Duloxetine

generic for Cymbalta

Duloxetine Side Effects

See also Warning section.

Nausea, dry mouth, constipation, loss of appetite, tiredness, drowsiness, or increased sweating may occur. If any of these effects persist or worsen, tell your doctor promptly.

Dizziness or lightheadedness may occur, especially when you first start or increase your dose of this drug. To reduce the risk of dizziness, lightheadedness, or falling, get up slowly when rising from a sitting or lying position.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

This medication may raise your blood pressure. Check your blood pressure regularly and tell your doctor if the results are high.

Tell your doctor right away if any of these serious side effects occur: confusion, easy bruising/bleeding, decreased interest in sex, changes in sexual ability, muscle cramps/weakness, shaking (tremor), difficulty urinating, signs of liver problems (such as stomach/abdominal pain, persistent nausea, vomiting, yellowing eyes/skin, dark urine).

Get medical help right away if you have any very serious side effects, including: black/bloody stools, vomit that looks like coffee grounds, seizure, eye pain/swelling/redness, widened pupils, vision changes (such as seeing rainbows around lights at night, blurred vision).

This medication may increase serotonin and rarely cause a very serious condition called serotonin syndrome/toxicity. The risk increases if you are also taking other drugs that increase serotonin, so tell your doctor or pharmacist of all the drugs you take (see Drug Interactions section). Get medical help right away if you develop some of the following symptoms: fast heartbeat, hallucinations, loss of coordination, severe dizziness, severe nausea/vomiting/diarrhea, twitching muscles, unexplained fever, unusual agitation/restlessness.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing, skin blisters, mouth sores.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US -

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
  • hypothyroidism
  • hyperprolactinemia
  • SIADH syndrome
  • hypercholesterolemia
  • hyponatremia
  • increased risk of bleeding
  • acute confusion
  • manic disorder
  • hypomania
  • mood changes
  • suicidal
  • suicidal ideation
  • libido changes
  • disorder of ejaculation
  • bruxism
  • agitation
  • aggressive behavior
  • myoclonus
  • extrapyramidal disease
  • serotonin syndrome
  • blurred vision
  • dry eye
  • mydriasis
  • tinnitus
  • earache
  • hypertension
  • hypertensive crisis
  • acute myocardial infarction
  • supraventricular tachycardia
  • cutaneous vasculitis
  • orthostatic hypotension
  • hemorrhage
  • ecchymosis
  • sore throat
  • throat constriction
  • xerostomia
  • stomatitis
  • gastric ulcer
  • gastritis
  • dyspepsia
  • colitis
  • constipation
  • hepatocellular damage
  • hepatic failure
  • hepatitis
  • obstructive hyperbilirubinemia
  • acute pancreatitis
  • gastrointestinal hemorrhage
  • erectile dysfunction
  • galactorrhea not associated with childbirth
  • abnormal vaginal bleeding
  • skin photosensitivity
  • contact dermatitis
  • erythema multiforme
  • Stevens-Johnson syndrome
  • erythema
  • pruritus of skin
  • urticaria
  • muscle spasm
  • drowsy
  • hallucinations
  • syncope
  • seizure disorder
  • vertigo
  • dizziness
  • sleep disorder
  • insomnia
  • fatigue
  • hyperhidrosis
  • chills
  • tremor
  • trismus
  • muscle fasciculation
  • akathisia
  • dysgeusia
  • gait abnormality
  • dyskinesia
  • hypesthesia
  • skin rash
  • hyperbilirubinemia
  • flushing
  • anorexia
  • weight gain
  • weight loss
  • polydipsia
  • headache disorder
  • dysarthria
  • epistaxis
  • halitosis
  • palpitations
  • yawning
  • cough
  • nausea
  • flatulence
  • eructation
  • diarrhea
  • dysuria
  • urinary retention
  • polyuria
  • nocturia

Drug Interactions

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

Some products that may interact with this drug include: other drugs that can cause bleeding/bruising (including antiplatelet drugs such as clopidogrel, NSAIDs such as ibuprofen, "blood thinners" such as warfarin).

Other medications can affect the removal of duloxetine from your body, which may affect how duloxetine works. Examples include cimetidine, certain quinolone antibiotics (such as ciprofloxacin, enoxacin), among others.

This medication can slow down the removal of other medications from your body, which may affect how they work. Examples of affected drugs include antiarrhythmic drugs (such as propafenone, flecainide, quinidine), antipsychotics (such as thioridazine), tricyclic antidepressants (such as desipramine, imipramine), among others.

Taking MAO inhibitors with this medication may cause a serious (possibly fatal) drug interaction. Avoid taking MAO inhibitors (isocarboxazid, linezolid, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, safinamide, selegiline, tranylcypromine) during treatment with this medication. Most MAO inhibitors should also not be taken for two weeks before and at least 5 days after treatment with this medication. Ask your doctor when to start or stop taking this medication.

The risk of serotonin syndrome/toxicity increases if you are also taking other drugs that increase serotonin. Examples include street drugs such as MDMA/"ecstasy," St. John's wort, certain antidepressants (including SSRIs such as fluoxetine/paroxetine, other SNRIs such as desvenlafaxine/venlafaxine), tryptophan, among others. The risk of serotonin syndrome/toxicity may be more likely when you start or increase the dose of these drugs.

Tell your doctor or pharmacist if you are taking other products that cause drowsiness including alcohol, marijuana (cannabis), antihistamines (such as cetirizine, diphenhydramine), drugs for sleep or anxiety (such as alprazolam, diazepam, zolpidem), muscle relaxants, and opioid pain relievers (such as codeine). Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely.

Aspirin can increase the risk of bleeding when used with this medication. However, if your doctor has directed you to take low-dose aspirin for heart attack or stroke prevention (usually at dosages of 81-325 milligrams a day), you should continue taking it unless your doctor instructs you otherwise.