Patients should be advised to inform their physicians if they are taking, or plan to take, any prescription or over-the-counter medications, since there is a potential for interactions. You may freely link to RxList out how to add an RxList Search box to your website. Patients with these diagnoses were generally excluded from clinical studies during product’s premarketing testing. Although a causal link between the emergence of such symptoms and either the worsening of depression and/or the emergence of suicidal impulses has not established, there is concern that such symptoms may represent precursors to emerging suicidality. Therefore, because Cymbalta is an of both serotonin and norepinephrine reuptake, it is recommended that Cymbalta not be used in combination with an MAOI, or within at least 14 days of discontinuing treatment with an MAOI. If the decision has been made to discontinue treatment, medication should be tapered, as rapidly as is feasible, but with recognition that abrupt discontinuation can be associated with certain symptoms (see PRECAUTIONS and DOSAGE ADMINISTRATION , Discontinuing Cymbalta , for a description of risks of discontinuation of Cymbalta). Furthermore, behaviors with increased reactivity, such as increased startle response to noise and decreased habituation of locomotor activity, were observed in pups following maternal exposure to 30 mg/kg/day. Use in Patients with Concomitant Illness Clinical experience with Cymbalta in patients with concomitant systemic illnesses is limited. In controlled trials in MDD, elevations of alanine transaminase ( ALT ) to >3 times the upper limit of normal occurred in 0. Two placebo-treated patients also had transaminase elevations with elevated bilirubin. , diabetics). Controlled Narrow-Angle Glaucoma In clinical trials, Cymbalta was associated with an increased risk of ; therefore, it should be used cautiously in patients with controlled narrow-angle glaucoma (see CONTRAINDICATIONS , Uncontrolled Narrow-Angle Glaucoma). Postmarketing reports indicate that elevated transaminases, bilirubin and alkaline phosphatase have occurred in patients with chronic liver disease or cirrhosis. Get information when you Google. g. , Mutagenesis, Impairment of Fertility Carcinogenesis Duloxetine was administered in the diet to mice and rats for 2 years. Get RxList-trusted information when you Google. Symptoms such as these may be associated with an increased risk for thinking and behavior and indicate a need for very close monitoring and possibly in the medication. Click here for a screening tool? A gradual reduction in the dose rather abrupt cessation is recommended whenever possible. All pediatric patients being treated with antidepressants for any indication should be closely for clinical , suicidality, and unusual in behavior, especially during the initial few months of a course of drug therapy, or at times of dose changes, either increases or decreases. | |