Cymbalta Dosage

Name of generic origin: duloxetine 
Drug class: Serotonin-norepinephrine reuptake inhibitors 

Medically reviewed by  A Ras MD.

Recommended Adult Dosing

Dosage forms:  DR CAP: 20 mg, 30 mg, 60 mg

Major depressive disorder

[60 mg PO qd]

Start: 20-30 mg PO bid; Max: 120 mg/day; Info: may start 30 mg PO qd x1wk if tolerability concern; doses >60 mg/day rarely more effective, may increase ADR risk; do not open cap; taper dose gradually to D/C

Generalized anxiety disorder

[60 mg PO qd]

Max: 120 mg/day; Info: start 30 mg PO qd x2wk in elderly pts; may start 30 mg PO qd x1wk if tolerability concern; may increase dose in 30 mg increments; doses >60 mg/day rarely more effective, may incr. ADR risk; do not open cap; taper dose gradually to D/C

Neuropathic pain, diabetic

[60 mg PO qd]

Max: 120 mg/day; Info: may start 30 mg PO qd x1wk if tolerability concern; doses >60 mg/day rarely more effective, may increase ADR risk; do not open cap; taper dose gradually to D/C

Fibromyalgia

[60 mg PO qd]

Start: 30 mg PO qd x1wk; Max: 60 mg/day; Info: some pts may respond to 30 mg/day; do not open cap; taper dose gradually to D/C

Musculoskeletal pain, chronic

[60 mg PO qd]

Start: 30 mg PO qd x1wk; Max: 60 mg/day; Info: do not open cap; taper dose gradually to D/C

*Stress urinary incontinence

[40 mg PO bid]

Start: 20 mg PO bid x1wk; Info: do not open cap; taper dose gradually to D/C

Renal dosing

[neuropathic pain, diabetic]

CrCl 30-89: consider decr. start dose, titrate slowly; CrCl <30: avoid use

HD/PD: not defined

[all other indications]

CrCl <30: avoid use

HD/PD: not defined

Hepatic dosing

[see below]

chronic hepatic dz or cirrhosis: avoid use

 Recommended Peds Dosing

Dosage forms:  DR CAP: 20 mg, 30 mg, 60 mg

Generalized anxiety disorder

[7-17 yo]

Dose: 30-60 mg PO qd; Start: 30 mg PO qd, may incr. by 30 mg/day after 2wk; Max: 120 mg/day; Info: do not open cap; taper dose gradually to D/C

Fibromyalgia

[13-17 yo]

Dose: 30-60 mg PO qd; Start: 30 mg PO qd x1wk; Max: 60 mg/day; Info: do not open cap; taper dose gradually to D/C

Renal dosing

[see below]

CrCl <30: avoid use

HD/PD: not defined

Hepatic dosing

[see below]

chronic hepatic dz or cirrhosis: avoid use

SRC: NLM .