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Claims Journal 3rd Edition                                                                                                                                                          Claims Journal 3rd Edition
                                                                                                                                                                     Cymbalta





             O.P.L



               Prepared by Sundos Basudan




                                                                                                                                       Use and Dose                   Adverse reactions              Contraindications


                                                    Cymbalta (duloxetine) is a selective serotonin and nor-                      -Major Depressive Disorder          constipation,diarrhea,            - The use of MAOIs with
                                                    epinephrine reuptake inhibitor antidepressant (SSNRI).                       -Generalized Anxiety Disorder       dizziness, drowsiness, fatigue,   Cymbalta or within 5 days
                                                                                                                                 -Diabetic Peripheral                hypersomnia, insomnia,            of stopping treatment with
                                                                                                                                 Neuropathy                          nausea, sedation, headache,       Cymbalta is contraindicated
                                                    Coverage                                                                     -Fibromyalgia                       and xerostomia.                   because of an increased risk
                                                    - Cymbalta is covered only in acute cases of depressive                      -Chronic Musculoskeletal Pain                                         of serotonin syndrome.
                                                    disorder and anxiety disorder.                                                                                                                     - The use of Cymbalta within
                                                                                                                                                                                                       14 days of stopping an MAOI
                                                    - Cymbalta is approved by SFDA for                                           For adult— Starting dose is 30                                        intended to treat psychiatric
                                                    diabetic neuropathic pain if it is prescribed by neurolo-                    mg for one week, then increase                                        disorders is also contraindi-
                                                    gist or endocrinologist only.                                                to 60 mg once daily.                                                  cated



                                                                                                                                 For Children, Adolescents and
                                                                                                                                 Elderly — Initiate Cymbalta at     Use in specific populations
                                                                                                                                 a dose of 30 mg once daily for      - Cymbalta should not be used during pregnancy
                                                                                                                                 2 weeks before increase to the      unless the benefit outweighs the risk to the
                                                                                                                                 target dose of 60 mg.               fetus
                                                                                                                                                                     FDA pregnancy category: C

                                                                                                                                                                     - Cymbalta is not recommended in breastfeeding
                                                                                                                                                                     because it’s excreted into human milk.
                                                                                                                                                                     If used, the infant should be monitored for
                                                                                                                                                                     drowsiness, adequate weight gain, and develop-
                                                                                                                                                                     mental milestones






























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