Can you help me? Authorized generic drugs are identical to the brand name products, sometimes manufactured in the same facility. Prasco initially sold an authorized generic version of Cymbalta duloxetine but no longer does so. A spokesperson told us that there is currently no authorized generic for Cymbalta. You are not the only visitor to our website who has reported problems with generic Cymbalta duloxetine. Here are some other stories from readers: When generics finally become available, they tend to be much easier for the public to obtain through a variety of insurances.
Even though the FDA reassures patients that the use of this medication is safe, due to their strict guidelines when they approve medications, there is some concern with a drug reaction called serotonin syndrome. The TGA Therapeutic Goods Administration in Australia has received about 31 reports of serotonin syndrome symptoms from patients using the generic drug since September Some of the reports included other medications that seemed to work together in causing the symptomatology, but within at least 21 of the cases Duloxetine was the only culprit causing the symptoms.
Gastric lavage with a large-bore orogastric tube with appropriate airway protection, if needed, may be indicated if performed soon after ingestion or in symptomatic patients. Activated charcoal may be useful in limiting absorption of duloxetine from the gastrointestinal tract. Administration of activated charcoal has been shown to decrease AUC and Cmax by an average of one-third, although some subjects had a limited effect of activated charcoal. Due to the large volume of distribution of this drug, forced diuresis, dialysis, hemoperfusion, and exchange transfusion are unlikely to be beneficial.
In managing overdose, the possibility of multiple drug involvement should be considered. The physician should consider contacting a poison control center or www.
Pharmacodynamics Preclinical studies have shown that duloxetine is a potent inhibitor of neuronal serotonin and norepinephrine reuptake and a less potent inhibitor of dopamine reuptake. Duloxetine has no significant affinity for dopaminergic, adrenergic, cholinergic, histaminergic, opioid , glutamate , and GABA receptors in vitro.
Duloxetine does not inhibit monoamine oxidase MAO. Pharmacokinetics Duloxetine has an elimination half-life of about 12 hours range 8 to 17 hours and its pharmacokinetics are dose proportional over the therapeutic range.
Steady-state plasma concentrations are typically achieved after 3 days of dosing. Absorption And Distribution Orally administered duloxetine hydrochloride is well absorbed.
There is a median 2 hour lag until absorption begins Tlag , with maximal plasma concentrations Cmax of duloxetine occurring 6 hours post dose.
There is a 3 hour delay in absorption and a one-third increase in apparent clearance of duloxetine after an evening dose as compared to a morning dose. The apparent volume of distribution averages about L. The interaction between duloxetine and other highly protein bound drugs has not been fully evaluated.
Plasma protein binding of duloxetine is not affected by renal or hepatic impairment. Metabolism And Elimination Biotransformation and disposition of duloxetine in humans have been determined following oral administration of 14C-labeled duloxetine. The major biotransformation pathways for duloxetine involve oxidation of the naphthyl ring followed by conjugation and further oxidation. Metabolites found in plasma include 4-hydroxy duloxetine glucuronide and 5-hydroxy, 6-methoxy duloxetine sulfate.
Many additional metabolites have been identified in urine, some representing only minor pathways of elimination. Duloxetine undergoes extensive metabolism, but the major circulating metabolites have not been shown to contribute significantly to the pharmacologic activity of duloxetine. Duloxetine has an enteric coating that prevents dissolution until it reaches a segment of the gastrointestinal that has a pH higher than 5. In theory, drugs that raise the pH in the gastrointestinal system for example, Prilosec may cause duloxetine to be released early while conditions that slow gastric empyting for example, diabetes may cause premature breakdown of duloxetine.
Nevertheless, aAdministration of duloxetine with an antacid or famotidine Axid did not significantly affect the absorption of duloxetine. Prepay online to lock in your savings. Bring your prescription to a participating pharmacy and have them fill it, as usual.
At pickup, show the pharmacist your Blink Card, and have them process it as the primary payor. Do I need a prescription? Even though Blink does not need a copy of your prescription, you must have a valid prescription from the doctor to pick up at the pharmacy. Check your blood sugar regularly as directed and share the results with your doctor.
Your doctor may need to adjust your diabetes medication, exercise program , or diet. Before having surgery, tell your doctor or dentist about all the products you use including prescription drugs , nonprescription drugs, and herbal products.
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