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Cymbalta Side Effects in Detail

Openmedi.orgSide effects of insomnia


5/8/2014
03:32 | Author: Emma Coleman

Side effects of insomnia
Cymbalta Side Effects in Detail

In placebo controlled trials, patients treated with duloxetine (the active ingredient contained in Cymbalta) for up to 9 weeks had an average weight loss of approximay 0.5 kg compared to an average weight gain of 0.2 kg in placebo treated patients. Tinnitus has been reported upon treatment discontinuation.

For Healthcare Professionals Applies to duloxetine: oral delayed release capsule.

Immunologic side effects including seasonal allergy have been reported.

General side effects including insomnia (8% to 13%), fatigue (2% to 15%), decreased appetite (3% to 11%), asthenia (2% to 8%), anorexia (3% to 5%), pyrexia (1% to 3%), gait disturbance, and excessive yawning have been reported. Initial insomnia has been reported frequently. Trismus has also been reported.

Although infrequent, several cases of duloxetine (the active ingredient contained in Cymbalta) induced hyponatremia have been reported. In one case report, duloxetine induced hyponatremia was confirmed after inadvertent rechallenge. It has been suggested that there is a dose-related effect in the development of hyponatremia with duloxetine. Numerous cases of hyponatremia have been reported following treatment with a selective serotonin reuptake inhibitor (SSRI). Risk factors for the development of SSRI associated hyponatremia including advanced age, female gender, concomitant use of diuretics, low body weight, and lower baseline serum sodium levels have been identified. Hyponatremia tends to develop within the first few weeks of treatment (range 3 to 120 days) and typically resolves within 2 weeks (range 48 hours to 6 weeks) after therapy has been discontinued with some patients requiring treatment (e.g., water restriction, dietary sodium). The proposed mechanism for the development of hyponatremia involves the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) via release of antidiuretic hormone.

You should check with your doctor immediay if any of these side effects occur when taking duloxetine:

A meta-analysis consisting of 12 randomized placebo-controlled trials (n=2996) found no evidence of a treatment-related increase in risk of suicidal behaviors or ideation with duloxetine (the active ingredient contained in Cymbalta) compared with placebo in patients with major depressive disorder. Aggression and anger have been reported particularly early in treatment or after treatment discontinuation.

Dermatologic side effects including hyperhidrosis (6% to 8%), and increased sweating (6%) have been reported. Night sweats, pruritus, and rash have been reported frequently. Contact dermatitis, acne, alopecia, cold sweat, ecchymosis, eczema, erythema, face edema, increased tendency to bruise, cutaneous reactions, and photosensitivity reaction have been reported infrequently. Serious skin reactions including Stevens-Johnson Syndrome that have required drug discontinuation and/or hospitalization have been reported with duloxetine (the active ingredient contained in Cymbalta) Erythema multiforme and urticaria have also been reported.

Psychiatric side effects including agitation (6%) and anxiety (3%) have been reported. Irritability, lethargy, nervousness, nightmare, restlessness, and sleep disorders have been reported frequently. Completed suicide, mania, manic switching, mood swings, pressure of speech, sluggishness, attempted suicide, aggression and anger have been reported infrequently. A case of hypomania has also been reported.

Nervous system side effects have included somnolence (7% to 21%), dizziness (6% to 17%), headache (13% to 20%), tremor (up to 5%), paraesthesia (4%), dysgeusia (3%), restless legs syndrome, seizures, and sleep abnormalities. Hallucinations have been reported.

Hypersensitivity side effects have included anaphylactic reaction, angioneurotic edema, and hypersensitivity.

Note: This page contains information about the side effects of duloxetine. Some of the dosage forms included on this document may not apply to the brand name Cymbalta.

In addition to its needed effects, some unwanted effects may be caused by duloxetine (the active ingredient contained in Cymbalta). In the event that any of these side effects do occur, they may require medical attention.

Applies to duloxetine: oral capsule, oral capsule delayed release.

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Musculoskeletal side effects including musculoskeletal pain (5%), muscle cramps ( 4% to 5%), muscle spasms (4%), and myalgia (1% to 4%) have been reported.

Respiratory side effects including nasopharyngitis (7% to 9%), upper respiratory tract infection (7%), pharyngolaryngeal pain (1% to 6%), and cough (3% to 5%) have been reported.

Gastrointestinal side effects including nausea (14% to 30%), dry mouth (5% to 15%), constipation (5% to 18%), diarrhea (7% to 13%), vomiting (5% to 6%), dyspepsia (4% to 5%), loose stools (2% to 3%), and viral gastroenteritis (2%) have been reported. Gastritis has been reported frequently. Blood in the stool, colitis, dysphagia, acquired esophageal stenosis, gastric ulcer, gingivitis, irritable bowel syndrome, and lower abdominal pain have been reported infrequently.

Genitourinary side effects including decreased libido (6% of males and 1% of females), abnormal orgasm (4% of males and 2% of females), erectile dysfunction (up to 4%), delayed ejaculation (3%), ejaculatory dysfunction (3%), penis disorder (2%), gynecological bleeding, and sexual dysfunction have been reported. gynecological bleeding.

Not all side effects for Cymbalta may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.

Other side effects including decreased appetite (8%), hot flushes (2% to 3%), increased weight (2%), decreased weight (2%), and tinnitus have been reported.

Approval History Calendar Drug history at FDA.

CSA Schedule N Not a controlled drug.

Nausea (3.5%) was the most common adverse event reported as a reason for discontinuation and considered to be drug related in trials of patients treated for diabetic peripheral neuropathic pain. Additionally, nausea (1.4%) was the only common adverse event reported as a reason for discontinuation and considered to be drug related in trials of patients treated for major depressive disorder.

Some of the side effects that can occur with duloxetine may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to l you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

Metabolic side effects have infrequently included hyponatremia.

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Hepatic side effects including small mean increases from baseline to endpoint in ALT, AST, CPK, and alkaline phosphatase have been reported. (Infrequent, modest, transient, abnormal values were reported.).

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Dizziness (1.6%), somnolence (1.6%), and fatigue (1.1%) were the common adverse events reported as reasons for discontinuation and considered to be drug related in trials of patients treated for diabetic peripheral neuropathic pain. Nearly all selective serotonin reuptake inhibitors, mixed serotonin/norepinephrine reuptake inhibitors, and tricyclic antidepressants cause sleep abnormalities to some extent. These antidepressants have marked dose-dependent effects on rapid eye movement (REM) sleep, causing reductions in the overall amount of REM sleep over the night and delays the first entry into REM sleep (increased REM sleep onset latency (ROL)), both in healthy subjects and depressed patients. The antidepressants that increase serotonin function appear to have the greatest effect on REM sleep. The reduction in REM sleep is greatest early in treatment, but gradually returns towards baseline during long-term therapy; however, ROL remains long. Following discontinuation of therapy the amount of REM sleep tends to rebound. Some of these drugs (i.e., bupropion, mirtazapine, nefazodone, trazodone, trimipramine) appear to have a modest or minimal effect on REM sleep. Seizures have been reported upon treatment discontinuation.

Pregnancy Category C Risk cannot be ruled out.

Availability Rx Prescription only.

Generic Name: duloxetine.

Renal side effects including pollakiuria (1% to 5%), polyuria, and urinary tract infection (3%) have been reported. Dysuria has been reported frequently. Micturition urgency, urinary hesitation, urinary incontinence, urinary retention, and decreased urine flow have been reported infrequently.

Cardiovascular side effects have been reported including increases in blood pressure averaging 2 mm Hg systolic and 0.5 mm Hg diastolic, an increase in the incidence of at least on measurement of systolic blood pressure over 140 mm Hg, and an increase in heart rate of approximay 2 beats per minute. Palpitations (2%) have been reported. Peripheral edema and phlebitis have been reported infrequently. A case of tachycardia has also been reported. Hypertensive crisis and supraventricular arrhythmia have been reported.

Data sources include Micromedex (updated Sep 26th, 2014), Cerner Multum (updated Oct 16th, 2014), Wolters Kluwer (updated Oct 9th, 2014) and others. To view content sources and attributions, refer to our editorial policy.

If any of the following symptoms of overdose occur while taking duloxetine, get emergency help immediay:

Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill, knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the substances you are taking, check with your doctor, nurse, or pharmacist.

Ocular side effects including blurred vision (up to 4%) have been reported.

Endocrine side effects have included galactorrhea, hyperglycemia, and hyperprolactinemia.

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Hematologic side effects including anemia, leukopenia, increased white blood cell count, lymphadenopathy, and thrombocytopenia have been reported infrequently.


Side effects of insomnia