For the millions of Americans affected by fibromyalgia, medications offer hope for treating the condition’s widespread joint and muscle pain and fatigue.
Cymbalta (duloxetine) is approved by the Food and Drug Administration for the management of fibromyalgia in adults. Read on to find out if Cymbalta might be right for you.
Cymbalta belongs to a class of medications called SNRIs (serotonin-norepinephrine reuptake inhibitors) that block the reabsorption of the neurotransmitters norepinephrine and serotonin in the brain.
Prior to being approved for fibromyalgia, it was approved for the treatment of:
- generalized anxiety disorder (GAD)
- major depressive disorder (MDD)
- diabetic peripheral neuropathic pain (DPNP)
- chronic musculoskeletal pain
Although the exact cause of fibromyalgia is unknown, researchers suggest that the brains of people with fibromyalgia are changed by repeated nerve stimulation. Involved in the change can be an abnormal increase of certain neurotransmitters (chemicals that signal pain).
Also, it is suggested that the brain’s pain receptors become more sensitive and can overreact to pain signals.
Cymbalta increases the amounts of serotonin and norepinephrine in the brain. These chemicals help keep mental balance and stop the movement of pain signals in the brain.
Cymbalta is associated with numerous possible side effects. Many do not typically require medical attention including:
- appetite changes
- blurred vision
- dry mouth
- increased sweating
Side effects to inform your doctor about immediately include:
- abdominal swelling
- allergic reactions like itching, rash or hives, swelling of face, lips, face or tongue
- blood pressure changes
- blisters or peeling skin
- dark urine
- flu-like symptoms
- irregular and/or rapid heartbeat
- loss of balance and/or dizziness
- loss of contact with reality, hallucinations
- mood changes
- suicidal thoughts
- unusual bruising or bleeding
- weight loss
SNRIs are known to cause sexual side effects. So, Cymbalta may cause sexual side effects, such as issues with:
While sexual side effects are a problem for some people, for many they are minor or moderate as their bodies adjust to the medication. The severeness of these side effects can also be dependent on dosage level.
According to the National Alliance on Mental Illness (NAMI), duloxetine (Cymbalta) should not be taken with or within two weeks of taking monoamine oxidase inhibitors (MAOIs) such as:
- tranylcypromine (Parnate)
- selegiline (Emsam)
- rasagiline (Azilect)
- phenelzine (Nardil)
- isocarboxazid (Marplan)
NAMI also indicates that it might increase the effects of certain medications that may cause bleeding such as:
- ibuprofen (Advil, Motrin)
- warfarin (Coumadin)
NAMI also indicates that the levels and effects of Cymbalta might be increased by some medications including:
- cimetidine (Tagamet)
- ciprofloxacin (Cipro)
- fluoxetine (Prozac)
- fluvoxamine (Luvox)
- paroxetine (Paxil)
It is important that your doctor knows all the other medications you use. Doctors are aware of the above list as well as other medications that commonly interact with Cymbalta. They’ll make decisions about avoidance or dosage adjustment where appropriate.
Only stop taking Cymbalta with doctor approval. Missing doses has the potential for increasing your risk of relapse in your symptoms.
When you’re ready to stop taking Cymbalta, talk with your doctor about gradually decreasing your dose. Stopping suddenly might result in withdrawal symptoms such as:
- paresthesias (prickling, tingling, prickling skin sensations)
It is likely your doctor will be able to help you lessen withdrawal symptoms.
While taking Cymbalta you’ll also want to avoid drinking alcohol or misusing substances such as opioids. Not only might they decrease the benefits that Cymbalta is delivering, but they could increase the severity of side effects.
Also, alcohol consumption can increase the risk of liver problems while simultaneously taking Cymbalta.
Another SNRI approved to treat fibromyalgia is Savella (milnacipran). Also approved is Lyrica (pregabalin), an epilepsy and nerve pain medication.
Your doctor might also recommend:
- over-the-counter pain relievers such as acetaminophen (Tylenol) and ibuprofen (Advil, Motrin)
- prescription pain relievers such as tramadol (Ultram)
- anti-seizure drugs such as gabapentin (Neurontin)
Both physically and emotionally, fibromyalgia can be a difficult condition to live with. Medications such as Cymbalta have been effective in treating many of the symptoms of this chronic and often disabling disease.
If your doctor recommends Cymbalta, ask them questions about its ideal effects on treating your symptoms, as well as its potential side effects. Discuss your course of action if you experience side effects.
Always make sure to give your doctor all information about other medications and supplements that you are taking.