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What is the highest mg of cymbalta - Cymbalta (Duloxetine) I am 58 years old and have been taking Cymbalta 60 mg for depression and Lexapro 10 mg for anxiety for approximately two years now.

What is the highest mg of cymbalta

Also, doses should be increased in 30 mg increments and should take place over a longer, controlled period of time. And, if you decide to get off the medication then you should also do this gradually to avoid Cymbalta Withdrawal Symptoms How to Take Cymbalta Cymbalta dosage can be taken with or without food — so whatever you are more comfortable with. In any event, the medication needs to be swallowed whole and should not be chewed up or opened up and mixed with food or beverages.

This is a medication that is being released gradually throughout the day so taking it whole ensures the appropriate amount of dose being released over time. This medication should be stored at room temperature. How Do You Take Cymbalta? Cymbalta is a capsule that you take by mouth once a day.

The recommended dose is 60 milligrams a day. However, your doctor will likely tell you to take 30 milligrams a day for the first week, before increasing you to the full dose. It is important to keep in mind that there is no evidence to suggest that taking more than 60 milligrams a day will further reduce your pain. In fact, doing so increases your chances of side effects.

Continued If the medicine upsets your stomach , you can try taking it with a meal or some crackers. You should not drink alcohol when taking Cymbalta. Doing so can increase your risk of liver damage. If you miss a dose, you should take it as soon as you remember -- unless it is close to the time when you are supposed to take the next one.

If so, skip the missed dose, and go back to your regular medication schedule. When duloxetine was administered orally to pregnant rats throughout gestation and lactation, pup weights at birth and pup survival to 1 day postpartum were decreased at a dose 2 times the MRHD.

At this dose, pup behaviors consistent with increased reactivity, such as increased startle response to noise and decreased habituation of locomotor activity were observed. Post-weaning growth was not adversely affected.

Reported clinical findings have included respiratory distress, cyanosis , apnea , seizures, temperature instability, feeding difficulty, vomiting, hypoglycemia , hypotonia , hypertonia , hyperreflexia, tremor, jitteriness, irritability, and constant crying.

Post-weaning growth and reproductive performance of the progeny were not affected adversely by maternal duloxetine treatment. The estimated daily infant dose was approximately 0. The peak concentration measured in breast milk occurred at a median of 3 hours after the dose. Pediatric Use Generalized Anxiety Disorder In pediatric patients aged 7 to 17 years, efficacy was demonstrated in one 10week, placebo-controlled trial. The safety and effectiveness in pediatric patients less than 7 years of age have not been established.

Major Depressive Disorder Efficacy was not demonstrated in two week, placebo-controlled trials with pediatric patients with MDD, age 7 to The most frequently observed adverse reactions in the clinical trials included nausea, headache, decreased weight, and abdominal pain.

Of the patients in CLBP premarketing studies, Of the patients in OA premarketing studies, Of the 1, patients in FM premarketing studies, 7. In the MDD, GAD, DPNP, FM, OA, and CLBP studies, no overall differences in safety or effectiveness were generally observed between these subjects and younger subjects, and other reported clinical experience has not identified differences in responses between the elderly and younger patients, but greater sensitivity of some older individuals cannot be ruled out.

In an analysis of data from all placebo-controlled-trials, patients treated with CYMBALTA reported a higher rate of falls compared to patients treated with placebo. Underlying risk appears to increase steadily with age. As elderly patients tend to have a higher prevalence of risk factors for falls such as medications, medical comorbidities and gait disturbances, the impact of increasing age by itself on falls during treatment with CYMBALTA is unclear.

The pharmacokinetics of duloxetine after a single dose of 40 mg were compared in healthy elderly females 65 to 77 years and healthy middle-age females 32 to 50 years. Dosage adjustment based on the age of the patient is not necessary. Dosage adjustment based on gender is not necessary. Dosage modifications are not recommended for smokers. Race No specific pharmacokinetic study was conducted to investigate the effects of race.

Hepatic Impairment Patients with clinically evident hepatic impairment have decreased duloxetine metabolism and elimination. The elimination half-life, however, was similar in both groups.

The AUCs of the major circulating metabolites, 4-hydroxy duloxetine glucuronide and 5-hydroxy, 6-methoxy duloxetine sulfate, largely excreted in urine, were approximately 7-to 9-fold higher and would be expected to increase further with multiple dosing. Signs and symptoms of overdose duloxetine alone or with mixed drugs included somnolence, coma, serotonin syndrome, seizures, syncope, tachycardia, hypotension, hypertension, and vomiting.

In case of acute overdose, treatment should consist of those general measures employed in the management of overdose with any drug. An adequate airway, oxygenation, and ventilation should be assured, and cardiac rhythm and vital signs should be monitored.

Induction of emesis is not recommended. Gastric lavage with a large-bore orogastric tube with appropriate airway protection, if needed, may be indicated if performed soon after ingestion or in symptomatic patients. Activated charcoal may be useful in limiting absorption of duloxetine from the gastrointestinal tract. Administration of activated charcoal has been shown to decrease AUC and Cmax by an average of one-third, although some subjects had a limited effect of activated charcoal.

Because of the potential effect of duloxetine on platelets, patients receiving warfarin therapy should be carefully monitored when duloxetine is initiated or discontinued [see Warnings and Precautions 5.

Drugs that Affect Gastric Acidity Cymbalta has an enteric coating that resists dissolution until reaching a segment of the gastrointestinal tract where the pH exceeds 5. In extremely acidic conditions, Cymbalta, unprotected by the enteric coating, may undergo hydrolysis to form naphthol. Caution is advised in using Cymbalta in patients with conditions that may slow gastric emptying e. Drugs that raise the gastrointestinal pH may lead to an earlier release of duloxetine. It is unknown whether the concomitant administration of proton pump inhibitors affects duloxetine absorption [see Warnings and Precautions 5.

Therefore, an increase in the metabolism of CYP1A2 substrates e. In a clinical study, the pharmacokinetics of S-warfarin, a CYP2C9 substrate, were not significantly affected by duloxetine [see Drug Interactions 7. Therefore, an increase or decrease in the metabolism of CYP3A substrates e. Inhibition of the metabolism of CYP2C19 substrates is therefore not anticipated, although clinical studies have not been performed.

Serotonergic Drugs [See Dosage and Administration 2. Alcohol When Cymbalta and ethanol were administered several hours apart so that peak concentrations of each would coincide, Cymbalta did not increase the impairment of mental and motor skills caused by alcohol. In the Cymbalta clinical trials database, three Cymbalta-treated patients had liver injury as manifested by ALT and total bilirubin elevations, with evidence of obstruction. Substantial intercurrent ethanol use was present in each of these cases, and this may have contributed to the abnormalities seen [see Warnings and Precautions 5.

Drugs Highly Bound to Plasma Protein Because duloxetine is highly bound to plasma protein, administration of Cymbalta to a patient taking another drug that is highly protein bound may cause increased free concentrations of the other drug, potentially resulting in adverse reactions. To enroll, contact the Cymbalta Pregnancy Registry at or www. Risk Summary — There are no adequate and well-controlled studies of Cymbalta administration in pregnant women.

When duloxetine was administered orally to pregnant rats throughout gestation and lactation, pup weights at birth and pup survival to 1 day postpartum were decreased at a dose 2 times the MRHD. At this dose, pup behaviors consistent with increased reactivity, such as increased startle response to noise and decreased habituation of locomotor activity were observed.

Post-weaning growth was not adversely affected. Cymbalta should be used in pregnancy only if the potential benefit justifies the potential risk to the fetus. Reported clinical findings have included respiratory distress, cyanosis, apnea, seizures, temperature instability, feeding difficulty, vomiting, hypoglycemia, hypotonia, hypertonia, hyperreflexia, tremor, jitteriness, irritability, and constant crying.

It should be noted that, in some cases, the clinical picture is consistent with serotonin syndrome [see Warnings and Precautions 5. Post-weaning growth and reproductive performance of the progeny were not affected adversely by maternal duloxetine treatment. Nursing Mothers Risk Summary Cymbalta is present in human milk. In a published study, lactating women who were weaning their infants were given Cymbalta.

The estimated daily infant dose was approximately 0. The developmental and health benefits of human milk feeding should be considered along with the mother's clinical need for Cymbalta and any potential adverse effects on the milk-fed child from the drug or from the underlying maternal condition. Exercise caution when Cymbalta is administered to a nursing woman.

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