Altostrata

Tips for tapering off Cymbalta (duloxetine)

84 posts in this topic

Welcome, KD0105. Please read this topic from the beginning. Counting beads is the only way to taper Cymbalta. Some people weigh them to be sure dosing is consistent.

Share this post


Link to post
Share on other sites

I've contacted my compounding pharmacist about this.  I'm hoping he will respond to my email.

ChessieCat, have you had an answer to this question from your pharmacist yet?

Share this post


Link to post
Share on other sites

No.  He never got back to me and I haven't been in for my new batch yet.

 

The mods have discussed it and think it is highly unlikely that the individual beads would be made to release at different times.

Share this post


Link to post
Share on other sites

I'm new to this topic, so please forgive me if I'm overlooking something obvious...

 

There appears to be a logical problem underlying all of the tapering strategies in this thread. I just had a lengthy discussion with my local pharmacist, and she claims that the "micro-beads" contained in Cymbalta are heterogeneous wrt enteric coating. In other words (to use a made-up example): 25% of the beads might be coated to time-release after 1 hour, 25% to release after 2 hours, 25% after 4 hours, and 25% after 8 hours. The problem is that when you sub-divide your dosage, you have no way of knowing whether you're getting a balanced cross-section of these different enteric coatings.

I was told something similar by my doctor, but I'm not sure it is correct. I found the controlled release patent at https://www.google.com/patents/EP1904039A2?cl=en&dq=cymbalta&hl=en&sa=X&ved=0ahUKEwjWgrvz1eLSAhVB8CYKHTUKBmgQ6AEIHDAA

 

I can't find a clear indication that different beads are designed to be dissolved at different times. All that is clear is that the drug is slowly released as the coating dissolves:

 

"Once the dosage form reaches the intestine and pH approaches more than 5.5, the enteric coating starts to dissolve and drug core in polymeric carrier is exposed to the intestinal fluid. The dosage form starts to release the drug in the intestine in a controlled rate by polymeric diffusion, dissolution and erosion mechanisms and the process occurs for prolonged period of time. The dosage form completely erodes and dissolves within the dosing interval (24h), thereby ensuring complete drug release in the intestine."

Share this post


Link to post
Share on other sites

I wouldn't worry about this. Counting beads is the only way to taper Cymbalta. There is no other option.

 

Do your best to take what looks like a cross-section of beads.

 

We have many people here who have done this successfully. Go to the Introductions forum and use search for "cymbalta" to find their stories.

Share this post


Link to post
Share on other sites

I wouldn't worry about this. Counting beads is the only way to taper Cymbalta. There is no other option.

 

I agree. It just frustrates me that pharmacists and doctors would tell patients that weighing/counting beads will interfere with the timed release when there is no written proof that it would. Oh well.

Share this post


Link to post
Share on other sites

If you really want to play it safe, you can get empty enteric coated capsules to protect the beads from stomach acid. They cost considerably more than a gelatin or vegan capsule: 

 

An amazon search for empty enteric coated capsules.

Share this post


Link to post
Share on other sites

My Citron duloxtine (generic Cymbalta) 60 mg capsules won't open.....feels like they are glued together.  I've found 2 that came apart, but the rest won't no matter how hard I pull.  Does anyone have any suggestions?

Share this post


Link to post
Share on other sites

You would have to be very careful.  You could try holding a capsule upright and snipping off the very top with scissors or use a craft knife.  If you can't get the scissors to snip, you could try making a small starter slit with a craft knife so you can then cut with scissors.

Share this post


Link to post
Share on other sites

The tiny beads inside a Cymbalta capsule are individually coated to protect them from stomach acid. The gelatin capsule is only a container, it doesn't provide timed release or protection from stomach acid.

 

As far as I know, you cannot buy empty enteric capsules. They are available only to drug manufacturers.

 

If your Cymbalta capsules don't open by grasping at both ends and twisting, you'll just have to break them carefully (or cut them) over a clean container. It may be handy for you to get empty (largish) gelatin capsules so you can package your beads in them for multiple doses; for example, your doses for the week.

Share this post


Link to post
Share on other sites

There are so many brands and sizes of gelatin capsules on Amazon that it's confusing.  What kind and size should I buy?  

Share this post


Link to post
Share on other sites

I think I read somewhere 00.  It's better to get the larger size because it is easier to get the beads into them.  You could get the giant 000 ones, but you need to consider whether you would be able to swallow them.

 

I've just found it:  post by Alto

 

She suggests 0 or 00.  But you need to consider your ability to handle the smaller size.  Comparison picture with measurements

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!


Register a new account

Sign in

Already have an account? Sign in here.


Sign In Now