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River Professional Group - Your Neighborhood Drugstore Online

Frequently Asked Questions

Do you carry the antidepressant SSNRI Cymbalta (duloxetine)?

Short Answer


Long Answer

Duloxetine (dul OX eh teen) hydrochloride (HCl) has been used in various countries to treat:

  • major depressive disorder (MDD),
  • generalized anxiety disorder (GAD),
  • stress urinary incontinence (SUI),
  • fibromyalgia (FM),
  • as well as pain caused by nerve damage in people with diabetes (diabetic neuropathy).

It is undergoing testing with people who suffer from Chronic Fatigue Syndrome (CFS).

It belongs to a class of antidepressants called "Selective Serotonin and Norepinephrine Reuptake Inhibitors" (SSNRIs).

It is marketed under trade names like Symbal, Yentreve, Ariclaim, Xeristar and Cymbalta (sim-BAWL'-tuh). It was approved by the U.S. FDA in 2004 for MDD and GAD (but not SUI) and Health Canada approved it in 2007 for depression.

Additional Information


Duloxetine is a drug which primarily targets major depressive disorder (MDD), generalized anxiety disorder (GAD), pain related to diabetic peripheral neuropathy and in some countries stress urinary incontinence (SUI). It is manufactured and marketed by Eli Lilly and Company. Duloxetine has not yet been FDA approved for stress urinary incontinence or for fibromyalgia.

webmd.com/drugs /drug-91491-Cymbalta+Oral.aspx? drugid=91491&drugname=Cymbalta+Oral

To reduce your risk of side effects, your doctor may start you at a low dose and gradually increase your dose. Follow your doctor's instructions carefully. Do not take more or less medication or take it more frequently than prescribed. Your condition will not improve any faster, and your risk of side effects will increase. Use this medication regularly in order to get the most benefit from it. To help you remember, use it at the same time(s) each day.


Why patients take duloxetine, how long current patients have been taking duloxetine, why patients stopped taking duloxetine, how long patients took duloxetine before stopping.

pdrhealth.com/drugs /rx/rx-mono.aspx? contentFileName=Cym1693.html& contentName=Cymbalta&contentId=154

Side effects may include: Appetite changes, constipation, diarrhea, dizziness, dry mouth, fatigue, headache, insomnia, nausea, sexual difficulties, sleepiness, sweating, tremor, urinary difficulties, vomiting, weakness.

mentalhealth.about.com /od/psychopharmacology/a/cymbalta1.htm

In August of 2004 the U.S. Food and Drug Administration (FDA) approved Cymbalta (duloxetine HCl), judging it a safe and effective treatment for major depressive disorder. Cymbalta was later approved to treat the pain of diabetic peripheral neuropathy, making it one of the more versatile antidepressants on the market.


Take Cymbalta at about the same time each day. Swallow the capsule whole; do not chew it or break it open. Cymbalta may be taken with or without food. It may take several weeks before the drug begins to work. Continue taking Cymbalta even if you begin to feel better. Do not stop taking Cymbalta without your doctor's approval. Abruptly stopping treatment may cause severe side effects.


The antidepressant Cymbalta (duloxetine HCl; pronounced sim-BAWL'-tuh), a dual-reuptake inhibitor of serotonin and norepinephrine, 60 mg once or twice daily, significantly reduced pain in more than half of women treated for fibromyalgia, with and without major depression, according to 12-week data presented this week at the annual meeting of the American College of Rheumatology.

These data are being presented one month after another study, in which Cymbalta also significantly reduced pain in women with fibromyalgia versus placebo, was published in Arthritis and Rheumatism.

aids.about.com /od/generalinformation/a/cymbalta1.htm

To understand how Cymbalta works, you must first understand the physiology or cause of depression. There are two naturally occurring chemicals in the brain that are responsible for mood and mood stability. Under normal circumstances, these two chemicals, serotonin and norepinephrine, are in a specific balance. However, these chemicals can become out of balance, causing changes in mood, specifically depression. Cymbalta works by re-establishing the balance of these two chemicals, and in turn relieving the symptoms of depression.


Apart from MAO inhibitors, there are a large variety of drugs that you may or may not be able to mix with Cymbalta medication. These drugs may include:

  • A quinolone antibiotic such as trovafloxacin (Trovan), ciprofloxacin (Cipro), ofloxacin (Floxin) etc.
  • A tricyclic antidepressant such as amitriptyline (Elavil), imipramine (Tofranil), doxepin (Sinequan), nortriptyline (Pamelor) etc.
  • An antiarrhythmic such as flecainide (Tambocor) or propafenone (Rythmol) etc.
  • A phenothiazine such as chlorpromazine (Thorazine), fluphenazine (Prolixin), mesoridazine (Serentil), perphenazine (Trilafon), prochlorperazine (Compazine) etc.
  • A selective serotonin reuptake inhibitor (SSRI) such as fluoxetine (Prozac, Sarafem), paroxetine (Paxil, Pexeva), fluvoxamine (Luvox) etc.
  • Venlafaxine which is most commonly known as Effexor.

Duloxetine should not be used in combination with a monoamine oxidase inhibitor (MAOI) - phenelzine (Nardil), tranylcypromine (Parnate), isocarboxazid (Marplan), selegiline (Eldepryl) - or within at least 14 days of discontinuing the MAOI. At least 5 days should be allowed after stopping duloxetine before starting an MAOI. Combinations of SSRIs and MAOIs have led to serious, sometimes fatal, reactions including very high body temperature, rigidity, rapid fluctuations of heart rate and blood pressure, extreme agitation progressing to delirium and coma.

The use of duloxetine with other medicines that can increase the amount of serotonin the body may result in "serotonin syndrome." Serotonin syndrome symptoms may include agitation, hallucinations, coma, increased heart rate, changes in blood pressure, high body temperature, incoordination, nausea, vomiting, and diarrhea. Such medicines include MAOIs, the triptan class of anti-migraine medicines [e.g. sumatriptan (Imitrex)], as well as clomipramine (Anafranil), trazodone (Desyrel), tricyclic antidepressants such as amitriptyline (Elavil).