Cymbalta's Dosage: What to Know
This drug has a boxed warning, 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.
Cymbalta and certain other drugs used to treat depression can increase the risk of suicidal thoughts and behavior in children and young adults. This risk is higher in people ages 24 years and younger. Because of this, doctors will monitor anyone taking Cymbalta for signs of new or worsening depression and suicidal thoughts and behavior. They may also recommend that close family members of anyone taking Cymbalta watch for mood changes.
For more information about the boxed warning for Cymbalta, talk with your doctor or pharmacist.
Cymbalta is a brand-name prescription medication that contains the active drug duloxetine. It belongs to a class of drugs called serotonin and norepinephrine reuptake inhibitors (SNRIs). Cymbalta is available in a generic form.
This medication has been approved by the Food and Drug Administration (FDA) to treat the following conditions:
|In adults||• major depressive disorder (also called clinical depression)
• generalized anxiety disorder
• nerve pain related to diabetes
• long-term muscle, bone, and joint pain
|In children ages 7 years and older||• generalized anxiety disorder|
|In children ages 13 years and older||• fibromyalgia|
In this article, you’ll find additional information about Cymbalta’s dosage and details on how to take the drug. For a comprehensive overview of Cymbalta, view this article.
Finding a healthcare professional
If you’re interested in taking Cymbalta, search here to find a doctor who might prescribe it.
This article describes typical recommended dosages for Cymbalta. These dosages are provided by the drug’s manufacturer.
Always follow the dosage of Cymbalta that your doctor prescribes.
Commonly recommended dosages for Cymbalta are shown below.
You should take the dosage your doctor prescribes for you.They’ll recommend the dosage that’s best for your condition.
Cymbalta’s form and strengths
Cymbalta comes as a delayed-release capsule that you take by mouth. “Delayed release” means the medication delays the release of its active drug until the capsule passes through your stomach.
Cymbalta capsules are available in the following strengths:
- 20 milligrams (mg)
- 30 mg
- 60 mg
Typical recommended dosages
Usually, doctors will prescribe a low dosage of Cymbalta at the start of treatment. Then, they’ll adjust the dosage every 1 or 2 weeks if needed. Ultimately, your doctor will prescribe the smallest dosage of Cymbalta that gives the desired effect.
Cymbalta dosage for anxiety
Below is an overview of Cymbalta’s recommended dosage for generalized anxiety disorder in adults. Your doctor will prescribe the dosage of Cymbalta that’s right for your condition.
- Starting dosage: 60 mg once daily or 30 mg once daily in adults ages 65 years and older
- Maintenance dosage: 60 mg once daily
- Maximum dosage: 120 mg per day
Cymbalta dosage for other conditions
Below is an overview of Cymbalta’s recommended dosage for the drug’s other uses in adults. This includes the dosage for fibromyalgia and the dosage for depression. Your doctor will prescribe the dosage of Cymbalta that’s right for your condition.
|Condition||Starting dosage||Maintenance dosage||Maximum dosage|
|depression||40 mg to 60 mg per day, divided into once- or twice-daily dosing||60 mg per day, divided into once- or twice-daily dosing||120 mg per day|
|fibromyalgia||30 mg once daily||60 mg once daily||60 mg per day|
|diabetic nerve pain||60 mg once daily||60 mg once daily||60 mg per day|
|muscle, bone, and joint pain||30 mg once daily||60 mg once daily||60 mg per day|
Cymbalta is approved to treat generalized anxiety disorder and fibromyalgia in certain children. The table below summarizes Cymbalta dosages for children based on the condition their doctor is prescribing Cymbalta to treat. Be sure to follow dosage instructions given by your child’s doctor.
|Condition||Starting dosage||Maintenance dosage||Maximum dosage|
|generalized anxiety disorder in children ages 7 years and older||30 mg once daily||30 mg to 60 mg once daily||120 mg per day|
|fibromyalgia in children ages 13 years and older||30 mg once daily||60 mg once daily||60 mg per day|
Length of treatment
Doctors typically prescribe Cymbalta as a long-term treatment. You’ll likely take it long term if you and your doctor feel it’s safe and effective for your condition.
Below are some common questions related to Cymbalta’s dosage.
Would my doctor increase my Cymbalta dose from 30 mg to 60 mg? Or from 60 mg to 90 mg?
This depends on the condition your doctor is prescribing Cymbalta to treat.
If your doctor prescribes 30 milligrams (mg) of Cymbalta once daily as a starting dose for you for any condition, they may increase your dosage to 60 mg once daily, if necessary, after 1 or 2 weeks.
For diabetic nerve pain, fibromyalgia, or muscle, bone, or joint pain, your doctor may not increase your dose from 60 mg to 90 mg. This is because, for these conditions, 60 mg per day is the recommended maximum dosage of Cymbalta.
However, if you’re taking Cymbalta to treat depression or generalized anxiety disorder, your doctor may increase your dosage from 60 mg to 90 mg per day if they decide it’s safe and effective for you.
Talk with your doctor if you have questions about dosage adjustments during your Cymbalta treatment.
Does Cymbalta have a highest dose or max dose?
Yes. However, Cymbalta’s maximum dosage varies based on the condition you’re taking it to treat.
The maximum recommended dosage of Cymbalta to treat depression and generalized anxiety disorder is 120 mg per day.
For the following conditions, the maximum recommended Cymbalta dosage is 60 mg per day:
- diabetic nerve pain
- long-term muscle, bone, or joint pain
For more information about Cymbalta’s dosage ranges, see the “Cymbalta: Dosage” section above.
What is Cymbalta’s dosage for nerve pain?
The recommended Cymbalta maintenance dosage to treat nerve pain related to diabetes is 60 mg once daily. This is also the recommended starting and maximum dosage for this condition.
If your doctor decides that a lower dosage is safer for you, they may have you start with a dosage of 30 mg once daily. Your doctor may gradually increase this dosage based on how your condition responds to the treatment.
For more information about Cymbalta’s dosage for nerve pain, see the “Cymbalta: Dosage” section above.
Is there a lowest dose of Cymbalta?
Yes, 30 mg once daily is the lowest dosage for Cymbalta.
This is typically prescribed as a starting dosage of Cymbalta. Your doctor may have you take this dosage for 1 or 2 weeks before increasing your dosage if needed. They do this to give your body time to get used to the medication and lower your risk of side effects.
A 30-mg dose may also be prescribed for children taking Cymbalta. Their doctor may increase their dosage if necessary.
Talk with your doctor if you have questions about your Cymbalta dosage.
Your doctor will consider several factors when prescribing the dosage for Cymbalta. These factors include:
- your age
- the condition you’re taking Cymbalta to treat
- the severity of your condition
- other medications you take
Your prescribed dosage may also vary based on other medical conditions you have.
Recommended adjustments in dosage
There are a few reasons your doctor may adjust your Cymbalta dosage.
If you’re age 65 years or older, your doctor may start you on a lower dose of Cymbalta to treat your condition. This is because older adults may have an increased risk of certain side effects from Cymbalta, such as low blood sodium levels and falls.
Kidney or liver problems
Let your doctor know if you have kidney or liver problems, such as a history of kidney stones or cirrhosis, before starting Cymbalta. Kidney or liver problems may affect how well your body breaks down this medication, which can increase your risk of side effects.
If you have mild or moderate kidney or liver problems, your doctor will likely prescribe a lower dosage of Cymbalta. However, your doctor may not prescribe this medication if you have severe kidney or liver problems, including chronic kidney failure or chronic liver disease. Instead, they’ll recommend a different treatment for your condition.
Cymbalta is broken down in your liver by two enzymes (certain proteins) called CYP1A2 and CYP2D6. Certain drugs inhibit (slow down) the action of these enzymes. Taking Cymbalta with any of these medications can slow the breakdown of Cymbalta in your body. This can increase the amount of Cymbalta in your body and increase your risk of side effects from this drug.
Due to this risk, your doctor will likely reduce your Cymbalta dosage if you take any medications that inhibit CYP2D6. Examples of strong CYP2D6 inhibitors include certain antidepressants, such as bupropion (Wellbutrin SR, Wellbutrin XL) and fluoxetine (Prozac). They also include the heart rhythm medication quinidine.
If you take drugs that inhibit CYP1A2, your doctor may not prescribe Cymbalta. Examples of strong CYP1A2 inhibitors include the antibiotic drug ciprofloxacin (Cipro) and the antidepressant drug fluvoxamine (Luvox).
Cymbalta comes as a delayed-release capsule that you’ll take by mouth. You can take this medication with or without food.
Take Cymbalta exactly as your doctor instructs. They may have you take this medication once daily or twice per day. If your doctor prescribes Cymbalta once daily, you can take your dose at any time of the day. If they prescribe it twice daily, you should take your dose in the morning and the evening.
Be sure to swallow Cymbalta capsules whole. Do not chew, crush, or open the capsules. Avoid sprinkling the contents of the capsules in food or mixing it with liquid. Doing so can affect the way the medication is released in your body.
If you have difficulty swallowing capsules, view this article. It provides suggestions on how to take this form of medication. Also, talk with your doctor or pharmacist about taking your medication.
If you find it challenging to read the label on your prescription, tell your doctor or pharmacist. Certain pharmacies provide medication labels with large print or braille. They may also offer labels containing a scannable code that your smartphone can convert from text to speech. If your pharmacy doesn’t provide these choices, your doctor or pharmacist may be able to recommend a pharmacy that does.
If it’s difficult for you to open medication bottles, ask your pharmacist if they can dispense Cymbalta in an easy-open container. They also may recommend ways to help make it easier to open the bottles.
If you miss a dose of Cymbalta, take it as soon as you remember. If it’s almost time for your next dose, skip the missed dose. Then, take your next dose at the regular time. Do not take two Cymbalta doses at the same time to make up for a missed dose. This can increase your risk of side effects from Cymbalta.
View these medication reminder options to help avoid missing doses. You could also set an alarm or download a reminder app on your phone.
If you take more than the recommended dosage of Cymbalta, serious effects can occur. Do not take more Cymbalta than your doctor prescribes.
Symptoms of overdose
Symptoms that an overdose of Cymbalta could cause include:
- fast heart rate
- low or high blood pressure
- serotonin syndrome (a serious condition caused by a high level of the chemical serotonin)
What to do in case of overdose
Call your doctor if you think you’ve taken too much of this drug. Also, you can call the American Association of Poison Control Centers at 800-222-1222 or use its online tool. However, if your symptoms are severe, call 911 or a local emergency number. Or go to the nearest emergency room right away.
There haven’t been studies to determine whether Cymbalta causes dependence. (With dependence, your body needs the drug to function like usual.)
However, you can have withdrawal symptoms if you suddenly stop taking Cymbalta. (Withdrawal symptoms are side effects that can occur when you stop taking a drug that your body has become dependent on.)
Withdrawal symptoms of Cymbalta can include:
- sensation of pins and needles or electric shock (sometimes called brain zaps)
- trouble sleeping
- excessive sweating
To decrease your risk of having withdrawal symptoms, avoid stopping your Cymbalta treatment suddenly. If you want to stop taking Cymbalta, talk with your doctor first. They’ll gradually decrease your dosage over a few weeks.
Let your doctor know if you have withdrawal symptoms while stopping Cymbalta. They can adjust your dosage further to minimize your symptoms.
Talk with your doctor or pharmacist for additional information about Cymbalta’s dosage. Keep in mind that the dosages presented in this article are typical dosages provided by the drug’s manufacturer. Your doctor will recommend the dosage of Cymbalta that’s right for you and your condition. Always follow the dosage that your doctor prescribes for you.
As with any medications you’re taking, do not change your Cymbalta dosage without a recommendation from your doctor.
In addition to discussing Cymbalta with your doctor, you may find the following articles helpful in learning more.
- Overview of Cymbalta. For comprehensive details on Cymbalta, see this article.
- Drug comparisons. To learn how Cymbalta compares with Lexapro, read this article.
- Information on side effects. If you’d like to know about possible side effects of Cymbalta, view this article.
- Details about Cymbalta’s uses. To learn more about the conditions Cymbalta is used to treat, see the following articles:
Disclaimer: Healthgrades 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.