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Cymbalta for Fibromyalgia Treatment

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Risks and Warnings

Cymbalta and other antidepressants may increase the risk for suicidal thoughts and behaviors in people under age 24. After you are prescribed Cymbalta, your doctor will monitor you closely for unusual behavior changes, new or worsening signs of depression, or suicidal thoughts.

Cymbalta may cause a drop in salt (sodium) levels in the blood, a potentially life-threatening condition called hyponatremia. Older adults, particularly those who take diuretics ("water pills") are more likely to develop this complication. Hyponatremia can cause headaches, confusion, weakness, and in severe cases can lead to fainting, seizures, coma, and death.

Some patients taking Cymbalta have developed liver problems. In rare cases, this has lead to liver failure and death. Contact your health care provider immediately if you develop any of the following symptoms while taking Cymbalta:

  • Dark colored urine
  • Itching
  • Pain in the right, upper belly area
  • Unexplained flu-like symptoms
  • Yellow skin or eyes (jaundice)

Drug Interactions

In rare cases, a life-threatening condition called serotonin syndrome has occurred in patients who have taken Cymbalta. Serotonin syndrome most often results when someone takes two or more medications that increase the body's serotonin levels at the same time. You need serotonin for your brain and nerve cells to function, but too much of it can be dangerous. Serotonin syndrome can lead to rapid changes in blood pressure, muscle rigidity, seizures, and even death.

This is why it is so important that your health care providers know what medications you are taking. Always tell them about all the medicines you take, including over-the-counter drugs and herbs and supplements.

Drugs that may interact with Cymbalta and cause serotonin syndrome include:

  • Cough medicines that contain dextromethorphan
  • Monoamine oxidase inhibitors (MAOIs)
  • Nausea and heartburn medications such as metoclopramide (Reglan) and ondansetron (Zofran)
  • Pain medications, including meperidine (Demerol, a painkiller) and tramadol (Ultram)
  • St. John's wort
  • Triptans, used to treat migraine headaches

Other drugs may also interact with Cymbalta, including:

  • Blood thinners, including warfarin, aspirin, and nonsteroidal anti-inflammatory drugs (NSAIDs). Taking Cymbalta with such medications may increase your chances for bleeding events.
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