicine, you must get medical advice immediately. You may need a test to assess the effect of taking extra doses. This is because the effects of taking too much medicine are very complex so it is very important that you seek medical advice.

Contact your prescriber, pharmacist, specialist clinic or call 111 for advice.

Make sure you take all of your medicine containers with you if you are advised to go to hospital.

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Stopping your medicine

If you are not having any problems taking this medicine then do not stop taking it, even if you feel better, unless advised to do so by your prescriber. If, however, you find that this medicine is causing you problems then you should talk to your prescriber about your concerns.

If your medical team decides that it is best that you do not take this medicine any more, they may advise that you do not stop Cymbalta abruptly. This is because, in some instances, stopping Cymbalta abruptly can cause withdrawal symptoms or cause your original condition to return. In these instances, reducing the dose of Cymbalta gradually over time may reduce the chances of having these problems.

If you are in any doubt, contact your prescriber, pharmacist, specialist clinic or call 111.

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Looking after your medicine

The instructions on how you should keep your medicine are on the pharmacy label. You should keep your medicine in the original container. This will help to keep your medicine in the best condition and also allow you to check the instructions. Do not take the medicine if the packaging appears to have been tampered with or if the medicine shows any signs of damage. Make sure that the medicine is out of the sight and reach of children.

In the case of Cymbalta:

  • do not store in temperatures above 30°C
  • store the medicine in the original container to protect it from moisture

You must not take the medicine after the expiry date shown on the packaging. If you have any unused medicine, return it to your pharmacist who will dispose of it safely.

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Whether this medicine is suitable for you

Cymbalta is not suitable for everyone and some people should never use it. Other people should only use it with special care. It is important that the person prescribing this medicine knows your full medical history.

Your prescriber may only prescribe this medicine with special care or may not prescribe it at all if you:

Furthermore the prescriber may only prescribe this medicine with special care or may not prescribe it at all for someone under 18 years of age.

As part of the process of assessing suitability to take this medicine a prescriber may also arrange tests:

  • to check that this medicine is not having any undesired effects

Over time it is possible that Cymbalta can become unsuitable for some people, or they may become unsuitable for it. If at any time it appears that Cymbalta has become unsuitable, it is important that the prescriber is contacted immediately.

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Side-effects

A medicine is only made available to the public if the clinical trials have shown that the benefits of taking the medicine outweigh the risks.

Once a medicine has been licensed, information on the medicine's effects, both intended and unintended, is continuously recorded and updated.

Some side-effects may be serious while others may only be a mild inconvenience.

Everyone's reaction to a medicine is different. It is difficult to predict which side-effects you will have from taking a particular medicine, or whether you will have any side-effects at all. The important thing is to tell your prescriber or pharmacist if you are having problems with your medicine.

Very common: More than 1 in 10 people who take Cymbalta:

  • dry mouth
  • feeling dizzy
  • headaches
  • nausea - seek immediate medical advice if you develop nausea
  • sleepiness

Common: More than 1 in 100 people who take Cymbalta:

Uncommon: More than 1 in 1000 people who take Cymbalta:

  • a drop in blood pressure on standing or sitting up
  • abnormal gait
  • abnormal laboratory test results
  • abnormal muscle movements or problems controlling muscle movement
  • abnormal thoughts or feelings
  • apathy
  • belching
  • blood sugar control changes in diabetics
  • chest pain
  • chills
  • cold sweats
  • coldness of the extremities
  • concentration problems
  • dermatitis
  • ear pain
  • easy bruising of the skin
  • ejaculation problems
  • enlargement of the pupil
  • eye or eyesight problems
  • fainting or brief loss of consciousness
  • faster heart rate
  • feeling hot or cold
  • feeling nervous
  • feeling restless and inability to sit still
  • feelings of disorientation
  • gastritis
  • gastroenteritis
  • gastrointestinal bleeding
  • general feeling of being unwell
  • heart problems
  • increased blood sugar levels
  • laryngitis
  • liver problems
  • menstrual problems
  • muscle twitching
  • night sweats
  • nose bleed
  • passing much more urine than usual
  • photosensitivity skin reaction
  • restless legs syndrome
  • sexual dysfunction
  • sleeping problems
  • swallowing difficulties
  • taste changes
  • teeth grinding
  • testicular pain
  • thirst
  • thoughts of committing suicide or suicide attempts - seek immediate medical advice if you have thoughts of self-harm, committing suicide or if you are feeling distressed
  • throat tightness
  • urinary hesitation
  • urinary problems
  • urinary retention
  • urinating more often at night
  • urticaria
  • vaginal bleeding
  • vertigo
  • weight gain

Rare: More than 1 in 10,000 people who take Cymbalta:

The frequency of these side-effects is unknown:

  • coma
  • withdrawal symptoms can occur when this medicine is stopped abruptly. These may include: dizziness; nausea; vomiting; headache; irritability; diarrhoea; excessive sweating; vertigo; tremor; feeling anxious or agitated; tiredness; muscle pain or tenderness; sensory problems such as paraesthesiae or electric shock-like sensations particularly in the head; sleeping problems such as difficulty sleeping, sleepiness or strange dreams

If you feel unwell or if you have concerns about a side-effect, you will need to seek advice. If you feel very ill, get medical help straight away. Contact your prescriber, pharmacist, nurse or call 111.

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Taking other medicines

If you are taking more than one medicine they may interact with each other. At times your prescriber may decide to use medicines that interact, in other cases this may not be appropriate.

The decision to use medicines that interact depends on your specific circumstances. Your prescriber may decide to use medicines that interact, if it is believed that the benefits of taking the medicines together outweigh the risks. In such cases, it may be necessary to alter your dose or monitor you more closely.

Tell your prescriber the names of all the medicines that you are taking so that they can consider all possible interactions. This includes all the medicines which have been prescribed by your GP, hospital doctor, dentist, nurse, health visitor, midwife or pharmacist. You must also tell your prescriber about medicines which you have bought over the counter without prescriptions.

The following medicines may interact with Cymbalta:

The following types of medicine may interact with Cymbalta:

Some recreational drugs are also known to interact with Cymbalta. Make sure that you tell your prescriber if you plan to use or have recently used:

  • tobacco

If you are taking Cymbalta and any of the medicines, types of medicines or recreational drugs shown above, make sure your prescriber knows about it.

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Complementary preparations and vitamins

Medicines can interact with complementary preparations and vitamins.

Make sure you tell your prescriber the names of all the complementary preparations and vitamins that you are taking or are planning to take.

Your prescriber can then decide whether it is appropriate for you to take combinations that are known to interact.

In the case of Cymbalta:

If you have been prescribed Cymbalta you should only take something on the above list on the specific advice of your prescriber or pharmacist.

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Driving and operating machinery

When taking any medicine you should be aware that it might interfere with your ability to drive or operate machinery safely.

In the case of Cymbalta:

  • this medicine could affect your ability to drive or operate machinery

Like all medicines Cymbalta can cause side effects. You should see how this medicine affects you and then judge if you are safe to drive or operate machinery. If you are in any doubt, talk to your prescriber.

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Diet

Medicines can interact with certain foods. In some cases, this may be harmful and your prescriber may advise you to avoid certain foods.

In the case of Cymbalta:

  • there are no specific foods that you must exclude from your diet when taking Cymbalta
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Alcohol

Alcohol can interact with certain medicines.

In the case of Cymbalta:

You should seek advice from your prescriber as to whether you may drink alcohol while taking this medicine.

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Family planning and pregnancy

Most medicines, in some way, can affect the development of a baby in the womb. The effect on the baby differs between medicines and also depends on the stage of pregnancy that you have reached when you take the medicine.

In the case of Cymbalta:

  • you should only take this medicine during pregnancy if your doctor thinks that you need it
  • if you become pregnant, or think you have become pregnant while taking Cymbalta, you must contact your prescriber

You need to discuss your specific circumstances with your doctor to weigh up the overall risks and benefits of taking this medicine. You and your doctor can make a decision about whether you are going to take this medicine during pregnancy.

If the decision is that you should not have Cymbalta, then you should discuss whether there is an alternative medicine that you could take during pregnancy.

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Breast-feeding

Certain medicines can pass into breast milk and may reach your baby through breast-feeding.

In the case of Cymbalta:

  • breast-feeding is not recommended while taking this medicine

Before you have your baby you should discuss breast-feeding with your doctor or midwife. They will help you decide what is best for you and your baby based on the benefits and risks associated with this medicine. If you wish to breast-feed you should discuss with your prescriber whether there are any other medicines you could take which would also allow you to breast-feed. You should not stop this medicine without taking advice from your doctor.

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Ingredients of your medicine

Medicines contain active ingredients. They may also contain other, additional ingredients that help ensure the stability, safety and effectiveness of the medicine. They are also added to improve the medicine's taste and appearance and to make it easier to take. Some may be used to prolong the life of the medicine.

You should check that you are able to take the ingredients in your medicine, especially if you have any allergies.

Cymbalta contains:

  • edible green ink

    • black iron oxide - synthetic (E172)
    • propylene glycol
    • shellac
    • yellow iron oxide - synthetic (E172)
  • hypromellose
  • hypromellose acetate succinate
  • indigo carmine (E132)
  • sodium lauryl sulphate
  • sucrose
  • sugar spheres
  • talc
  • titanium dioxide (E171)
  • triethyl citrate

If you are not able to take any of the ingredients in your medicine, talk to your prescriber or pharmacist to see if they can suggest an alternative medicine. If you have reacted badly to Cymbalta before, do not take Cymbalta. Talk to your prescriber, pharmacist or nurse as soon as possible.

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Cymbalta, Version 17, last updated 20 Nov 2013