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-   -   What can I take with Cymbalta? (https://www.neurotalk.org/peripheral-neuropathy/150707-cymbalta.html)

mrsD 05-26-2011 03:29 AM

Here is a drug checker to use:

http://www.drugs.com/drug_interactions.html

Cymbalta is the only antidepressant with potential to damage the liver. It has a warning in this regard.
Quote:

There have been reports of hepatic failure, sometimes fatal, in patients treated with Cymbalta (duloxetine hcl) . These cases have presented as hepatitis with abdominal pain, hepatomegaly, and elevation of transaminase levels to more than twenty times the upper limit of normal with or without jaundice, reflecting a mixed or hepatocellular pattern of liver injury. Cymbalta (duloxetine hcl) should be discontinued in patients who develop jaundice or other evidence of clinically significant liver dysfunction and should not be resumed unless another cause can be established.

Cases of cholestatic jaundice with minimal elevation of transaminase levels have also been reported. Other postmarketing reports indicate that elevated transaminases, bilirubin, and alkaline phosphatase have occurred in patients with chronic liver disease or cirrhosis.
http://www.rxlist.com/cymbalta-drug.htm

Keep this in mind if you use combination drug therapies. They may be additive to the liver. This especially pertains to Tylenol.

nsw43 05-27-2011 08:53 PM

Quote:

Originally Posted by malawigirl08 (Post 773721)
I was prescribed Cymbalta last week at my neuro visit but didn't take it until today as I had my lignacaine infusion so didn't want a false benefit.
I was in so much pain in the past few days(due to overdoing it and the weather) that I took a Cymbalta this morning and went to work, the feeling I had was horrendous- I couldn't keep up with conversations and kept zoning out, I was also very sleepy, is this normal?

What dosage did you take? They typically prescribe 60 mg for neuropathic pain but I started at a much lower dose and even had problems with that, so I can only imagine what 60 mg would be like as an initial dose.

If you want to keep trying it, back off the dosage and see how it affects you. I have found it does block the pain very well, though I understand different people have different reactions.

nsw43 05-27-2011 08:58 PM

Quote:

Originally Posted by mrsD (Post 772962)
I would be concerned about taking Elavil and Cymbalta together.

This could lead to serotonin syndrome.

You could discuss tapering off the Cymbalta... this drug is toxic to the liver in some people, and if it is not doing anything positive for you anymore, you need to consider dumping it.

Some patients have a difficult time tapering off Cymbalta, so be prepared for that.

When I was on a lower dose of Cymbalta my doctor at the time prescribed Elavil 10 mg at night because I was having a very difficult time sleeping. My current doctor doesn't want me to mix Cymbalta and Elavil for the very reason you give - risk of serotonin syndrome.

I do get a benefit from Cymbalta; it's just not as great as it used to be, and I imagine its painkilling properties will continue to fade. It has been enormously helpful as an antidepressant and antianxiety medication, and those effects seem to be holding.

daniella 05-28-2011 03:19 AM

Sometimes for me I am not sure if it is the med having less of a positive impact or it is just the time is worse pain wise. I go through periods where I have flares that are worse then others and it is not from anything I did. Well I don't think anyway. I think it is great you feel a positive mental impact though. Really when I was feeling better mentally it was helping me cope with my pain and health problems better.
I just read back and you stated you are sensitive to the other meds like neurontin. Like I said when I first got dx I started this med and had a really hard time. Then about 2 years later I tried it again but very small dose and increased very slow. With each increase I felt very bad but it did lessen as time passed and then felt ok. I know some side effects are too bad to stick with the med but some do pass.

malawigirl08 05-28-2011 06:06 AM

Quote:

Originally Posted by nsw43 (Post 774274)
What dosage did you take? They typically prescribe 60 mg for neuropathic pain but I started at a much lower dose and even had problems with that, so I can only imagine what 60 mg would be like as an initial dose.

If you want to keep trying it, back off the dosage and see how it affects you. I have found it does block the pain very well, though I understand different people have different reactions.

The dose was 30mg, I felt awful for two days and haven't taken it since, the pain did subside that night but I can't risk feeling that way again.
I may go back to my GP and ask if he can start me at 10mgs( if that is possible ).
I am also taking imipramine and wondered if two antidepressants is too much although the neuro said to take both.
Are you able to function normally taking Cymbalta, my worry is that I become so doped up that I can't perform my job or my family duties properly- this happened with my dad( he existed going from bed to sofa and became a social recluse, no life for anyone and he was still in pain:( )

nsw43 05-28-2011 08:17 PM

Quote:

Originally Posted by malawigirl08 (Post 774342)
The dose was 30mg, I felt awful for two days and haven't taken it since, the pain did subside that night but I can't risk feeling that way again.
I may go back to my GP and ask if he can start me at 10mgs( if that is possible ).
I am also taking imipramine and wondered if two antidepressants is too much although the neuro said to take both.
Are you able to function normally taking Cymbalta, my worry is that I become so doped up that I can't perform my job or my family duties properly- this happened with my dad( he existed going from bed to sofa and became a social recluse, no life for anyone and he was still in pain:( )

Cymbalta comes in a 20mg dose so you might ask for that. I'm not recommending the following for anyone, but I'll just tell you what I did: The medication comes in the form of little pellets inside a capsule. In order to titrate up from a small dose, I opened a 30mg capsule and divided the pellets to get 15 mg. I incrementally increased the dose over the ensuing two years using this technique, which I KNOW isn't kosher but I had to do it or else wouldn't have been able to tolerate the side effects.

Because of this slow and incremental increase in dosage, I've been able to function pretty well. There were times when I was a little dopey, but fortunately/unfortunately my body adjusted so I could perform fairly normally. I'm lucky to be retired so my life isn't rigorous, though I do consulting work (writing) that requires some mental agility.

The Cymbalta has helped me to deal with the ridiculous pain and progressive nature of the disease, so I prize it. Before I took it, I was suicidal, and I don't want to go that way again.

daniella 05-29-2011 06:14 AM

Mala for about 2 weeks when I started Cymbalta I lived in the bathroom I thought I would throw up I was so nauseous. I started on 30 then increased. Anyhow my pain doctor was like you may even throw up but try to stick with it and it should pass. It did for me but did I feel bad at the start. Some side effects are too bad to stick with and everyone is different but just thought I would share. I would call your doctor to get his thoughts.

malawigirl08 05-29-2011 02:40 PM

Quote:

Originally Posted by daniella (Post 774597)
Mala for about 2 weeks when I started Cymbalta I lived in the bathroom I thought I would throw up I was so nauseous. I started on 30 then increased. Anyhow my pain doctor was like you may even throw up but try to stick with it and it should pass. It did for me but did I feel bad at the start. Some side effects are too bad to stick with and everyone is different but just thought I would share. I would call your doctor to get his thoughts.

My neurologist told me to take it in the morning, do you think it would help to take it at night and the most severe effects would then be during the night and I should be ok the next day:) I think I will call my doc after the holiday weekend and lower the 30 mg dose .

daniella 05-29-2011 08:00 PM

I was told when I started it to take it at dinner so the side effects were not as bad. I woiuld ask your doctor cause that could help.

nsw43 05-31-2011 04:08 PM

Quote:

Originally Posted by daniella (Post 774785)
I was told when I started it to take it at dinner so the side effects were not as bad. I woiuld ask your doctor cause that could help.

Taking Cymbalta with food reduces its effect by 30% to 50% so it really should be taken on an empty stomach.

If you take it at night before bed, you can sleep through a lot of the bad side effects. I had pretty bad nausea for the first few weeks and took Zofran (an effective but hideously expensive anti-nausea medication) for that.


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