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Some cases presented with features resembling neuroleptic malignant syndrome. g. In clinical trials , three Cymbalta patients had elevations of transaminases and bilirubin, but also had elevation of alkaline phosphatase , suggesting an obstructive process; in these patients, there was evidence of heavy alcohol use and this may have contributed to the abnormalities seen. There was no significant difference in the frequency of sustained (3 consecutive visits) elevated blood pressure. Laboratory Tests No specific laboratory tests are recommended. g. Because it is possible that duloxetine and alcohol may interact to cause liver injury or that duloxetine may aggravate pre-existing liver disease, Cymbalta should ordinarily not be to patients with substantial alcohol use or evidence of chronic liver disease. All pediatric being treated with antidepressants for any indication should be observed closely for clinical worsening, suicidality, unusual changes in behavior, especially during the initial few months of a course of drug therapy, or at times of dose changes, either increases or decreases. The risk of blood pressure decreases may be greater in patients concomitant medications that induce orthostatic hypotension (such as antihypertensives) or are potent CYP1A2 inhibitors (see CLINICAL PHARMACOLOGY , Drug-Drug Interactions, and PRECAUTIONS , DRUG INTERACTIONS ) in patients duloxetine at doses above 60 mg daily. As observed in DPNP trials, Cymbalta treatment worsens glycemic control in some patients with diabetes. For this reason, Cymbalta is not recommended for patients end-stage renal disease or severe renal impairment ( creatinine clearance <30 mL/min) (see CLINICAL PHARMACOLOGY and DOSAGE AND ADMINISTRATION ). It is also unknown whether the suicidality risk extends to adults. Activation of Mania/Hypomania In placebo-controlled trials in patients with major depressive disorder, activation of mania or hypomania was reported in 0! Tumor incidence was not increased in male mice receiving duloxetine at doses up to 100 mg/kg/day (8 times the MRHD and 4 times the human dose of 120 mg/day on a mg/m 2 basis). Next: Cymbalta - Overdosage & Contraindications » « : Cymbalta - Side Effects &amp; Drug Interactions « previous 1 2 3 4 5 6 7 next » --> Health Tools from WebMD First Aid & Emergencies From allergies to sunburn, we can help. 8%. It should be noted that, in some cases, the clinical picture is consistent with serotonin syndrome (see WARNINGS , Monoamine Oxidase Inhibitors). In clinical trials , three Cymbalta patients had elevations of transaminases and bilirubin, but also had elevation of phosphatasesuggesting an obstructive process; in these patients, there was evidence of heavy alcohol use and this may have contributed to the abnormalities seen. Additionally, duloxetine was not genotoxic in an in vitro mammalian forward mutation assay in mouse lymphoma cells or in an in vitro unscheduled DNA synthesis (UDS) assay in primary rat hepatocytes, and did not induce sister chromatid exchange in Chinese hamster bone marrow in vivo.