Cymbalta® (Duloxetine) Capsules: Uses, Dosing, and Safety

What Cymbalta® (Duloxetine) Is and How It Works

Duloxetine is an antidepressant in the serotonin–norepinephrine reuptake inhibitor (SNRI) class. It is used for major depressive disorder, generalized anxiety disorder, diabetic peripheral neuropathic pain, fibromyalgia, and chronic musculoskeletal pain. This duloxetine medication is supplied as delayed‑release capsules in strengths such as duloxetine 20 mg, duloxetine 30 mg, and duloxetine 60 mg. Many patients compare duloxetine cost across pharmacies to manage ongoing therapy.

YouDrugstore is a licensed Canadian pharmacy in Manitoba; pharmacists review prescriptions before dispensing, and we offer brand and generic medicines at Canadian prices, plus OTC items, with online ordering and customer-service chat during posted hours.

Duloxetine works by increasing serotonin and norepinephrine in the central nervous system. This helps regulate mood, lessen anxiety, and reduce pain signaling from nerves. Capsules contain duloxetine HCl beads with an enteric coat to dissolve past the stomach.

Typical dosing is once daily. Some patients take duloxetine for anxiety; others use duloxetine for depression or neuropathic pain. The duloxetine brand name is Cymbalta, and duloxetine generic name remains duloxetine HCl. Delayed‑release labeling may read duloxetine HCl DR 30 mg or duloxetine HCl DR 60 mg.

Dosage and Usage

• Major depressive disorder: start 30 mg once daily for 1 week, then 60 mg once daily. Some may remain at 30 mg duloxetine if tolerated and effective.
• Generalized anxiety disorder: start 30 mg once daily for 1 week, then 60 mg once daily. Older adults may start lower and increase more slowly.
• Diabetic peripheral neuropathic pain: usual target 60 mg once daily; some start at 30 mg for 1 week to improve tolerance.
• Fibromyalgia or chronic musculoskeletal pain: start 30 mg once daily for 1 week, then 60 mg once daily.
• Maximum studied dose is 120 mg/day. Limited added benefit above 60 mg. Some patients take 90 mg duloxetine using a 30 mg + 60 mg capsule combination under medical supervision.
• Swallow capsules whole. Do not crush or chew. Do not open the capsule, as the beads are enteric coated.
• Take at the same time each day, with or without food.
• Missed dose: take when remembered unless it is close to the next dose. Do not double doses.
• Do not stop suddenly. Gradual taper helps reduce discontinuation symptoms.

• Store your capsules at 20–25 °C (68–77 °F); short excursions 15–30 °C (59–86 °F) are acceptable.
• Keep in the original, tightly closed container to protect from moisture.
• Avoid heat, humidity, and direct sunlight. Do not refrigerate or freeze.
• When traveling, keep your duloxetine 30 mg or duloxetine 60 mg capsule supply in carry‑on luggage with a copy of your prescription.
• If a capsule is damaged or opened, discard it and use a new one.

Benefits and Savings

Duloxetine can improve mood, reduce worry, and help restore daily function. For painful conditions, many patients report less burning, tingling, or deep ache. Once‑daily dosing is convenient, and delayed‑release beads help reduce stomach irritation.

Ordering from YouDrugstore helps you access Canadian pricing. Typical savings run 60–80% versus usual U.S. cash prices, which supports long‑term therapy. You can compare duloxetine price per month across bottle sizes, and multi‑month supplies may lower the average duloxetine cost. Reorder reminders help you stay on schedule.

Available strengths include duloxetine 20 mg capsule, duloxetine 30 mg capsule, and duloxetine 60 mg capsule. Labeling may list duloxetine DR 30 mg or duloxetine HCl 60 mg depending on the manufacturer.

Side Effects and Safety

• Nausea, dry mouth, constipation, or diarrhea
• Dizziness, sleepiness, or insomnia
• Headache, fatigue, sweating increase
• Decreased appetite or weight change
• Sexual side effects (libido or orgasm changes)
• Increased blood pressure or heart rate
• Tremor or restlessness

Serious but less common risks include liver injury, severe skin reactions, angle‑closure glaucoma, low sodium (SIADH), seizures, and serotonin syndrome (especially with other serotonergic drugs). Antidepressants may increase suicidal thoughts in children, adolescents, and young adults. Bleeding risk rises with NSAIDs, aspirin, or anticoagulants. Mania or hypomania may occur in susceptible patients. Hypoglycemia can occur when duloxetine is combined with insulin or sulfonylureas due to improved glycemic control and overlapping symptoms; dose adjustments of those agents may be needed.

Onset Time

For depression and anxiety, some improvement may appear in 1–2 weeks. Stronger benefits often build by weeks 4–6 at a stable dose. For neuropathic or musculoskeletal pain, relief can begin within 1 week for some, though several weeks may be needed to reach full effect.

Compare With Alternatives

Selective serotonin reuptake inhibitors are common first‑line options for depression and anxiety. Escitalopram offers once‑daily dosing and a favorable side‑effect profile for many adults. It may be preferred when norepinephrine activity is not desired.

SNRIs include duloxetine and venlafaxine. Fluoxetine is an SSRI with a long half‑life that can help patients sensitive to withdrawal effects, though activation or insomnia can occur. Fluvoxamine is another SSRI sometimes used in anxiety‑related conditions.

For neuropathic pain and fibromyalgia, alternatives may include gabapentinoids or tricyclic antidepressants. The choice depends on medical history, other medicines, and tolerability. You can learn more about related conditions in our categories for Depression and Neuropathic Pain.

For a broader overview, see our article What Are The Best Medications For Depression and review common interaction risks in Drug Interactions The Top Interactions That Should Be On Your Radar.

Combination Therapy

• With SSRIs or other SNRIs: usually avoided due to serotonin syndrome risk.
• With bupropion: sometimes used for residual symptoms; monitor blood pressure and anxiety.
• With antipsychotic augmentation: may be used in treatment‑resistant depression; monitor metabolic and EPS risks.
• With migraine preventives or neuropathic agents: coordinate dosing to limit sedation or dizziness.
• With insulin or sulfonylureas: watch for hypoglycemia; dose reductions of glucose‑lowering drugs may be considered by prescribers.

Patient Suitability and Cost-Saving Tips

Duloxetine may not be suitable for severe liver disease, substantial alcohol use, or uncontrolled narrow‑angle glaucoma. Use caution with significant kidney impairment, seizure disorders, or a history of mania, and in older adults at fall risk. Late‑pregnancy exposure can affect the newborn; breastfeeding transfers small amounts into milk.

Do not use with monoamine oxidase inhibitors (MAOIs), or within 14 days of stopping an MAOI. Avoid linezolid or IV methylene blue. Duloxetine inhibits CYP2D6 and is a substrate of CYP1A2 and CYP2D6; interactions can occur with tricyclics, some antipsychotics, metoprolol, tamoxifen, and opioid prodrugs.

To manage duloxetine price, consider larger fills when appropriate, which can lower the per‑month duloxetine cost. You can set gentle email reminders for refills. Compare prices across strengths such as duloxetine HCl DR 30 mg versus duloxetine HCl 60 mg based on prescribed dosing.

For chronic pain topics, see our overview on Arthritis What Are The Most Common Forms Of Arthritis, and our categories for Chronic Musculoskeletal Pain and Fibromyalgia.

Authoritative Sources

FDA Prescribing Information for Cymbalta

Health Canada Drug Product Database: Duloxetine

Cymbalta Patient Information (Manufacturer)

Order Cymbalta® (Duloxetine) from YouDrugstore: add to cart, upload your prescription, and we ship with prompt, express, cold-chain handling.

This material is educational and does not replace advice from a healthcare professional. Always follow your prescriber’s guidance and the medication leaflet.