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Reviewed by Kristin Hall, FNP
Written by Our Editorial Team
Cymbalta, and the generic version duloxetine, is a prescription drug most often used in the treatment of depression, along with generalized anxiety disorder, in adults. It is worth noting that Cymbalta is not approved to treat bipolar disorder.
This antidepressant is in a class of medications known as serotonin-norepinephrine reuptake inhibitors (SNRIs), which are used to treat certain mental health disorders, like major depression. They work by increasing the levels of certain chemicals called serotonin and norepinephrine in your brain.
If you are taking this medication, you obviously want it to work for you. One thing that can factor into a medication working properly is the time of day you take it.
Cymbalta comes in a delayed-release capsule. This means that the medication is released in your intestine to prevent stomach acids from breaking down the medication. It can take up to four weeks before you start to notice this antidepressant medication working to reduce your symptoms of depression.
When taken for major depression or any other type of depression, it’s usually taken one or two times a day. The starting dose is between 40mg and 60mg a day. From there, a healthcare provider may increase your dosage as you adjust to it, up to a maximum dosage of 120mg times per day.
If you are taking Cymbalta for generalized anxiety disorder (GAD), you’ll only need to take one daily dose. The starting dose for GAD is 60mg, with a maximum recommended dose of 120mg.
There is no official recommended time of day to take Cymbalta — it’s up to you! However, you may want to keep potential side effects of the medication in mind and let those influence when you take it.
For example, taking Cymbalta can cause tiredness or drowsiness. If you notice this, you may want to adjust to taking it at night so that you aren’t walking around like a zombie all day.
On the flip side, another side effect is increased urination — which could be annoying at night. So, if you notice that, you may be better off taking it in the morning.
Whatever time of day you determine is best for you, it’s always important to be consistent with when you take your medication.
As far as side effects, the above mentioned side effects are totally normal. Even still, if you notice anything, it’s always a good idea to speak with your healthcare provider so they can monitor whatever side effects you are experiencing.
Other common side effects include nausea, constipation, weight loss or weight gain, heartburn, decreased appetite, sexual side effects, sweating, musculoskeletal pain and more. Mild side effects usually go away after you adjust to taking the medication.
Some side effects are more severe — like unusual bruising, swelling of the abdomen, abdominal pain, yellowing of the skin, blood pressure issues, confusion or feeling unsteady while you walk. If you notice any of these, contact a healthcare provider as soon as you can.
There’s no need to take Cymbalta with food. But if you experience some of the common symptoms associated with Cymbalta, it’s possible taking it with food can help. For example, some people don’t like to be nauseous on an empty stomach.
When it comes to how you take Cymbalta, the capsule should always be swallowed whole, with water if you need it. You should never chew or crush this medication. It’s also important not to open the capsule and mix it with water.
If you are on other types of medications, tell your healthcare provider about those before you begin taking Cymbalta. That way, he or she can ensure that there won’t be a bad drug interaction between what you’re taking and Cymbalta. You should also mention if you’ve ever had any allergic reactions to medication before.
On that note, it’s also important to disclose any medical conditions you may have with your healthcare provider. For example, Cymbalta may not be great for people with diabetes.
People who take CYP1A2 inhibitors or thioridazine should not take Cymbalta.
If you are on another medication that affects your serotonin levels — called serotonergic medications — you may also want to avoid taking Cymbalta, as it could increase your risk of serotonin syndrome.
This potentially dangerous condition occurs when your body has too much serotonin. Symptoms of serotonin syndrome include restlessness, diarrhea, chest pain, hallucinations, eye pain, nausea and more.
You should also not take Cymbalta if you are taking a monoamine oxidase inhibitor. In fact, if you have taken a MAOI within two weeks, you should not take this medication.
Along with the medications mentioned above, you should be careful with alcohol when taking Cymbalta, because alcohol increases your risk of liver damage when taking duloxetine. Be sure to discuss how much alcohol you tend to drink with your healthcare provider before you begin taking Cymbalta.
Forgot to take your dose of Cymbalta? That’s okay. Just take it as soon as you remember.
If you are really close to your next dose, do not double up. Instead, just take your next dose as normal.
If you have any questions or concerns about missing a dose or what to do, reach out to a healthcare provider for advice.
Have trouble remembering to take your medication around the same time each day? You may want to set an alarm on your phone to remind you. This can take the pressure off having to remember. Another idea: Try taking it at a time when you do something else each day. For example, you brush your teeth every morning. If you pair brushing your teeth with taking your Cymbalta, it will be harder to forget.
If you decide you want to stop taking Cymbalta, it’s best to consult with a healthcare professional on the best way to come off of it. If you stop suddenly, you may experience withdrawal symptoms and adverse effects (also called discontinuation syndrome). Instead, healthcare providers can guide you in how to taper your dosage slowly until you’re totally off of it.
There’s no specific recommended time on when you should take this medication. While it’s important to be consistent in taking your prescription, you can choose what time of day is best for you.
One way to make the decision is based on common side effects that you may experience. Like, if you tend to get a little drowsy when you take it, you may want to take it at night.
Other common side effects include weight gain and weight loss, sexual side effects and frequent urination. Though rare, more severe side effects include blood pressure issues, unusual bleeding, abdominal pain, severe skin reactions and more. If you notice any of these things, contact a healthcare provider immediately. There is also a risk of serotonin syndrome — especially if you take another serotonergic medication.
If you’d like to talk to a mental health professional about taking Cymbalta or other antidepressant medications for treatment of depression or generalized anxiety disorder, consider scheduling an online consultation for medical advice.
Kristin Hall is a board-certified Family Nurse Practitioner with decades of experience in clinical practice and leadership.
She has an extensive background in Family Medicine as both a front-line healthcare provider and clinical leader through her work as a primary care provider, retail health clinician and as Principal Investigator with the NIH.
Certified through the American Nurses Credentialing Center, she brings her expertise in Family Medicine into your home by helping people improve their health and actively participate in their own healthcare.
Kristin is a St. Louis native and earned her master’s degree in Nursing from St. Louis University, and is also a member of the American Academy of Nurse Practitioners. You can find Kristin on LinkedIn for more information.
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