Cymbalta is a brand-name capsule that’s prescribed for certain conditions, such as depression. Cymbalta contains the active ingredient duloxetine and belongs to the serotonin-norepinephrine reuptake inhibitor (SNRI) drug class.

The Food and Drug Administration (FDA) has approved Cymbalta to treat the following in adults:

Cymbalta is also approved to treat the following in children:

  • GAD in children ages 7 years and older
  • fibromyalgia in children ages 13 years and older

For more information about how Cymbalta is used to treat these conditions, see the “Cymbalta uses” section below.

Drug details

You’ll find key information about Cymbalta below.

  • Drug form: delayed-release oral capsule
  • Generic available? yes
  • Prescription required? yes
  • Controlled substance? no
  • Year of FDA approval: 2004

Cymbalta is available as a generic drug called duloxetine. A generic drug is an exact copy of the active drug in a brand-name medication. The generic is considered to be as safe and effective as the original drug. Generics tend to cost less than brand-name drugs.

If you’re interested in taking the generic form of Cymbalta, talk with your doctor. They can tell you whether it comes in strengths that can be used for your condition.

Cymbalta can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Cymbalta. These lists do not include all possible side effects.

For more information on the possible side effects of Cymbalta, talk with your doctor or pharmacist. They can give you tips on how to manage any side effects that may be bothersome.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs it has approved. If you would like to notify the FDA about a side effect you’ve had with Cymbalta, you can do so through MedWatch.

Mild side effects

Mild side effects of Cymbalta can include:*

Most of these side effects may go away within a few days or a couple of weeks. But if they become more severe or do not go away, talk with your doctor or pharmacist.

* This is a partial list of mild side effects from Cymbalta. To learn about other mild side effects, talk with your doctor or pharmacist, or visit Cymbalta’s prescribing information.
† For more information on this side effect, see “Side effect details” below.
‡ Sex and gender exist on spectrums. In this article, use of the terms “male” and “female” refers to sex assigned at birth.

Serious side effects

Serious side effects from Cymbalta aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

Serious side effects and their symptoms can include:

* For more information on this side effect, see “Side effect details” below.
† Cymbalta has a boxed warning for this side effect. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). To learn more, see “Side effect details” below.

Side effects in children

Cymbalta is approved for use in children ages 7 years and older with generalized anxiety disorder (GAD). It’s also approved for use in children ages 13 years and older with fibromyalgia.

Mild side effects of Cymbalta in children commonly seen in clinical trials include:*

  • abdominal pain
  • decreased appetite
  • decreased weight
  • diarrhea
  • fatigue
  • headache
  • nausea or vomiting

Cymbalta can also increase the risk of suicidal thoughts and behaviors in children. The drug has a boxed warning for this side effect. To learn more, see “Side effect details” below.

Other serious side effects weren’t reported in Cymbalta clinical trials with children. If you have additional questions about potential serious side effects your child may experience with Cymbalta, talk with your child’s doctor.

* This is a partial list of mild side effects from Cymbalta that occur in children. To learn about other mild side effects, talk with your child’s doctor or pharmacist, or visit Cymbalta’s prescribing information.

How long do side effects from Cymbalta last?

How long side effects from Cymbalta last can vary depending on the side effect.

Also, your risk of certain side effects may be higher when you first start taking the drug. For example:

  • Your risk of suicidal thoughts or behaviors may be highest in your first few months of taking Cymbalta or after your dose is changed. However, this can occur at any time while taking Cymbalta.
  • Your risk of orthostatic hypotension (changes in blood pressure when you stand suddenly that could lead to falls) may be highest in your first week of taking Cymbalta.

Other side effects may occur for as long as you’re taking the drug. One example is nausea. For some people, taking Cymbalta with food may help prevent or lessen this side effect.

If you have questions about how long Cymbalta side effects last or how to manage them, talk with your doctor or pharmacist.

Side effect details

You may wonder how often certain side effects occur with this drug. Here’s some detail on certain side effects this drug may cause.

For further details about Cymbalta’s side effects, see this article.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Cymbalta. Symptoms of a mild allergic reaction can include:

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your tongue, mouth, or throat
  • trouble breathing
  • blisters
  • peeling rash

It’s not known how often allergic reaction occurred in people taking Cymbalta in clinical trials.

Call your doctor right away if you have a severe allergic reaction to Cymbalta. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

Weight gain and weight loss

Cymbalta may cause weight loss or weight gain. However, weight loss is more common in children taking Cymbalta than in adults taking the drug. This is based on what was seen in clinical trials of Cymbalta.

While taking Cymbalta, your child’s doctor will monitor their weight to make sure it stays in a healthy range for their age. If their doctor has any concerns with your child’s weight, they may have your child try a different medication to treat their condition.

If you have questions or concerns about weight gain or loss while taking Cymbalta, talk with your doctor.

Insomnia

Some people may experience insomnia (trouble sleeping) while taking Cymbalta, as reported in clinical trials.

With insomnia, you can have trouble falling asleep or staying asleep. It can cause you to wake up too early. If you experience sleep issues while taking Cymbalta, talk with your doctor. They may suggest ways to manage this side effect. Or they may have you try a different medication to treat your condition.

Headache

Headaches can occur while taking Cymbalta. This side effect was reported in clinical trials of the drug.

Headache can also be a symptom of hyponatremia (low sodium levels). This is a serious side effect that can occur with Cymbalta. For this reason, contact your doctor if you experience headaches that don’t go away or seem severe while taking Cymbalta. Your doctor can determine the cause of your headaches. They may also decide to have you try a different medication for your condition.

Suicidal thoughts and behaviors

Like other antidepressants, Cymbalta may raise the risk of suicidal thoughts and behaviors. Cymbalta has a boxed warning for this side effect. A boxed warning is the most serious warning from the FDA.

Clinical trials have shown that antidepressants increase the risk of suicidal thoughts and behaviors in children and young adults ages 18 to 24 years. It’s thought that this risk is highest in the first few months of treatment with Cymbalta or after the dose has been changed.

In people ages 65 years and older, antidepressants can actually reduce the risk of suicidal thoughts and behaviors.

During your treatment, you should watch closely for any new or sudden changes in your behavior, feelings, moods, or thoughts. Also ask your family members, caregivers, and healthcare professionals to look for changes in your behavior or moods. Call your doctor right away if you or someone else notices any changes.

Also, if you experience any of the following feelings or symptoms, call your doctor right away:

  • aggressive or violent behavior
  • anxiety or depression that’s new or gets worse
  • mania (extreme increases in activity or talking)
  • feeling very restless, agitated, or irritated
  • panic attacks
  • thoughts about suicide or dying
  • other unusual changes in your behavior or mood

Suicide prevention

If you know someone at immediate risk of self-harm, suicide, or hurting another person:

  • Ask the tough question: “Are you considering suicide?”
  • Listen to the person without judgment.
  • Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
  • Stay with the person until professional help arrives.
  • Try to remove any weapons, medications, or other potentially harmful objects if it’s safe to do so.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.

Find more links and local resources.

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The Food and Drug Administration (FDA) approves prescription drugs such as Cymbalta to treat certain conditions. Cymbalta may also be used off-label for other conditions. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.

The FDA has approved Cymbalta to treat the following in adults:

Cymbalta is also approved to treat the following in children:

  • GAD in children ages 7 years and older
  • fibromyalgia in children ages 13 years and older

Cymbalta for depression

Cymbalta is FDA-approved to treat major depressive disorder (MDD), also commonly called depression. With this condition, you may feel sadness, loss, or anger that interferes with your daily activities.

Symptoms of depression can vary from person to person. However, some common symptoms include:

  • digestive problems
  • feeling tired easily
  • not being able to concentrate or complete tasks
  • loss of interest in activities you usually enjoy
  • mood changes, such as feeling irritable
  • sleeping problems (such as sleeping too much or too little)
  • thoughts of suicide or dying

The causes of depression aren’t fully known. It also isn’t known how Cymbalta works to treat depression. However, it’s thought that the drug changes the levels of certain chemicals in your brain that affect your mood and well-being.

To learn more about MDD, visit our depression and mental health hubs.

Effectiveness for depression

Clinical trials have shown Cymbalta to be effective for treating depression. For details about these trials, see the Cymbalta prescribing information.

Cymbalta for anxiety

Cymbalta is FDA-approved to treat generalized anxiety disorder (GAD).

Almost everyone experiences anxiety at some point. It’s our body’s natural stress response. However, you may experience extreme feelings of anxiety, or anxiety that lasts longer than 6 months. If these feelings interfere with your daily life, you may have an anxiety disorder.

People with GAD have excessive anxiety that can occur frequently. Symptoms of GAD can vary but may include:

  • trouble concentrating
  • fast heart rate
  • rapid breathing
  • restlessness
  • trouble falling asleep

It isn’t known what causes GAD. It’s also not known how Cymbalta treats GAD. It’s thought that the drug changes levels of certain chemicals in the brain that affect mood and well-being.

To learn more about GAD, visit our anxiety and mental health hubs.

Effectiveness for anxiety

Clinical trials have shown Cymbalta to be effective for treating GAD. For details about these trials, see the Cymbalta prescribing information.

Cymbalta for pain from diabetic neuropathy

Cymbalta is FDA-approved to treat pain from diabetic neuropathy (nerve damage).

Diabetic neuropathy is a common condition in people with type 1 and type 2 diabetes. People with diabetes have high levels of glucose (sugar) in their blood. Over time, having increased glucose levels can cause nerve damage. Symptoms of diabetic neuropathy include numbness, pain, tingling, or weakness in the hands or feet.

It isn’t exactly known how Cymbalta works to treat pain from diabetic neuropathy. It’s thought that the drug reduces pain signals by changing the activity of certain chemicals in the brain.

To learn more about diabetic neuropathy, visit our diabetes hub.

Effectiveness for pain from diabetic neuropathy

Clinical trials have shown Cymbalta to be effective for treating pain from diabetic neuropathy. For details about these trials, see the Cymbalta prescribing information.

Cymbalta for fibromyalgia

Cymbalta is FDA-approved to treat fibromyalgia. This is a chronic (long-term) condition that can cause:

  • areas of tenderness
  • difficulty concentrating or thinking clearly
  • fatigue
  • musculoskeletal pain (pain in the bones, muscles, ligaments, nerves, and tendons)
  • trouble sleeping

It’s not known what causes fibromyalgia. There aren’t tests to diagnose it, and its symptoms are similar to those of other conditions. Fibromyalgia is often misdiagnosed and can be difficult to treat.

It’s also not known how Cymbalta works to treat fibromyalgia.

To learn more about fibromyalgia, refer to our list of fibromyalgia articles.

Effectiveness for fibromyalgia

Clinical trials have shown Cymbalta to be effective for treating fibromyalgia. For details about these trials, see the Cymbalta prescribing information.

Cymbalta for chronic musculoskeletal pain

Cymbalta is FDA-approved to treat chronic musculoskeletal pain. This refers to pain in the bones and muscles. Chronic pain is pain that lasts for more than 3 to 6 months.

It isn’t known how Cymbalta works to treat chronic musculoskeletal pain. It’s thought that the drug reduces pain signals by changing the activity of certain chemicals in the brain.

Effectiveness for chronic musculoskeletal pain

Clinical trials have shown Cymbalta to be effective for treating musculoskeletal pain. For details about these trials, see the Cymbalta prescribing information.

Cymbalta and children

Cymbalta is FDA-approved for use in children ages 7 years and older with GAD. It’s also approved for use in children ages 13 years and older with fibromyalgia.

Clinical trials have shown Cymbalta to be effective for treating these conditions in children.

The Cymbalta dosage your doctor prescribes will depend on several factors. These include:

  • the type and severity of the condition you’re taking Cymbalta to treat
  • your age
  • other medical conditions you may have
  • other medications you take
  • how your condition responds to Cymbalta
  • side effects you experience from the medication

Typically, your doctor will start you on a low dosage. Then they’ll adjust it over time to reach the amount that’s right for you. Your doctor will ultimately prescribe the smallest dosage that provides the desired effect.

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Drug forms and strengths

Cymbalta comes as a delayed-release oral capsule. (“Delayed release” means the drug is released into your body after the capsule passes into your intestine.) The capsules are available in three strengths: 20 milligrams (mg), 30 mg, and 60 mg.

Dosage for depression

The recommended starting dosage for treating depression in most adults is 40 to 60 mg daily. For the 40-mg dosage, you’ll take 20 mg twice per day. For the 60-mg dosage, you’ll take either 30 mg twice per day or 60 mg once per day. Your doctor may decide to start you on 30 mg per day before increasing to a higher dosage, however.

The maximum dosage of Cymbalta for treating depression in adults is 120 mg per day. However, it’s important to note that in clinical trials, researchers didn’t notice any benefit when the Cymbalta dose was increased above 60 mg per day. Because of this, the 120-mg dose isn’t recommended very often.

Dosage for anxiety

In adults younger than age 65 years, the recommended Cymbalta dosage for treating anxiety is 60 mg once per day. Your doctor may decide to start you on 30 mg once per day before increasing to this dose, however.

In adults ages 65 years and older, it’s recommended to start Cymbalta at a dose of 30 mg once per day. This dose should be continued for 2 weeks. After that, your doctor may increase the dose to 60 mg per day.

The maximum dosage of Cymbalta for treating anxiety in adults of any age is 120 mg per day. However, it’s important to note that in clinical trials, researchers didn’t notice any benefit when the Cymbalta dose was increased above 60 mg per day. Because of this, the 120-mg dose isn’t recommended very often.

Dosage for pain from diabetic neuropathy

For treating pain from diabetic neuropathy in adults, the recommended dose of Cymbalta is 60 mg once per day. Doses above 60 mg aren’t recommended for treating this condition.

Dosage for fibromyalgia

The recommended Cymbalta dosage for treating fibromyalgia in adults is 60 mg once per day. You’ll start by taking 30 mg once daily. After a week, your doctor may increase your dosage to 60 mg once daily. Doses above 60 mg are not recommended for treating this condition.

Dosage for chronic musculoskeletal pain

The recommended Cymbalta dose for treating chronic musculoskeletal pain in adults is 60 mg once per day.

You’ll start by taking 30 mg once daily. After a week, your doctor may increase your dosage to 60 mg once daily. Doses above 60 mg are not recommended for treating this condition.

Pediatric dosage

Cymbalta is approved to treat GAD and fibromyalgia in children.

Dosage for treating anxiety in children

For treating GAD in children ages 7 to 17 years, the recommended dosage of Cymbalta is 30 mg once per day. This dosage should be used for at least 2 weeks. After that, your child’s doctor can consider whether the dosage should be increased to 60 mg per day.

The maximum dosage for treating anxiety in children is 120 mg per day.

Dosage for treating fibromyalgia in children

For treating fibromyalgia in children ages 13 to 17 years, the recommended Cymbalta dosage is 30 mg once per day. Your child’s doctor may increase the dosage to 60 mg once per day, based on how well your child responds to the drug.

Dosage questions

Below are answers to some questions you may have about taking Cymbalta. For more information, refer to this article.

What if I miss a dose?

If you miss a dose of Cymbalta, take your missed dose as soon as you remember. However, if it’s almost time for your next dose, just skip your missed dose and take your next dose as scheduled. You should not take two doses at once to make up for a missed dose. This may raise your risk of side effects from the drug.

To help make sure you do not miss a dose, try using a medication reminder. This can include setting an alarm on your phone or downloading a reminder app. A kitchen timer can work, too.

Will I need to use this drug long term?

Cymbalta is meant to be used as a long-term treatment. If you and your doctor determine that Cymbalta is safe and effective for you, you’ll likely take it long term.

Cymbalta may cause withdrawal symptoms if the drug is stopped suddenly. Withdrawal symptoms are side effects that can occur when you stop taking a drug that your body has become dependent on. With dependence, your body needs the drug to function as usual.

Withdrawal symptoms of Cymbalta can include:

Because of the risk of withdrawal symptoms, you should not abruptly stop taking Cymbalta. To help lower your risk of these symptoms, your doctor will gradually reduce your dosage over time. This is known as a drug taper.

There isn’t a recommended length of time your taper should last. The length of your taper may depend on the dose of Cymbalta you take and the condition it’s being used to treat.

There haven’t been studies on whether Cymbalta can cause drug dependence. Studies in rats didn’t show a risk of dependence, but animal studies do not always predict what will happen in humans.

If you have additional questions about your risk of withdrawal or dependence with Cymbalta, talk with your doctor.

How long does Cymbalta stay in your system?

Cymbalta stays in your system for about 3 days after your last dose. If you have questions about how long you’ll feel the effects of the drug, including potential withdrawal symptoms, talk with your doctor.

Here are answers to some frequently asked questions about Cymbalta.

Is Cymbalta an SSRI?

No, Cymbalta isn’t a selective serotonin reuptake inhibitor (SSRI). However, it’s similar to an SSRI.

Cymbalta belongs to a class of medications known as serotonin-norepinephrine reuptake inhibitors (SNRIs). It affects your levels of both serotonin and norepinephrine, two chemicals that help nerve cells communicate. SSRIs, on the other hand, only affect your serotonin levels.

If you have questions about whether an SSRI or SNRI is right for treating your condition, talk with your doctor.

Is Cymbalta a controlled substance? Is it a narcotic?

No, Cymbalta isn’t a controlled substance or a narcotic. “Narcotics” is another term for opioids, which are a type of pain reliever. Controlled substances are medications that could cause either physical or mental dependence. With dependence, your body needs the drug to function as usual. The Drug Enforcement Administration (DEA) sets limits on who can make, possess, and use medications that are controlled substances.

Animal studies of Cymbalta didn’t show dependence in rats, although animal studies do not always predict what will happen in humans.

However, Cymbalta could cause withdrawal symptoms if you stop taking the drug suddenly. See the “Cymbalta withdrawal and dependence” section above to learn more.

Clinical trials didn’t show any signs that Cymbalta is addictive. Addiction is different from dependence. Addiction involves your brain’s reward pathways. It can lead someone to continue using a drug even though it’s causing serious problems in their life.

Although Cymbalta isn’t known to cause dependence or addiction, it’s not always possible to predict whether it could lead to misuse. (Misuse refers to taking a drug in a way other than how a doctor prescribes it.) This is because the drug affects your central nervous system (CNS). The CNS is where your brain’s reward pathways (which can be involved with addiction) are located.

If you have questions or concerns about your risk of dependence with Cymbalta, talk with your doctor.

How does Cymbalta make you feel?

Cymbalta is approved to treat mood disorders, such as depression and anxiety. Because it affects your mood, some people report feeling calm or having their mood boosted while taking the drug.

Cymbalta doesn’t make you feel “high” or euphoric. If you have questions about how Cymbalta may affect you, talk with your doctor or pharmacist.

Does Cymbalta make you sleepy?

It’s possible that you’ll feel sleepy while taking Cymbalta. This was one of the more common side effects of the drug in clinical trials.

Because Cymbalta can cause sleepiness, it’s important to use caution and avoid driving or operating machinery until you know how the drug will affect you.

If you have questions about side effects from Cymbalta, talk with your doctor or pharmacist. You can also learn more in the “Cymbalta side effects” section above.

You may wonder how Cymbalta compares with other medications that are prescribed for similar uses. Here we look at how Cymbalta and Lexapro are alike and different.

Ingredients

Cymbalta contains the active drug duloxetine. Lexapro contains the active drug escitalopram.

Cymbalta belongs to a class of medications known as serotonin-norepinephrine reuptake inhibitors (SNRIs). Lexapro belongs to a class of medications called selective serotonin reuptake inhibitors (SSRIs). SNRIs and SSRIs work in similar ways but do have differences. Both types of drugs are commonly used as antidepressants.

Uses

Here is a list of conditions that the Food and Drug Administration (FDA) has approved Cymbalta and Lexapro to treat.

Drug forms and administration

Cymbalta comes as a delayed-release oral capsule. (“Delayed release” means the drug is released into your body slowly over time.) It’s taken either once or twice per day.

Lexapro is available as a tablet that’s taken by mouth once per day.

Side effects and risks

Cymbalta and Lexapro have some similar side effects and others that vary. Below are examples of these side effects.

Mild side effects

This list contains 10 of the most common mild side effects that can occur with both Cymbalta and Lexapro (when taken individually):

Serious side effects

These lists contain examples of serious side effects that can occur with Cymbalta, with Lexapro, or with both drugs (when taken individually).

* Both Cymbalta and Lexapro have a boxed warning for this side effect. This is the most serious warning from the Food and Drug Administration (FDA). See “Side effect details” in the “Cymbalta side effects” section above to learn more about this warning for Cymbalta. Your doctor can tell you more about Lexapro’s boxed warning.

Effectiveness

Cymbalta and Lexapro have different FDA-approved uses, but they’re both used to treat the following conditions:

  • major depressive disorder (MDD) in adults
  • generalized anxiety disorder (GAD) in adults and children ages 7 years and older

The use of Cymbalta and Lexapro in treating depression in adults has been compared in a 2012 meta-analysis. A meta-analysis is a type of study that looks at the results of numerous clinical trials to see whether there are any consistent results across the studies.

In this meta-analysis, researchers looked at 16 different clinical trials that compared Cymbalta to other antidepressants, including three studies that compared Cymbalta with Lexapro. The researchers found the two drugs to be similarly effective for treating depression.

Cymbalta and Lexapro have also been compared in a 2019 meta-analysis for treating anxiety in adults. The researchers looked at 41 clinical trials involving a total of 11 antidepressants, including Cymbalta and Lexapro. They found Cymbalta and Lexapro to be similarly effective for treating anxiety.

Currently, there are no studies directly comparing Cymbalta and Lexapro for GAD in children. Separate clinical trials have shown that these drugs are safe and effective for treating this condition in children. For details of these clinical trials, see the prescribing information for Cymbalta and Lexapro.

Costs

The actual price you’ll pay for either Cymbalta or Lexapro depends on your insurance plan, your location, and the pharmacy you use.

Cymbalta is available as a generic drug called duloxetine. Lexapro is available as a generic drug called escitalopram. A generic drug is an exact copy of the active drug in a brand-name medication. The generic is considered to be as safe and effective as the original drug. Generics tend to cost less than brand-name drugs.

Visit Optum Perks to find coupons and savings for Cymbalta and Lexapro.

Cymbalta and Effexor XR are prescribed for similar uses. Here we look at how these drugs are alike and different.

Ingredients

Cymbalta contains the active drug duloxetine. Effexor XR contains the active drug venlafaxine extended release (ER). “Extended release” means the drug is slowly released into your body over a period of time.

Duloxetine and venlafaxine ER both belong to a class of medications known as serotonin-norepinephrine reuptake inhibitors (SNRIs). This medication class is commonly used as antidepressants.

Uses

Here is a list of conditions that the Food and Drug Administration (FDA) has approved Cymbalta and Effexor XR to treat.

Drug forms and administration

Cymbalta comes as a delayed-release oral capsule. (“Delayed release” means the drug is released into your body after the capsule passes into your intestine.) It’s taken either once or twice per day.

Effexor XR comes as an extended-release capsule that’s taken by mouth once per day. (“Extended release” means the drug is slowly released into your body over a long period of time.)

Side effects and risks

Cymbalta and Effexor XR have some similar side effects and others that differ. Below are examples of these side effects.

Mild side effects

This list contains 10 of the most common mild side effects that can occur with both Cymbalta and Effexor XR (when taken individually):

Serious side effects

These lists contain examples of serious side effects that can occur with Cymbalta, with Effexor XR, or with both drugs (when taken individually).

* Both Cymbalta and Effexor XR have a boxed warning for this side effect. This is the most serious warning from the Food and Drug Administration (FDA). See “Side effect details” in the “Cymbalta side effects” section above to learn more about this warning for Cymbalta. Your doctor can tell you more about Effexor XR’s boxed warning.

Effectiveness

Cymbalta and Effexor XR have different FDA-approved uses, but they’re both used to treat the following conditions:

  • major depressive disorder (MDD) in adults
  • generalized anxiety disorder (GAD) in adults

The use of Cymbalta and Effexor XR in treating depression in adults has been compared in a 2012 meta-analysis. A meta-analysis is a type of study that looks at the results of numerous clinical trials to see whether there are any consistent results across the studies.

In this meta-analysis, researchers looked at 16 clinical trials comparing Cymbalta with other antidepressants, including three studies that compared Cymbalta with Effexor XR. The researchers found the two drugs to be similarly effective for treating depression.

A 2019 meta-analysis compared several different types of medications to a placebo (treatments with no active drug ingredient) for treating generalized anxiety disorder (GAD) in adults. The results confirmed that certain antidepressants, including duloxetine and venlafaxine, are more effective than the placebo for GAD. The results also suggest that duloxetine and venlafaxine are better tolerated than certain other antidepressants.

Costs

The actual price you’ll pay for either Cymbalta or Effexor XR depends on your insurance plan, your location, and the pharmacy you use.

Cymbalta is available as a generic drug called duloxetine. Effexor XR is available as a generic drug called venlafaxine ER. A generic drug is an exact copy of the active drug in a brand-name medication. The generic is considered to be as safe and effective as the original drug. Generics tend to cost less than brand-name drugs.

Visit Optum Perks to find coupons and savings for Cymbalta and Effexor XR.

Other drugs are available that can treat your condition. Some may be a better fit for you than others. If you’re interested in finding an alternative to Cymbalta, talk with your doctor. They can tell you about other medications that may work well for you.

Note: Some of the drugs listed here are used off-label to treat these specific conditions. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.

Alternatives for depression

Examples of other drugs that may be used to treat depression include:

Alternatives for anxiety

Examples of other drugs that may be used to treat anxiety include:

  • benzodiazepines, such as:
  • buspirone
  • selective serotonin reuptake inhibitors (SSRIs), such as:
    • citalopram (Celexa)
    • escitalopram (Lexapro)
    • fluoxetine (Prozac)
    • fluvoxamine (Luvox)
    • paroxetine (Paxil)
    • sertraline (Zoloft)

Alternatives for pain from diabetic neuropathy

Examples of other drugs that may be used to treat pain from diabetic neuropathy (nerve damage) include:

Alternatives for fibromyalgia

Examples of other drugs that may be used to treat fibromyalgia include:

  • amitriptyline
  • cyclobenzaprine
  • gabapentin (Neurontin)
  • milnacipran (Savella)
  • pregabalin (Lyrica)
  • selective serotonin reuptake inhibitors (SSRIs), such as:
    • fluoxetine (Prozac)
    • paroxetine (Paxil)
    • sertraline (Zoloft)
  • venlafaxine, venlafaxine ER (Effexor XR)

Alternatives for chronic musculoskeletal pain

Examples of other drugs that may be used to treat chronic musculoskeletal pain (ongoing pain in the bones and muscles) include:

It’s possible that Cymbalta and alcohol can interact and cause damage to your liver.

On its own, Cymbalta has caused liver damage and liver failure. In rare cases, this liver damage was fatal. Liver damage wasn’t reported in clinical trials, but there have been reports of liver damage since the drug was first approved.

People taking Cymbalta should avoid drinking excessive amounts of alcohol. That’s because excessive alcohol use can also damage the liver over time. Therefore, drinking heavily during your Cymbalta treatment could raise your risk of liver damage even more. For more information, see “Liver or kidney problems” in the “Cymbalta precautions” section below.

If you drink alcohol, talk with your doctor before you start taking Cymbalta. Depending on the amount of alcohol you consume, they may decide to have you try a different medication for your condition.

Cymbalta is FDA-approved to treat the following in adults:

Cymbalta is also FDA-approved to treat the following in some children:

  • GAD in children ages 7 years and older
  • fibromyalgia in children ages 13 years and older

It isn’t known how Cymbalta works to treat any of these conditions. However, it’s thought that the drug changes the levels of certain chemicals in your brain that affect your mood and well-being. The drug may also reduce pain signals by changing the activity of certain chemicals in the brain.

Cymbalta belongs to a drug class called serotonin-norepinephrine reuptake inhibitors (SNRIs).

How long does it take to work?

Cymbalta begins working as soon as you take your dose. It takes about 3 days for levels of the drug to become stable in your body. Depending on the condition it’s being used to treat, it may take longer than this before you notice the full effects of the drug.

For example, in clinical trials, some adults with pain caused by diabetic neuropathy (nerve damage), as well as some adults with fibromyalgia, noticed improvement within 1 week of starting the drug.

However, the National Alliance on Mental Illness notes that full improvement of depression symptoms may take up to 8 weeks.

If you have questions about how Cymbalta works, or how long it takes to work, talk with your doctor or pharmacist.

Cymbalta can interact with several other medications. It can also interact with certain supplements.

Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase side effects or make them more severe.

In addition to the information below, you can see this article to learn about Cymbalta’s interactions.

Cymbalta and other medications

Below are lists of medications that can interact with Cymbalta. These lists do not contain all drugs that may interact with Cymbalta.

Before taking Cymbalta, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Cymbalta and other drugs that affect serotonin (such as Adderall and tramadol)

Cymbalta can increase serotonin levels in your body. Using Cymbalta with other drugs that also increase serotonin may raise your risk of serotonin syndrome.

Serotonin syndrome is a rare but potentially life threatening condition. It’s caused by increased blood levels of serotonin. Taking multiple medications that increase serotonin could cause serotonin to build up to dangerous levels in your blood.

Examples of other drugs that can increase serotonin levels include:

Before taking Cymbalta, be sure to tell your doctor if you take any of the medications listed above. They may want to monitor you for any signs of serotonin syndrome. Or they may have you take a different drug to treat your condition.

Drugs that inhibit CYP1A2 or CYP2D6

Certain medications inhibit (slow down) the activity of two enzymes, called CYP1A2 and CYP2D6. Taking Cymbalta with these drugs may increase Cymbalta levels in your body.

The CYP1A2 and CYP2D6 enzymes help your body break down drugs. Slowing down this process could raise your risk of side effects from Cymbalta.

Certain drugs have stronger effects on these enzymes. You should not use Cymbalta with medications that are considered strong CYP1A2 inhibitors. Examples of strong CYP1A2 inhibitors include:

  • cimetidine (Tagamet HB)
  • ciprofloxacin (Cipro)
  • fluvoxamine (Luvox)

Drugs that inhibit the CYP2D6 enzyme may also affect Cymbalta levels. However, this interaction isn’t as serious as with CYP1A2 inhibitors. Examples of CYP2D6 inhibitors include:

  • fluoxetine (Prozac)
  • paroxetine (Paxil)
  • quinidine

Before you take Cymbalta, be sure to tell your doctor if you take any of these medications. They can determine which drug is the best fit for you.

Drugs that are metabolized by CYP2D6

Although Cymbalta is broken down by CYP2D6, the drug can also inhibit (slow down) this enzyme. This means it can affect the levels of other drugs that are also broken down by this enzyme.

This should not cause issues with most medications broken down by CYP2D6. However, some medications can cause side effects if their levels in your body are changed slightly. Examples of these drugs include:

  • TCAs, such as:
    • amitriptyline
    • imipramine
    • nortriptyline
  • certain drugs for irregular heartbeat, including:
    • flecainide
    • propafenone
  • thioridazine (should not be used with Cymbalta)

Before taking Cymbalta, talk with your doctor about all the medications you take. They can determine whether Cymbalta can be taken with your other medications.

Drugs that affect your blood’s ability to clot

Drugs that affect serotonin levels, such as Cymbalta, may increase your risk of bleeding. If Cymbalta is used with drugs that affect your blood’s ability to form clots, this may raise your risk even more.

Examples of drugs that affect your blood’s ability to clot include:

Before taking Cymbalta, tell your doctor if you take any of the medications listed above. They may monitor you more closely to see whether you’re at risk of bleeding. This monitoring may include ordering blood tests. Or they may decide to use a different medication to treat your condition.

Cymbalta and herbs and supplements

You should not use Cymbalta with St. John’s wort. This is an herb that some people take for depression.

Cymbalta can raise your serotonin levels. Because St. John’s wort also increases serotonin levels, taking Cymbalta with this supplement may raise your risk of serotonin syndrome. For more information on serotonin syndrome, see the “Cymbalta and other drugs that affect serotonin (such as Adderall and tramadol)” section above.

Cymbalta and foods

There aren’t any foods that have been specifically reported to interact with Cymbalta. If you have any questions about eating certain foods with Cymbalta, talk with your doctor.

Cymbalta may cause complications if taken during pregnancy. However, more research is needed in this area.

Research has shown that taking Cymbalta the month before delivery may increase the risk of postpartum hemorrhage (severe bleeding immediately after giving birth). However, other studies haven’t shown a clear risk of congenital anomalies (commonly known as birth defects) caused by Cymbalta.

If you’re pregnant or planning a pregnancy, talk with your doctor before you take Cymbalta. You should also tell your doctor right away if you become pregnant while taking this drug.

If you decide to take Cymbalta during pregnancy, consider enrolling in the National Pregnancy Registry for Antidepressants. This registry collects information about the safety of antidepressants such as Cymbalta when used during pregnancy. For details, visit the registry’s website or call 866-961-2388.

You should take Cymbalta according to your doctor’s or healthcare professional’s instructions.

Cymbalta comes as a delayed-release oral capsule. (“Delayed release” means the drug is released into your body after the capsule passes into your intestine.) You’ll take it either once or twice per day, depending on the condition you’re using it to treat.

When to take

You can take Cymbalta at any time of the day. However, you should try to take it around the same time every day. This helps make sure you have a consistent amount of the drug in your body.

The best time for you to take Cymbalta may depend on what you use the drug for and how often you take it each day. Your doctor can help you decide the best time for you to take Cymbalta.

To help make sure you do not miss a dose, try using a medication reminder. This can include setting an alarm on your phone or downloading a reminder app. A kitchen timer can work, too.

Taking Cymbalta with food

Cymbalta can be taken with or without food.

Can Cymbalta be crushed, split, or chewed?

No, you should not crush, split, or chew Cymbalta capsules. You also should not open the capsules to mix them with food or liquids. Doing so may affect how well your body absorbs the drug. This could raise your risk of side effects or make the drug less effective.

If you have difficulty swallowing capsules, see this article for tips on taking pills. Your doctor or pharmacy can also suggest ways to make Cymbalta easier to take.

Using more than the recommended dosage of Cymbalta can lead to serious side effects.

Do not use more Cymbalta than your doctor recommends.

Overdose symptoms

Signs and symptoms of an overdose can include:

What to do in case of overdose

If you think you’ve taken too much of this drug, call your doctor. You can also call America’s Poison Centers at 800-222-1222 or use its online tool. But if your symptoms are severe, call 911 or your local emergency number, or go to the nearest emergency room right away.

As with all medications, the cost of Cymbalta can vary. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

Before approving coverage for Cymbalta, your insurance company may require you to get prior authorization. This means that your doctor and insurance company will need to communicate about your prescription before the insurance company will cover the drug. The insurance company will review the prior authorization request and decide whether the drug will be covered.

If you’re not sure whether you’ll need to get prior authorization for Cymbalta, contact your insurance company.

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To save money on your Cymbalta prescription, explore the Optum Perks coupons below. (Optum Perks is a sister site of Medical News Today.)

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Financial and insurance assistance

If you need financial support to pay for Cymbalta, or if you need help understanding your insurance coverage, help is available.

Eli Lilly and Company, the manufacturer of Cymbalta, offers a program called Lilly Cares that may help with the cost of the drug. For more information and to find out if you’re eligible for support, call 800-545-6962 or visit the program website.

Generic version

Cymbalta is available in a generic form called duloxetine. A generic drug is an exact copy of the active drug in a brand-name medication. The generic is considered to be as safe and effective as the original drug. And generics tend to cost less than brand-name drugs.

If your doctor has prescribed Cymbalta and you’re interested in using duloxetine instead, talk with your doctor. They may have a preference for one version or the other. You’ll also need to check your insurance plan, as it may only cover one or the other.

Depending on the condition it’s being used to treat, Cymbalta may be used alone or with other medications.

If you have questions about using other drugs with Cymbalta, talk with your doctor or pharmacist. They can review your medications and discuss treatment options with you.

Cymbalta may cause complications if taken during pregnancy. However, more research is needed in this area. If you’re sexually active and you or your partner can become pregnant, talk with your doctor about your birth control needs while you’re using Cymbalta.

For more information about taking Cymbalta during pregnancy, see the “Cymbalta and pregnancy” section above.

Cymbalta passes into breast milk, but it’s not known to cause serious side effects. However, there have been a few reports of drowsiness, feeding problems, and difficulty gaining weight in infants exposed to breast milk containing duloxetine. (Duloxetine is the active drug in Cymbalta.)

If you choose to breastfeed while taking Cymbalta, you should watch for any feeding problems or drowsiness in your child.

If you’re considering breastfeeding while taking Cymbalta, talk with your doctor. Together, you can weigh the risks and benefits of breastfeeding while taking the drug and discuss your other treatment and feeding options.

This drug comes with several precautions.

Boxed warning: Risk of suicidal thoughts and behaviors

This drug has a boxed warning. This is the most serious warning from the Food and Drug Administration (FDA). A boxed warning alerts doctors and patients about drug effects that may be dangerous.

Clinical trials have shown antidepressants such as Cymbalta increase the risk of suicidal thoughts and behaviors in children and young adults ages 18 to 24 years. In people ages 65 years and older, antidepressants can actually reduce this risk.

During your treatment, you should watch closely for any new or sudden changes in your behavior, feelings, moods, or thoughts. Also ask your family members, caregivers, and healthcare professionals to look for changes in your behavior or moods. Call your doctor right away if you or someone else notices any changes.

For more information, see the “Cymbalta side effects” section above.

Other precautions

Before taking Cymbalta, talk with your doctor about your health history. Cymbalta may not be right for you if you have certain medical conditions or other factors affecting your health. These include:

  • Heart problems, including high blood pressure. Cymbalta may increase your blood pressure. If you already have hypertension (high blood pressure) or other heart problems, you may not be able to take Cymbalta. Before taking this drug, tell your doctor about any heart problems you may have, including high blood pressure.
  • Diabetes. If you have diabetes, Cymbalta may make it more difficult to manage your blood sugar. Tell your doctor if you have diabetes before you take Cymbalta.
  • Liver or kidney problems. Your liver and kidneys help clear Cymbalta from your body. If you have liver or kidney problems, Cymbalta levels could build up in your body. This could raise your risk of side effects. Before you take Cymbalta, tell your doctor about any liver or kidney problems you have.
  • Closed-angle glaucoma. Cymbalta can cause closed-angle glaucoma. If not treated right away, this condition can result in blindness. Some people are born with eye angles that are more narrow than usual, which could raise their risk of this side effect. If you’re unsure whether you have narrow eye angles, talk with your doctor. You can get an exam to determine your risk.
  • Seizures or convulsions. Cymbalta may cause seizures or convulsions. The drug hasn’t been studied in people with seizure disorders. Therefore, it isn’t known how safe the drug is to use in people with this type of condition. Tell your doctor about any history of seizures or convulsions before you take Cymbalta.
  • Bipolar disorder or mania. Cymbalta may cause a mixed, manic, or hypomanic episode in people at risk of bipolar disorder (such as people with mood conditions). Before taking Cymbalta, your doctor should screen you for bipolar disorder. If you have a history of bipolar disorder or mania, tell your doctor before taking Cymbalta.
  • Hyponatremia. Cymbalta can cause hyponatremia (low sodium levels). If you have hyponatremia or have had it in the past, talk with your doctor before you take Cymbalta.
  • Delayed stomach emptying. Cymbalta capsules contain a special coating that helps protect the drug against the acid in your stomach. If you have a condition that delays stomach emptying, such as diabetes, your stomach may break down this special coating. This could make the drug less effective. Before taking Cymbalta, tell your doctor if you have a condition that delays your stomach from emptying.
  • Bleeding problems. Drugs that affect serotonin levels, such as Cymbalta, may raise your risk of bleeding. If you have other conditions that cause bleeding problems, this risk may be even higher. Before taking Cymbalta, tell your doctor about any history of bleeding problems you may have.
  • Allergic reaction. If you’ve had an allergic reaction to Cymbalta or any of its ingredients, you should not take Cymbalta. Ask your doctor about other medications that may be better options for you.
  • Pregnancy. Cymbalta may cause complications if taken during pregnancy. For more information, see the “Cymbalta and pregnancy” section above.
  • Breastfeeding. Cymbalta passes into breast milk. Talk with your doctor about the risks and benefits of taking this drug while breastfeeding. For more information, see the “Cymbalta and breastfeeding” section above.

Note: For more information about the potential negative effects of Cymbalta, see the “Cymbalta side effects” section above.

When you get Cymbalta from the pharmacy, the pharmacist will add an expiration date to the label on the bottle. This date is typically 1 year from the date they dispensed the medication.

The expiration date helps guarantee that the medication is effective during this time. The current stance of the Food and Drug Administration (FDA) is to avoid using expired medications. If you have unused medication that has gone past the expiration date, ask your pharmacist how to correctly dispose of it.

Storage

How long a medication remains good can depend on many factors, including how and where you store the medication.

Cymbalta capsules should be stored at room temperature (77°F/25°C) in a tightly sealed container away from light. For short periods of time, Cymbalta may be stored between 59°F and 86°F (15°C and 30°C). Avoid storing this medication in areas where it could get damp or wet, such as bathrooms.

Disposal

If you no longer need to take Cymbalta and have leftover medication, it’s important to dispose of it safely. This helps prevent others, including children and pets, from taking the drug by accident. It also helps keep the drug from harming the environment.

This article provides several useful tips on medication disposal. You can also ask your pharmacist for information on how to dispose of your medication.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

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