Cymbalta Duloxetine 28 Tablets

• Adjunct ingredients: Capsule content: Hypromellose, hydroxypropyl methyl cellulose acetate succinate, sucrose, sugar spheres, talcum, titanium dioxide (E171), triethyl citrate.

Capsule content: gelatin, sodium lauryl sulphate, titanium dioxide (E171), indigo carmin (E132), yellow iron oxide (E172), white food ink Ingredients of white food ink

: titanium dioxide (E171), propylene glycol, shellac, povidone.

You should read this USE INSTRUCTION carefully before you start using this medicine, because it contains important information for you.

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Keep these instructions for use. You can need to read again.

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If you have any further questions, please consult your doctor or pharmacist.

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This medicine has been prescribed for you personally, do not give it to others.

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When using this medicine, tell your doctor if you go to a doctor or to a hospital.

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We sleep exactly as written in this instruction. Do not use high or low doses other than the recommended dose for the medication.

In this Instructions for Use:

1. What is CYMBALTA and what is it used for? 2. Things to consider before using CYMBALTA 3. How to use CYMBALTA? 4. What are the possible side effects? 5. CYMBALTA hiding

headings are included.

1. What is CYMBALTA and what is it used for? CYMBALTA capsules are printed with "60 mg" on opaque green skin and "9542" on opaque blue cap. CYMBALTA is packaged in 28 capsules.

CYMBALTA is a drug containing duloxetine active substance. CYMBALTA increases serotonin and noradrenaline levels in the nervous system.

Cymbalta you (adults)

• Depression

• neuropathic pain associated with diabetes (neuropathic linked to diabetes caused by nerve damage, pain, stabbing, stinging, and as aching, throbbing its equivalent in electrical shock to the medical language of pain is identified with concepts like. Sensation in the area where the pain

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loss may be hot or cold, pressure, can cause the sensation of pain stimuli such as touch.)

• generalized anxiety disorder (generalized anxiety disorder, constantly anxious and nervous feeling,.)

• fibromyalgia (fibromyalgia especially at the back, marked on the neck and shoulder including all visible on the body and fatigue is a musculoskeletal disorder also characterized by pain that may accompany it.)

• chronic pain (bone, chronic pain in the joints or muscles, continuously sensed recurrent sensation of tension, pain and / or stiffness.)

says give for the treatment of named diseases .

CYMBALTA starts to show no effect in the majority of people with depression or anxiety within two weeks, but it can be up to 2-4 weeks before you feel better. When you are feeling better, your doctor may continue to give you CYMBALTA to prevent your depression and anxiety from recurring.

People with diabetic neuropathic pain can go a few weeks until they feel good. If you do not feel well after two months of treatment, speak to your doctor.

2. Before using CYMBALTA

CYMBALTA can only be prescribed by a doctor.

The use of antidepressants in children and young people up to age 24 is likely to increase suicidal thoughts or behavior. For this reason, it is necessary to closely monitor the patient, the family and the caregivers, especially for the reasons such as uneasiness of the patient, unexpected behavior changes such as uneasiness, excessive mobility, or the possibility of suicide during the beginning and the first months of treatment.

Cymbalta Do be used:

If

• duloxetine or if you are allergic to any of the excipients of the drug (See "Excipients" portion)

• If you have liver disease

• have severe kidney disease

• Currently monoamine oxidase inhibitor (MAOI), known are currently using the drug or if you have used within the past 14 days ( "use in combination with other drugs" refer to the section)

• Often fluvoxamine for the treatment of depression, if you are using some infections used in the treatment ciprofloxacin or enoxacin

• If you are using other medicines containing duloxetine ( "use in combination with other drugs" refer to the section)

• Control If you have narrow angle glaucoma (sudden increase in intraocular pressure and severe pain and visual impairment) that is not below

Tell your doctor if you have high blood pressure or heart disease. Your doctor will tell you if you can take CYMBALTA.

Use CYMBALTA CAREFULLY in the following situations The following are the reasons why CYMBALTA may not be suitable for you. If you talk with your doctor any of them before using the present cymbalta in the first of the following:

If

• If you use other medications for the treatment of depression ( "use in combination with other drugs" refer to the section)

• used for the treatment of vegetable roads John's Wort (St. John's Wort) If you are using

• If you have kidney disease

• You have had a seizure • You have a

manic state

• You suffer from bipolar disorder (Bipolar disorder, Manic Depressive Illness)

• You have eye problems such as some glaucoma (increased pressure in the eye)

• Bleeding disorders (tendency to bruise)If you are at

•risk of a low sodium level (eg if you are on diuretic medication, especially if you are older)

• If you are currently using a medication that may cause liver failureIf you havedrug that

•hepatitis, increase your liver enzymesIf you

•are taking anothercontains duloxetine If you are on medication (see section "Use with other medicines")

•if you arecharacter with unwanted or painful restlessness and inability to sit up

CYMBALTA may cause discomfort or difficulty in sitting or restingaccustomed to the. If this happens to you, tell your doctor.

Suicidal thoughts and increased depression or anxiety disorders If you are depressed and / or have an anxiety disorder, sometimes you may be thinking of harming yourself or killing yourself. This may increase when the antidepressant drugs are first used, since it usually takes 2 weeks but sometimes more time to fully demonstrate the effects of these drugs.

If you have the following, you are more likely to think this way:If you have been thinking about

•killing or harming yourself before • You are

a young adult. Data from clinical trials have shown that young adults aged 25 years who have been treated with antidepressants and who have psychiatric disorders tend to be more suicidal.

If you have any unpleasant thoughts or actions at any time, or if any, report them to your doctor immediately.

You can tell if you have a relatives or a close friend that you are depressed or have an anxiety disorder and want to read it from it. This may be useful for you.depression or anxiety disorder is

you may ask whether yourworse byor whether you are worried about the change in your behavior.

Use in children and adolescents under the age of 18: CYMBALTA should not normally be used in children and adolescents under the age of 18. You should also be aware that when these drugs are used in patients under 18 years of age, there is an increased risk of side effects such as suicide attempts, suicidal thoughts, and hostility (aggression, opposition and anxiety). Nevertheless, your doctor may recommend CYMBALTA under the age of 18, believing it will be of benefit. If your doctor prescribes CYMBALTA to a patient under the age of 18, and you want to discuss this, please come back to your doctor. When patients under the age of 18 are taking CYMBALTA, any of the above mentioned symptoms will appear and you should inform your doctor if it gets worse. Long-term safety effects of CYMBALTA on growth, maturation, cognitive and behavioral development in this age group of patients have not yet been demonstrated.

Please consult your doctor if these reminders apply to you at any time in the past.

Use of CYMBALTA with food and drink CYMBALTA can be used on hungry or tummy stomach. Care should be taken when taking alcohol while being treated with CYMBALTA.

Consult your doctor or pharmacist before using Pregnancy Pills.

You can only use CYMBALTA with your doctor's decision after discussing potential benefits and potential risks for your unborn child with your doctor. Do not use CYMBALTA during pregnancy unless it is necessary.

Make sure your doctor knows you use CYMBALTA. If you take medication when you are pregnant, similar medicines (SSRI group medications) can increase the risk of a serious condition called newborn's permanent pulmonary hypertension (PPHN), which causes the baby to breathe faster and blush. These symptoms usually begin within the first 24 hours after birth. If your baby is in such a case, contact your doctor immediately.

If you start using CYMBALTA towards the end of your pregnancy, your baby may show some symptoms when you are born. These symptoms usually begin shortly after birth or within a few days of birth. These symptoms may include loose muscles, tremors, a state of excitement, a lack of nutrition, difficulty breathing, and seizures. If you have any of these symptoms when you are born or if you are worried about the health of your baby, call your doctor if you are on probation.

If you notice that you are pregnant during your treatment, or if you plan to become pregnant, consult your doctor or pharmacist immediately.

Breastfeeding Consult your doctor or pharmacist before using the medicine.

Tell your doctor if you are breastfeeding. The use of lactating CYMBALTA is not recommended.

Using the car and machine CYMBALTA can cause you to feel drowsy and dizzy. Do not use any tools or machinery without knowing how CYMBALTA is affecting you. Important information about some of the ingredients contained in CYMBALTA contains CYMBALTA sucrose. If your doctor tells you that you are not well tolerated with certain sugars, consult your doctor before taking this medicine. CYMBALTA contains less than 1 mmol (23 mg) of sodium per capsule; no side effects due to sodium are expected at this dose.

Duloxetine, an active ingredient of CYMBALTA, is also found in other medicines and can be used in the following situations:

Diabetic neuropathic pain, fibromyalgia, chronic pain of bones, joints or muscles, depression, anxiety and urinary incontinence.

At the same time, avoid using multiple doses of these drugs. Check with your doctor if you are taking any other medicine that currently contains duloxetine.

Your doctor should decide whether you should use CYMBALTA with other medicines. Before you check with your doctor, do not start using any medication, including over-the-counter medicines and herbal medicines, and do not leave any medication you use.

If you are using any medication of the following, tell your doctor:

Monoamine Oxidase Inhibitors (MAOIs): Currently monoamine oxidase inhibitor (MAOI) If you are using any other antidepressant drugs called (or if you have used in the last 14 days) should not use Cymbalta. Examples of MAOIs include moclobemide, an antidepressant, and linezolid, an antibiotic. Using a MAOI with many prescription medicines, including CYMBALTA, can cause side effects that can be serious and even life-threatening. The use of MAOI medicines should be discontinued at least 14 days before using CYMBALTA. You should stop using CYMBALTA 5 days before using a MAOI in the same way.

Sleeping medications: These may include medicines prescribed by your doctor, including benzodiazepines, strong painkillers, antipsychotics, phenobarbital, and antihistamines.

Drugs that increase serotonin levels include: Triptans, tramadol, tryptophan, SSRIs (such as paroxetine and fluoxetine), SNRIs (such as venlafaxine), tricyclic antidepressants (such as clomipramine, amitriptyline), pethidine, St. John's Wort, (such as moclobemide and linezolid). These medicines increase the risk of side effects. If you take any of these medicines together with CYMBALTA and experience any unusual symptoms, contact your doctor.

Oral anticoagulants or antiplatelet agents: blood thinner medications or anti-blood clotting drugs may increase the risk of bleeding.

CYP1A2 inhibitors such as fluvoxamine: CYMBALTA should not be used with inhibitors of CYP1A2, such as fluvoxamine.

CYP1A2 inducers: Smoking increases the activity of CYP1A2 enzyme involved in duloxetine metabolism. For this reason, duloxetine concentrations of 50% lower in plasma than non-smokers were shown.

If you are using or have recently used any medicine with or without a prescription, please tell your doctor or pharmacist about them.

3. How to use CYMBALTA?

Instructions for proper use and dose / application frequency: Always use this medicine as recommended by your doctor or pharmacist. If you are not sure, consult your doctor or pharmacist.

Route of administration and method: For the treatment of depression, diabetic neuropathic pain, fibromyalgia and chronic pain: Recommended CYMBALTA is 60 mg once a day once a day.

For the treatment of general anxiety disorder: CYMBALTA's usual starting dose is 30 mg once daily. The majority of patients will then continue on to 60 mg once a day, but your doctor will prescribe the dose best suited to you. According to what you have given your CYMBALTA, the dose can be adjusted up to 120 mg per day.

If you think that the effect of CYMBALTA is too much or too little, talk to your doctor.

Application form: CYMBALTA is for oral use. Your capsule is swallowed whole with water.

It may be easier to take the pill every day at the same time, since it helps to remember taking CYMBALTA.

Talk to your doctor about how long you should use CYMBALTA. Do not stop using CYMBALTA or change your dose without talking to your doctor. If untreated, your condition may not be recovered, and treatment may become more severe and more difficult.

If you have an impression that the effect of CYMBALTA is too strong or weak, talk to your doctor or pharmacist.

Different age groups:

Children and adolescence CYMBALTA should not normally be used in children and adolescents under 18 years of age.

There is no specific dose recommendation for patients over 65 years of age.

Special use cases CYMBALTY should not be used in patients with end-stage renal disease (requiring dialysis) or patients with severe renal impairment (estimated creatinine clearance <30 mL / min).

CYMBALTA should not be used in patients with any hepatic insufficiency.

If you use more CYMBALTA than you need: Patients who use more CYMBALTA than they need to use can experience the following symptoms: drowsiness, coma, serotonin syndrome (rarely feeling too much happiness, dizziness, clumsiness, restlessness, feeling drunk, fever, sweating, ), seizures, vomiting and heart attack.

If you use more than you need from CYMBALTA, talk to a doctor or pharmacist.

If you forget to use CYMBALTA: Do not take double doses to compensate for forgotten doses.

You notice that you have forgotten your pawn right away. But if it's time for the next dose, skip the dose you missed and take your next dose at the scheduled time. Do not use more CYMBALTA in a day than the amount prescribed for you on a daily basis.

CYMBALTA: If you feel better, do not stop using your capsules without telling your doctor. Your doctor will now ask you to reduce your dose for at least 2 weeks before stopping the treatment completely, since you no longer need to use CYMBALTA. Some patients who suddenly stop CYMBALTA may have the following symptoms:

(Such as dizziness, tingling sensation such as pinning, or feelings like electric shock (especially on your head), sleep disorders (vivid dreams, nightmares, sleepiness), fatigue, drowsiness, disturbed or anxious feelings, anxiety, nausea or vomiting, muscle aches, restlessness, diarrhea, excessive sweating, or vertigo (dizziness due to impaired balance).

These symptoms are usually not serious and disappear within a few days, but if you have symptoms that are causing problems for you, you should consult your doctor for recommendations.

If you have any additional questions about the use of this medicine, your doctor and pharmacist are ok.

4. What are the possible side effects?

As with all medicines, there may be side effects in people sensitive to substances in the contents of CYMBALTA.

Very common: it can be seen in at least 1 of 10 patients.

Common: less than 1 in 10 patients but more than 1 in 100 patients. Uncommon: less than 1 in 100 patients but more than 1 in 1,000 patients. Rare: less than 1 in 1,000 patients but more than 1 in 10,000 patients. Very rare: less than 1 in 10,000 patients. Unknown: It can not be predicted by moving from the available data.

Very common

• Headache, drowsy

• Nausea, mouthiness

Common

• Loss of appetite

• Stiffness, uneasiness, reduced sexual desire, anxiety, difficulty with orgasm orexperience, abnormal dreams

lack of• Dizziness, lethargy, chills, skin tingling and tingling

• Blurred vision

• Tinnitus (hearing sound even though there is no external sound)

• Sensation of heartbeat on the

Increase in blood pressure, increased pressure

head •• Increased stiffness

• Constipation, diarrhea, stomachache, vomiting, stomach uptightness or indigestion, gas discharge

• Increase in swelling, itchy rash

• Muscle aches, muscle contraction

• Painful urination, frequent urination

• Erectile dysfunction, premature ejaculation

• Falls (mostly in elderly patients), fatigue

• Weight loss

Children under 18 with depression treated with this medication and adolescents take the illegal first they experienced some weight loss when they started. Six months after the treatment started, they reached the same weight as other children and adolescents in their age and gender group.

Uncommon

• Infection in the throat that causes loudness,

• Suicidal thoughts, difficulty sleeping, grinding teeth or squeezing teeth, feeling mental confusion, loss of motivation

• Sudden contractions and strains in muscles, feelings of restlessness or inability to feel nervous, restlessness of legs syndrome, impairment of sleep quality,Difficulty in controlling movements, eg, lack of coordination or involuntary movements of the muscles, restless legs syndrome,

• Growing of eyeballs (dark center of the eye), vision problems

• Dizziness or dizziness, vertigo, earache