Duloxetine is also used to treat fibromyalgia (muscle pain and stiffness) and chronic (long-lasting) pain that is related to muscles and bones. Duloxetine belongs to a group of medicines known as selective serotonin and norepinephrine reuptake inhibitors (SSNRIs). These medicines are thought to work by increasing the activity of chemicals called serotonin and norepinephrine in the brain. This medicine is available only with your doctor's prescription. Do not take two doses of CYMBALTA at the same time. Do not open the capsule and sprinkle its contents on food or mix with liquids. If it is almost time for the next dose, skip the missed dose and take the next dose at the regular time. If a dose of CYMBALTA is missed, take the missed dose as soon as it is remembered. Administer CYMBALTA at a total dose of 40 mg/day (given as 20 mg twice daily) to 60 mg/day (given either once daily or as 30 mg twice daily). For some patients, it may be desirable to start at 30 mg once daily for 1 week, to allow patients to adjust to the medication before increasing to 60 mg once daily. While a 120 mg/day dose was shown to be effective, there is no evidence that doses greater than 60 mg/day confer any additional benefits. The safety of doses above 120 mg/day has not been adequately evaluated. Where to buy authentic cytotec Renovated radios Cymbalta Dosage. Typical Dose of Cymbalta. heat in the form of a warm washcloth applied to the bruise for 10 minutes or so 2 or 3 times a day may increase blood flow to the bruised area. For oral dosage form delayed-release capsules For treatment of anxiety Adults—At first, 60 milligrams mg once a day. Some patients may start at 30 mg once a day for 1 week before increasing the dose to 60 mg once a day. Your doctor may increase your dose as needed. However, the dose is usually not more than 120 mg per day. Determination of duloxetine hydrochloride in pharmaceutical dosage forms. The method is also applicable for analysis of related substances and for study of in. 40-60 mg/day PO initially (in single daily dose or divided q12hr for 1 week if patient needs to adjust to therapy) Titrate dose in increments of 30 mg/day over 1 week as tolerated Target dosage: 60 mg/day PO (in single daily dose or divided q12hr); not to exceed 120 mg/day (safety of dosages Treatment of chronic musculoskeletal pain, including discomfort from osteoarthritis and chronic lower back pain 30 mg/day PO initially for 1 week to allow for therapy adjustment Target dosage: 60 mg/day PO; not to exceed 60 mg/day Dosages ≥60 mg/day have not been shown to offer additional benefits Major depressive disorder and generalized anxiety disorder: Acute episodes often necessitate several months of sustained therapy Diabetic peripheral neuropathic pain: Efficacy for 12 weeks has not been studied; if diabetes is complicated by renal disease, consider lower starting dosage with gradual increase to effective dosage Fibromyalgia: Efficacy for ≥12 weeks has not been studied; continue treatment on basis of individual patient response Chronic musculoskeletal pain: Efficacy for ≥13 weeks has not been studied Uncontrolled narrow-angle glaucoma: Use not recommended due to increased risk of mydriasis Constipation (10%) Dizziness (10%) Insomnia (10%) Diarrhea (9-10%) Anorexia (8%) Decreased appetite (7-8%) Abdominal pain (6%) Hyperhidrosis (6%) Increased sweating (6%) Agitation (5%) Nasopharyngitis (5%) Vomiting (3-5%) Male sexual dysfunction (2-5%) Abdominal pain (4%) Decreased libido (4%) Musculoskeletal pain (4%) Upper respiratory tract infection (URTI) (4%) Abnormal orgasm (3%) Agitation (3%) Anxiety (3%) Blurred vision (3%) Cough (3%) Influenza (3%) Muscle spasms (3%) Tremor (3%) Abnormal dreams (2%) Dyspepsia (2%) Hot flushes (2%) Nausea (2%) Oropharyngeal pain (2%) Palpitations (2%) Paresthesia (2%) Weight loss (2%) Yawning (2%) Dysuria ( General: Anaphylactic reaction, angioneurotic edema, hypersensitivity Cardiovascular: Hypertensive crisis, supraventricular arrhythmia, myocardial infarction, tachycardia, Takotsubo cardiomyopathy Endocrine: Galactorrhea, gynecologic bleeding, hyperglycemia, hyperprolactinemia Neurologic: Restless legs syndrome, seizures upon treatment discontinuance, extrapyramidal disorders Ophthalmic: Glaucoma Otic: Tinnitus (upon treatment discontinuance) Psychiatric: Aggression and anger (particularly early in treatment or after treatment discontinuance), hallucinations Musculoskeletal: Trismus, muscle spasm Skin: Serious skin reactions (eg, erythema multiforme and Stevens-Johnson syndrome) necessitating drug discontinuance or hospitalization, urticaria, rash Gastrointestinal: Colitis (microscopic or unspecified),cutaneous vasculitis (sometimes associated with systemic involvement), acute pancreatitis Antidepressants increased the risk of suicidal thoughts and behavior in children, adolescents, and young adults in short-term studies These studies did not show an increase in the risk of suicidal thoughts and behavior with antidepressant use in patients 24 yr There was a reduction in risk with antidepressant use in patients ≥65 yr In patients of all ages who are started on antidepressant therapy, monitor closely for worsening, and for emergence of suicidal thoughts and behaviors Advise families and caregivers of the need for close observation and communication with the prescriber CYP1A2 inhibitors or thioridazine should not be coadministered Use caution in severe renal impairment, ESRD Heavy alcohol use Suicidality; monitor for clinical worsening and suicide risk, especially in children, adolescents and young adults (18-24 years) during early phases of treatment and alterations in dosage Serotonin syndrome or neuroleptic malignant syndrome-like reactions may occur; discontinue and initiate supportive therapy; closely monitor patients concomitantly receiving triptans, antipsychotics and serotonin precursors Neonates exposed to serotonin-noreponephrine reuptake inhibitors (SNRIs) or selective serotonin reuptake inhibitors (SSRIs) late in 3rd trimester of pregnancy have developed complications necessitating prolonged hospitalization, respiratory support, and tube feeding Screen patients for bipolar disorder; risk of mixed/manic episodes is increased in patients treated with antidepressants May cause activation of mania or hypomania Increased risk of hepatotoxicity, sometimes fatal; monitor for abdominal pain, hepatomegaly, elevations in hepatic transaminases exceeding 20 times upper limit of normal; jaundice; cholestatic jaundice with minimal elevations of hepatic transaminases have also been reported; use not recommended in patients with substantial alcohol use or chronic liver disease SSRIs and SNRIs may impair platelet aggregation and increase the risk of bleeding events, ranging from ecchymoses, hematomas, epistaxis, petechiae, and GI hemorrhage to life-threatening hemorrhage; concomitant use of aspirin, NSAIDs, warfarin, other anticoagulants, or other drugs known to affect platelet function may add to this risk Severe skin reactions (eg, erythema multiforme and Stevens-Johnson syndrome); discontinue at first appearance of blisters, peeling rash, mucosal erosions, or any other sign of hypersensitivity if no other etiology can be identified Orthostatic hypotension and syncope, especially during week 1 of therapy; monitor patients taking drugs that increase risk of orthostatic hypotension; consider dose reduction or discontinue therapy in patients who experience symptomatic orthostatic hypotension, falls and/or syncope Hyponatremia due to syndrome of inappropriate antidiuretic hormone (SIADH); cases of serum sodium Exact mechanism of action unknown; inhibits reuptake of serotonin and norepinephrine; weakly inhibits reuptake of dopamine; has no MAOI activity; has no significant activity for histaminergic H1 receptor or alpha2-adrenergic receptor The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information. In some cases, they may not be available in all strengths or forms as the brand-name drug. Duloxetine oral capsule is available as the brand-name drugs Cymbalta and Irenka. Generic drugs usually cost less than the brand-name version. Duloxetine oral capsule is used to treat: Duloxetine belongs to a class of drugs called serotonin-norepinephrine reuptake inhibitors (SNRIs). It works by balancing chemicals in your brain that cause depression and anxiety. By balancing these chemicals, this drug also helps inhibit pain signals from your nerves to your brain. Duloxetine oral capsule can cause sleepiness or may affect your ability to make decisions, think clearly, or react quickly. You shouldn’t drive, use heavy machinery, or do other dangerous activities until you know how it affects you. In adults, the more common side effects of duloxetine can include: Call your doctor right away if you have serious side effects. Duloxetine dosage forms Cymbalta Adult Dosing - Epocrates Online, Duloxetine Oral Route Proper Use - Mayo Clinic Where to buy viagra online yahoo answersCialis best priceBuy viagra americaMen's health where to buy viagra Cymbalta Dosage. Generic name Duloxetine hydrochloride 20mg. Dosage form capsule, delayed release. Medically reviewed on December 19, 2017. Cymbalta Dosage Guide -. Analysis of Duloxetine Hydrochloride and Its Related Compounds in.. Spectrofluorimetric Method for Determination of Duloxetine.. Cymbalta® Product Shelf Life. 24 months Storage Requirements. Dosage Form. Capsule. NDC# 43547-381-11. Strength. 60 mg. Size. 1000 Count. Reference Listed. Medscape - Generalized anxiety disorder, major depressive disorder, fibromyalgia-specific dosing for Cymbalta duloxetine, frequency-based adverse effects, comprehensive interactions, contraindications, pregnancy & lactation schedules, and cost information. Duloxetine Dosage forms and strength Duloxetine is generally preferred in oral route of administration i.e. Mouth. So it available in capsule or tablet forms for better action.