What time of day to take cymbalta
How and when to take duloxetine
Dosage and strength
For depression, anxiety and nerve pain, duloxetine comes in 30mg and 60mg capsules.
For stress urinary incontinence, duloxetine comes in 20mg and 40mg capsules.
How much you take will depend on what you're taking it for:
- depression – the starting dose is 60mg, taken once a day and this can be increased to 120mg, taken once a day
- anxiety – the starting dose is 30mg, taken once a day and this can be increased to 60mg, taken once a day
- nerve pain – the starting dose is 60mg taken once a day, and this can be increased to 60mg taken twice a day
- stress urinary incontinence – the starting dose is 20mg, taken twice a day and this can be increased to 40mg, taken twice a day, after 2 weeks
How to take it
Swallow the capsules whole with a drink of water or juice. Do not chew them.
You can take duloxetine with or without food, but it's best to take it at the same time each day.
How long to take it for
How long you take duloxetine for depends on why you're taking it.
For depression or anxiety, once you're feeling better, it's likely that you'll continue to take it for several more months. Most doctors recommend that you take antidepressants for 6 months to a year after you no longer feel depressed or anxious. Stopping your medicine too soon can make depression and anxiety come back.
When you stop taking it, your doctor will probably recommend reducing your dose gradually over several weeks, to help prevent withdrawal side effects.
For nerve pain or urinary incontinence, if duloxetine is helping your symptoms, you can continue taking it long term. Your doctor may check that you're still having relief from the pain or urinary incontinence every few months.
If you forget to take it
If you usually take duloxetine once a day, take the missed dose as soon as you remember, unless it's less than 12 hours until your next dose, in which case skip the missed dose and take the next one at the usual time.
If you usually take it twice a day, take the missed dose as soon as you remember, unless it's less than 4 hours until your next dose, in which case skip the missed dose and take the next one at the usual time.
Never take 2 doses at the same time to make up for a forgotten dose.
If you often forget doses, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.
If you take too much
Taking too much duloxetine can cause symptoms such as:
- feeling sleepy
- being sick (vomiting)
- tremors
- feeling dizzy
- a fast heart rate
- sweating
- feeling restless
The amount of duloxetine that can lead to an overdose varies from person to person.
Urgent advice: Contact 111 for advice now if:
- you take more than your prescribed dose of duloxetine
Go to 111.nhs.uk or call 111
If you need to go to A&E, do not drive yourself. Get someone else to drive you or call for an ambulance.
Take the duloxetine packet or the leaflet inside it, plus any remaining medicine, with you.
Immediate action required: Call 999 or go to A&E now if:
- you take more than your prescribed dose of duloxetine and you have a seizure or fit
Find your nearest A&E
Stopping taking duloxetine
If you have been feeling better for 6 months or more, your doctor may suggest coming off duloxetine.
Your doctor may reduce your dose gradually over several weeks, or longer if you've been taking duloxetine for a long time.
This is to help prevent any extra side effects you might get as a reaction to coming off the medicine.
Important: Important
Do not stop taking duloxetine suddenly or without talking to your doctor first.
Page last reviewed: 14 February 2022
Next review due: 14 February 2025
When is the Best Time to Take Cymbalta?
Medically reviewed by Kristin Hall, FNP
Written by Our Editorial Team
Last updated 10/15/2022
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.
What Time of Day Should You Take Cymbalta?
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.
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Do You Need to Take Cymbalta With Food?
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.
Can I Take Cymbalta With Other Medications?
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.
What if I Miss A Dose of 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.
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Taking Cymbalta at a Specific Time of Day
Cymbalta is a medication used to treat major depressive disorder and generalized anxiety disorder.
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.
3 Sources
Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references.
- Duloxetine. Medline Plus. Retrieved from https://medlineplus.gov/druginfo/meds/a604030.html#why
- Cymbalta. Highlights of Prescribing Information. Retrieved from https://www.accessdata.fda.gov/drugsatfda_docs/label/2010/022516lbl.pdf
- Serotonin Syndrome. Medline Plus https://medlineplus.gov/ency/article/007272.htm
This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.
Antidepressant Lilly Simbalta - « How to take antidepressants correctly and reduce the intensity of side effects ➡️ Those who know these secrets have a lower risk of interrupting treatment | Efficiency and withdrawal syndrome | Duloxetine or Cymbalta, is there a difference? »
Today I want to talk about such a drug as Simbalta, aka duloxetine. It is an SSRI antidepressant. In simple words, antidepressants of this group affect not only serotonin as antidepressants of the SSRI group, but also norepinephrine. Below I will talk about my experience with Cymbalta.
Packaging .
The preparation is sold in a cardboard box with a neutral design. The front side shows the name of the drug, the active substance and the number of tablets in the package. I now have two boxes of 14 capsules left. Prior to this, at the beginning of the course of treatment, I bought the drug in 28 capsules per pack.
It costs twice as much.
It should be borne in mind that 14 capsules are not enough even to understand whether an antidepressant works or not. It is better to buy a large package. The box contains a blister with capsules.
This format is quite a significant minus. When taking antidepressants, you initially need to go to the drug with a micro dose. In this case, you should start taking 30 milligrams, or even 15. But not 60 milligrams at once. At such high dosages, the approach to the drug turns out to be quite tough.
On sale, as far as I know, there are capsules with a volume of 30 milligrams, but I have never come across them all the time. It is impossible to divide the capsule, although there is still one way. I'll tell you more in the "experience" section.
Active ingredient.
The active ingredient of the drug is duloxetine.
I want to note that duloxetine is a relatively new antidepressant. In general, all antidepressants of the SSRI and SNRI groups are the latest developments of scientists.
Cymbalta side effects.
When buying a drug inside, you can find instructions for use, which will include side effects. I want to say the following, some are afraid of taking drugs and believe that since there are side effects in the instructions, then they will certainly happen. It is not true. Many side effects of the company are listed simply to avoid litigation. In general, the presence of large peppery side effects in the first place indicates that the drug is well studied. It is worse when the instructions say that there will be no side effects, but they eventually appear.
Application experience.
I had a standard dosage of simbalta. One dose of the drug in the morning, the course is at least half a year, ideally a year.
It is possible to take antidepressants for life, including simbalts. I didn't need something like that. I went on the drug with 30 milligrams a day. I took a capsule and poured everything on a dry surface. Then I took the capsules from the room where I first poured out all the contents. I divided the "powder" of simbalty into two equal parts and filled it into capsules from omez. It turned out two capsules of 15 milligrams. You can use any capsules, not necessarily omez. It's just the cheapest and it's not a pity to throw it away. Thus, I was able to enter the drug with a relatively small dosage.
In the first two weeks of taking antidepressants of this group (SSRIs and SSRIs), the condition noticeably worsens. If before that there was depression, anxiety and other conditions, then they intensify. This is absolutely normal. I once read a review where someone complained that you see the drug is ineffective and generally only made it worse. I don't understand how people write things like this.
Surely the doctor did not warn them about the peculiarities of the action of antidepressants.
In the first two weeks of taking, not only the condition worsens, but also side effects appear. If you need to go to the required dosage for more than two weeks, then the side effects will be much longer. On average, everything goes away in 10-14 days after establishing the desired dosage. No one evaluates the effect of using an antidepressant earlier than after a month of using the drug. It is necessary to drink daily strictly at the same time. You can not drink the drug anyhow, since there will not be a single concentration in the blood. You need to drink antidepressants for at least half a year, even if all the symptoms of depression have disappeared much earlier. It's all the gold standard of care. Sometimes the effect comes too late. For example, when I drank cipralex, I got the effect only after a month and a half from the start of the intake.
I had side effects when I started taking simbalia.
They won't get stuck because it's all individual. All side effects went away after I got to 60 milligrams a day. About a week after reaching this dosage, the side effects began to decrease and completely disappeared. In order for the side effects to be less pronounced, it is necessary to start taking it with a lower dosage. All this must be agreed with the doctor. In principle, any good doctor talks about it.
Depression began to disappear after about three weeks from the start of taking simbalta. Every day the condition began to improve until all the symptoms were completely gone. I had depression caused by taking one drug. Simply put, depression was a consequence of treatment with another drug and, in fact, was a side effect. Pl past this was anxiety and panic attacks. In general, everything went away after a few months from the start of treatment. I took the drug for about six months. I also tried duoloxenta, but still returned to simbalta.
To prevent insomnia, the drug should be taken in the morning.
It is better not to do this at night. Nevertheless, simbalta affects norepinephrine and this must be taken into account. Anxiety is removed in about 2-3 months, respectively, and panic attacks pass. Also a huge plus is that simbalta relieves pain. Many people prescribe it for pain, not depression. Tolerability was generally good. I've had worse antidepressants with a bunch of side effects.
Summing up, I can say that Cymbalta is a good and effective antidepressant. Side effects occur in the first weeks of treatment. When compared with other antidepressants that I drank, I can say that the side effects of simbalta are not the most harmless, but it happened worse. The drug works relatively quickly, which is a plus for me. Treats depression and gives energy. In addition, the drug effectively relieves pain. It is prescribed even for diabetes. There was no negative effect on weight. In fact, I did not see the difference between pure duloxetine and simbalta.
The drug was satisfied.
The drug should be taken in consultation with the attending physician. Here I share my experience with Cymbalta, and this review is not a recommendation for treatment.
Duloxetine for the treatment of painful neuropathy, chronic pain or fibromyalgia
Survey question
Does duloxetine work to treat pain generated by nerves when damaged by disease or pain caused by fibromyalgia?
Relevance
Duloxetine is a medicine used to treat depression and urinary incontinence (urinary leakage), and may also be useful for certain types of pain. Pain can occur spontaneously when there is damage to the nerves that carry pain information to the brain (neuropathic pain). When nerve damage occurs outside of the spinal cord, it is called peripheral neuropathy. Another type of pain, nociceptive pain, occurs when nerves sense damage to another tissue (such as a prick in the skin).
Some types of pain of unknown origin occur without visible nerve or tissue damage. This type of pain occurs, for example, with fibromyalgia. The purpose of this review was to evaluate the benefits and harms of duloxetine for the treatment of neuropathic pain and chronic pain of all types.
Study profile
We reviewed all published scientific literature and found 18 trials with a total of 6407 participants that were of sufficient quality to include in this review. Eight clinical trials examined the effect of duloxetine in painful diabetic neuropathy and six in pain associated with fibromyalgia. Three trials looked at painful physical symptoms associated with depression, and one small study looked at duloxetine for stroke pain or spinal cord disease (central pain).
Main results and quality of evidence
The usual dose of duloxetine is 60 mg. There was moderate-quality evidence that duloxetine at this dose reduced pain in painful diabetic peripheral neuropathy and fibromyalgia.
In diabetic peripheral neuropathic pain, 50% or slightly more had an improvement on duloxetine 60 mg per day more than one and a half times more often than in the placebo group. In other words, five people with diabetic peripheral neuropathy must receive duloxetine in order for one of them to achieve an effect of 50% or more. The effect on fibromyalgia was similar, but the number of patients needed to be treated for improvement of 50% or more was eight. Based on only one study, it is not possible to determine whether the 20 mg dose is effective, and the 120 mg dose was no more effective than 60 mg.
We calculated that there were sufficient trials for diabetic neuropathy to draw these conclusions and no further trials are required. For fibromyalgia and the painful symptoms associated with depression, more trials are needed to make strong claims about the effectiveness of duloxetine.
Most people who take duloxetine will have at least one side effect. They are mostly minor and the most common are feeling unwell, insomnia or drowsiness, headache, dry mouth, constipation or dizziness.
