Cymbalta, the brand of duloxetine, is an antidepressant medication classified as a serotonin/norepinephrine reuptake inhibitor. Cymbalta is used in the treatment of major depressive disorder, generalized anxiety disorder, management of fibromyalgia and management of pain caused from diabetic neuropathy. The medication prevents the breakdown and release of two chemicals, serotonin and norepinephrine, and allows them to remain in the brain, leading to improvement in symptoms. The medical condition of the patient will determine what dose and frequency are prescribed.
Dosage for Major Depressive Disorder
Cymbalta is approved for use in patients 18 years old or more for major depressive disorder. The initial dose is 40 to 60 mg per day, divided into 20 or 30 mg twice a day or given as a single daily dose of 60 mg, explains the "Drug Information Handbook." The maximum dose is 60 mg a day.
Dosage for Generalized Anxiety Disorder
Cymbalta may be given in generalized anxiety disorder for individuals 18 years or older. The initial dose is 30 mg for one week and may be increased to 60 mg. The dose may then be increased by increments of 30 mg daily until the desired effect is reached. The usual dose is 60 to 120 mg a day with a maximum dose is 120 mg.
Dosage in Fibromyalgia and Diabetic Neuropathy
Cymbalta.com states that the drug is approved for the management of fibromyalgia and helps reduce pain and improve function. The starting dose is 30 mg once a day for one week and it is then increased to the recommended dose of 60 mg once daily. Cymbalta may also be administered to patients with diabetic neuropathy, which is nerve damage caused by uncontrolled diabetes. The nerve damage typically causes pain in the feet, legs and hands. The dose for these patients is 60 mg once daily.
Dosage in Elderly Patients
The dosage of Cymbalta may differ depending on age and kidney and liver function. In elderly patients with major depressive disorder, the starting dose of Cymbalta is 20 mg once or twice daily. The dose may be increased 40 to 60 mg a day depending on how the patient responds. No dosage adjustment is necessary for other indications.
Dosage in Kidney and Liver Dysfunction
Cymbalta is not recommended in patients who have severe kidney dysfunction or end stage renal disease, explains the "Drug Information Handbook." Diabetics are at risk for developing kidney impairment if blood sugar levels are not controlled; the starting dose for use in diabetic neuropathy may be lower depending on the tolerance of the patient. Individuals with liver dysfunction should also avoid the use of the medication.
References
- "Drug Information Handbook"; Charles F. Lacy, Lora L. Armstrong, et al.; 2007
- Cymbalta: Cymbalta and Fibromyalgia
