Cymbalta

Before taking this medicine

Do not take Cymbalta with an MAOI antidepressant or within 14 days of stopping one. Do not start an MAOI antidepressant within 5 days of stopping Cymbalta. Do not start Cymbalta while receiving linezolid or intravenous methylene blue. These combinations increase the risk of serotonin syndrome. Cymbalta should be avoided in people with substantial alcohol use, chronic liver disease or cirrhosis, or severe kidney impairment (GFR below 30 mL/minute). Use with CYP1A2 inhibitors or thioridazine should also be avoided. Tell your prescriber if you have a personal or family history of bipolar disorder, mania or hypomania; a seizure disorder; untreated narrow drainage angles in the eyes; diabetes; or a condition that slows stomach emptying. Blood pressure should be checked before and during treatment. Cymbalta can cause blood pressure increases, blood pressure drops on standing, falls, fainting, low blood sodium and sexual dysfunction. In people treated for diabetic nerve pain, increases in blood sugar and HbA1c have been observed. Other medicines that affect serotonin increase the risk of serotonin syndrome, although it can also occur with Cymbalta alone. Antiplatelet medicines and anticoagulants can increase the risk of bleeding when taken with Cymbalta. Serious liver injury, sometimes fatal, and severe skin reactions have been reported. Cymbalta should be stopped if jaundice or other signs of significant liver dysfunction develop, or if unexplained blisters, peeling skin or sores on mucous membranes appear. Seek medical advice promptly if these occur. Tell your prescriber if you are pregnant. Use during the third trimester may increase the newborn’s risk of breathing or feeding difficulties, unstable body temperature, low muscle tone, tremor or irritability.