generic cymbalta capsules for treatment of major depressive disorder

Generic Cymbalta Capsules

© The Swiss Pharmacy, Geneva Switzerland

Generic Cymbalta Capsules are used to treat Major Depressive Disorder (MDD), Generalized Anxiety Disorder (GAD), Diabetic Peripheral Neuropathic Pain (DPNP), Fibromyalgia (FM) and Chronic Musculoskeletal Pain.It is available as Dulot capsules, Duzela capsules and Duvanta tablets.



The active pharmaceutical ingredient contained in Generic Cymbalta Capsules is Duloxetine Hydrochloride. Each capsule of Generic Cymbalta contains enteric-coated pellets of 22.4, 33.7, or 67.3 mg of Duloxetine Hydrochloride which is equivalent to 20, 30, or 60 mg of duloxetine, respectively.

Active Ingredient



Dulot Capsules and Duvanta Tablets



Chemical Structure



Generic Cymbalta should taken once daily with or without food. Generic Cymbalta capsules should be swallowed whole and should not be chewed or crushed. The recommended dosage of Generic Cymbalta for some of the indications is given below:Major Depressive Disorder (MDD): Starting Dose: 40mg/day to 60mg/day Target Dose Acute Treatment: 40 mg/day (20 mg twice daily) to 60 mg/day (once daily or as 30 mg twice daily);Target Dose Maintenance Treatment: 60 mg/day

Recommended Dosage



Generalized Anxiety Disorder (GAD):Starting Dose: 60mg/day Target Dose: 60 mg/day (once daily) Diabetic Peripheral Neuropathic Pain (DPNP):Starting Dose: 60mg/day Target Dose: 60 mg/day (once daily) Fibromyalgia (FM): Starting Dose: 30mg/day Target Dose: 60 mg/day (once daily) Chronic Musculoskeletal Pain:Starting Dose: 30mg/day Target Dose: 60 mg/day (once daily)

Recommended Dosage



ContraindicationsGeneric Cymbalta Capsules are contraindicated in patients with the following conditions:

➔Hypersensitivity to Duloxetine Hydrochloride, or any inactive component of this medication.➔Serotonin Syndrome and MAOIs: Do not use Monoamine Oxidase Inhibitors (MAOIs) intended to treat psychiatric disorders with generic Cymbalta or within 5 days of stopping treatment with generic Cymbalta. Do not use generic Cymbalta within 14 days of stopping an MAOI intended to treat psychiatric disorders.

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Contraindications➔Do not start generic Cymbalta in a patient who is being treated with linezolid or intravenous methylene blue.



Side Effects of Duloxetine Capsules

The most common side effects of Generic Cymbalta (Duloxetine Capsules) with an incidence rate of 5% or more and at least twice the incidence of placebo patients are nausea, dry mouth, somnolence, fatigue, constipation, decreased appetite, and hyperhidrosis.



Warnings And Precautions➔Hepatotoxicity: Hepatic failure, sometimes fatal, has been reported in patients treated with Duloxetine tablets (Generic Cymbalta).➔Discontinue Generic Cymbalta in patients who develop jaundice or other evidence of clinically significant liver dysfunction and should not be restarted unless another cause can be established.➔Generic Cymbalta should not be administered to patients with substantial alcohol use or evidence of chronic liver disease.➔Orthostatic Hypotension, Falls and Syncope: Cases have been reported with Duloxetine therapy.



Warnings And Precautions➔Serotonin Syndrome: Serotonin syndrome has been reported with SSRIs and SNRIs, including with Generic Cymbalta, both when taken alone, but particularly when administered along with other serotonergic agents. In case such symptoms occur, Duloxetine tablets should be stopped and supportive treatment initiated. If simultaneous use of Generic Cymbalta with other serotonergic medications is clinically required, patients should be made aware of a potential increased risk for serotonin syndrome, particularly during treatment initiation and dose increases.➔Severe Skin Reactions: Severe skin reactions, including erythema multiforme and Stevens-Johnson Syndrome (SJS), can occur with Duloxetine tablets.



Warnings And Precautions➔Discontinue treatment the first appearance of blisters, peeling rash, mucosal erosions, or any other sign of hypersensitivity if no other cause can be identified. ➔Abnormal Bleeding: Duloxetine tablets may increase the risk of bleeding events. Patients should be cautioned about the risk of bleeding associated with the concomitant use of Generic Cymbalta and NSAIDs, aspirin, or other drugs that affect coagulation.



Warnings And Precautions➔Discontinuation: May result in symptoms, including dizziness, headache, nausea, diarrhea, paresthesia, irritability, vomiting, insomnia, anxiety, hyperhidrosis, and fatigue. ➔Activation of mania or hypomania has occurred in patients treated with Duloxetine tablets. ➔Angle-Closure Glaucoma: Angle-closure glaucoma has occurred in patients with untreated anatomically narrow angles treated with antidepressants. ➔Generic Cymbalta should be prescribed with care in patients with a history of seizure disorder.



Warnings And Precautions➔Blood Pressure: Monitor blood pressure prior to initiating treatment and periodically throughout treatment ➔Inhibitors of CYP1A2 or Thioridazine should not administered along with Duloxetine tablets. ➔Hyponatremia: Cases of hyponatremia have been reported in patients treated with Duloxetine tablets. ➔Glucose Control in Diabetes: In diabetic peripheral neuropathic pain patients, small increases in fasting blood glucose, and HbA1c have been observed.



Warnings And Precautions

➔Conditions that Slow Gastric Emptying: Use Generic Cymbalta with caution in these patients. ➔Urinary Hesitation and Retention has been observed in some patients treated with Generic Cymbalta.



Overdose Symptoms

Fatalities have been very rarely reported due to Duloxetine overdose. The reported fatalities were primarily with mixed overdoses, but also with Duloxetine alone at a dose of approximately 1000 mg. Signs and symptoms of overdose (mostly with mixed drugs) included serotonin syndrome, somnolence, vomiting, and seizures.



Overdose Treatment

No specific antidote is known, but if serotonin syndrome ensues, specific treatment may be considered.

An airway has to be established. Monitoring of the patients cardiac and vital signs is recommended, along with appropriate symptomatic and supportive measures. Gastric lavage may be indicated if performed soon after ingestion or in symptomatic patients. Activated charcoal may be useful in limiting absorption.



Dulot Capsules manufactured by Lupin Ltd and Duzela capsules manufactured by Sun Pharma Ltd

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generic cymbalta capsules for treatment of major depressive disorder

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