Cymbalta (Duloxetine) Dosage Guide: Forms, Strengths, & How To Take It

What Is Cymbalta (Duloxetine)?

Cymbalta (Duloxetine) is an antidepressant medication of the pharmacological class of serotonin and norepinephrine reuptake inhibitors (SNRIs) that elevates serotonin and norepinephrine in the brain.¹ Although its chemical structure differs from other antidepressants, it is widely used as an initial treatment option. It has side effects that are normally well tolerated by many users, so speak to your physician to see if treatment with duloxetine may be viable for you.

What is Cymbalta Used to Treat?

Patients who have depression or anxiety can begin taking duloxetine as an initial treatment option for their condition. Similarly, duloxetine may be prescribed by doctors to patients who suffer from both fibromyalgia and depression. Children and adolescents between the ages of 7-17 may use Cymbalta. It is prescribed for kids with a generalized anxiety disorder who are at least 7 years old. It is also permitted for fibromyalgia-suffering youngsters 13 years of age and older.

Duloxetine can be used off-label for some conditions.² An off-label use of a medication is a use that is not FDA-approved. Prescribers can decide to use a medication off-label because, in their professional judgment, they believe it may benefit someone.

Cymbalta is commonly used as an FDA-approved medication to treat:

• Major depressive disorder (MDD) in adults
• Generalized anxiety disorder (GAD) in adults and pediatric patients 7 years of age and older
• Diabetic peripheral neuropathic pain in adults
• Fibromyalgia in adults and pediatric patients 13 years of age and older
• Chronic musculoskeletal pain in adults

Cymbalta can also be used off-label (non-FDA-approved) for treating:

• Stress urinary incontinence (SUI)
• Chronic fatigue syndrome
• Lower back pain
• Chemotherapy-induced peripheral neuropathy

Other FDA-Approved Uses for Cymbalta

Duloxetine is a medication that is used to treat major depressive disorder (MDD), generalized anxiety disorder (GAD) in adults and children over the age of 7, fibromyalgia in adults and pediatric patients over the age of 13, diabetic peripheral neuropathy and chronic musculoskeletal pain in adults.

Cymbalta Forms and Strengths

Duloxetine is available as pellets and a delayed-release capsule.³ The dosage depends on the ailment being treated, age, and severity of symptoms. Doctors may decide to start at a lower dose and gradually raise dosages as needed. The doctor may also lower the dosage if side effects are not well tolerated.

Cymbalta is available in the following forms:

• Delayed release capsule
• Pellets

Cymbalta is available in the following strengths:

• 20 milligrams
• 30 milligrams
• 60 milligrams

Patients should not alter the dosage or schedule of their medications without first consulting with their doctor. Take the medications exactly as directed with a full glass of water. You may take them with or without food but do not chew the capsules themselves.

Cymbalta Dosage for Adults

Duloxetine can treat several conditions in adults, including depression, anxiety, the pain brought on by diabetes-related nerve damage (diabetic peripheral neuropathy), fibromyalgia, and chronic (long-lasting) pain in the muscles and bones. The suggested dosage for persons under 65 is 60 mg, administered once a day. Depending on their condition, some people may begin taking 30 mg once a day before increasing the dose to 60 mg.

Most of the time, older adults are prescribed the same dosage of Cymbalta as adults under 65. Duloxetine is safe and well-tolerated in older adults with recurrent major depressive disorder and relieves anxiety, depression, and pain. It is known that duloxetine can cause liver damage in people who already have liver disease or who often drink alcohol. Duloxetine, however, can also cause liver damage in people without these risk conditions. Clinical investigations showed no evidence that people taking duloxetine had an increased risk of renal failure.

Cymbalta Dosage for Adults with Major Depressive Disorder (MDD)

The U.S. Food and Drug Administration (FDA) has granted Cymbalta approval to manage major depressive disorder. For depression treatment, it may take 6–8 weeks for a depressed mood and lack of interest in activities to improve. During the first two weeks, sleep, energy, or appetite may begin to improve. An early sign that the drug is functioning is improvement in these physical symptoms. Take your dose at approximately the same time each day, but this can be any time of day that works for you.

Here is Cymbalta dosage information for depression in adults:

• Typical starting dosage: Starting dose Cymbalta for adults is 40 mg/day (given as 20 mg twice daily)
• Dosage increases: May increase to 60 mg/day (given once or 30 mg twice daily).
• Maximum dosage: The max dosage of Cymbalta for major depressive disorder (MDD) is 120 milligrams (mg) daily.

Cymbalta Dosage for Adults with Generalized Anxiety Disorder (GAD)

Cymbalta is an antidepressant approved by the FDA for treating adults with generalized anxiety disorder (GAD). For anxiety treatment, you may start to see relief from your symptoms after 2-4 weeks of taking Cymbalta regularly. You can take Cymbalta at any time of the day. Always take your medications as prescribed by your doctor.

Here is Cymbalta dosage information for anxiety in adults:

• Typical starting dosage: The typical Cymbalta for anxiety dosage is 30–60 mg once daily.
• Dosage increases: For the first week, your doctor might advise a starting dose of 30 mg once daily, followed by an increase to 60 mg once daily.
• Maximum dosage: The Cymbalta max dosage for anxiety is 120 mg daily.

Here is Cymbalta dosage for anxiety in older adults:

• Typical starting dosage: 30 mg once daily is the suggested starting dosage.
• Dosage increases: Your doctor could increase your dosage to 60 mg once daily.
• Maximum dosage: The maximum dosage of Cymbalta for anxiety is 120 mg daily.

Cymbalta Dosage for Children & Adolescents

The FDA has given Cymbalta approval to treat fibromyalgia and generalized anxiety disorder in children and teenagers.⁴ The Cymbalta dosage for fibromyalgia and anxiety in children as well as anxiety in teenagers is often lower than the dosage for adults. Children 7 years of age and older are allowed to use Cymbalta. Your doctor must determine the use and dosage for children under seven.

Cymbalta Dosage for Children & Adolescents with Generalized Anxiety Disorder (GAD)

The FDA has approved duloxetine for GAD in kids between 7 and 17. After 2-4 weeks of taking Cymbalta daily, you may notice a decrease in your nervousness and alleviation from your anxiety-related symptoms.

Here is Cymbalta dosage information for children aged 7 and up with anxiety:

• Typical starting dosage: 30 mg once daily is the suggested starting dose.
• Dosage increases: If your child has no unfavorable side effects, their doctor could raise the dosage to 60 mg once daily if necessary.
• Maximum dosage: Duloxetine max dosage is no more than 60 mg daily.

Cymbalta Dosage for Non-FDA-Approved (Off-Label) Uses

Duloxetine can be used off-label for several mental health disorders. An off-label use of a medication is a use that is not FDA-approved. Prescribers can decide to use a medication off-label because, in their professional judgment, they believe it may benefit someone.

Possible off-label (non-FDA approved) uses of Cymbalta may include:

• Stress urinary incontinence (SUI)
• Chronic fatigue syndrome
• Lower back pain
• Chemotherapy-induced peripheral neuropathy (CIPN)

If you are interested in using Cymbalta for off-label use, you should talk with your healthcare professional. They can help to determine if it is safe for you to use Cymbalta and what dose you should take.

Cymbalta Dosing Considerations

Certain people need special dosing considerations and modifications with duloxetine. Share your medical history with your doctor to determine that it is safe for you, particularly if you: have ever had an allergic reaction to duloxetine or any other medication, have kidney or liver issues, have a heart condition, are currently taking or have recently taken other depression medications, have glaucoma, have ever experienced a seizure or fit, have manic episodes or bipolar disorder, bruise easily; are trying to become pregnant, are already pregnant, or are breastfeeding.

Conditions that require special Cymbalta dosing considerations include:

• Liver problems: Duloxetine medication has been connected to a few cases of clinically obvious acute liver injury and transitory asymptomatic rises in blood aminotransferase levels.
• Kidney problems: Renal impairment can influence a drug’s absorption, distribution, protein binding, renal excretion, or nonrenal clearance, all of which can impact pharmacokinetics.
• Glaucoma: Your eye pressure may rise if you use duloxetine.

What to Expect When Increasing Cymbalta Dosage

The side effects of Cymbalta are typically minimal.⁵ These side effects of frequently include nausea, headaches, exhaustion, vertigo, and vomiting. Since they frequently subside a few weeks after the initial dosage, these reactions typically do not necessitate medical treatment.

Age, general health, and how Cymbalta interacts with the body are some variables that affect how someone may respond to the medication. After starting a Cymbalta prescription, symptoms may improve after two to four weeks. Even if you do not feel better, you should not stop taking Cymbalta abruptly because recovery may take longer.

What if I Miss a Dose of Cymbalta?

Take duloxetine exactly as directed until you talk to your doctor about changing your prescription. It is advised to take the missed dose as soon as you remember or to omit it if it is almost time for your next dose of the medication.

When they feel better, some patients think about stopping their medications before the end date. If the medicine is stopped too soon, there is a higher possibility that depression or anxiety may return. If patients want to stop taking their medicine gradually, they should talk to their doctor about a tapering dose. Due to the possibility of antidepressant discontinuation syndrome, it is not recommended to discontinue taking duloxetine right away.⁶ Signs of antidepressant discontinuation syndrome might be flu-like symptoms, nausea, and vomiting.

Can You Overdose on Cymbalta?

Cymbalta overdose can happen and is harmful. This frequently happens when the drug is mixed with other substances. Duloxetine usage, when combined with other drugs, might result in serious consequences. Serotonin syndrome, irregular heartbeat, and convulsions are all possible side effects of duloxetine overdose. If you believe that you or someone else has overdosed on duloxetine, it is advised that you phone 9-1-1 or go to the closest emergency room.

What Should You Do If You Take Too Much Cymbalta?

If you believe that you or someone else has overdosed on Duloxetine, it is advised that you call 9-1-1 or go to the closest emergency room.

Can You Become Addicted to Cymbalta?

Although Cymbalta doesn’t cause the same euphoric high as most other medicines, people have been known to abuse it because of its relaxing and mood-enhancing properties. This misuse puts users at risk for severe side effects, including cramping in the abdomen, convulsions, and severe skin reactions. Call 911 immediately if you have any of these symptoms to seek assistance. Poison control can be reached at 800-222-1222 for additional support.