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Tips for tapering off Cymbalta (duloxetine)

Cymbalta duloxetine

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#73 Altostrata

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Posted 12 January 2017 - 05:33 PM

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.


This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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#74 KD0105

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Posted 02 February 2017 - 06:40 PM

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?


I've been on 60mg Cymbalta for 10 years. I attempted a slow taper 5 years ago and did not make it. This time I know more!  :wub:


#75 ChessieCat

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Posted 02 February 2017 - 07:22 PM

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.


Reminder to self:      P A T I E N C E       I want to go faster    but I won't

 

Antidepressants:  25 years - 1 unknown, Prozac (caused muscle weakness), Zoloft; Cipramil CTed (very sick for 2.5 wks soon after)

Pristiq:  50mg mid 2012, 100mg beg 2014 (mild Serotonin Toxicity)     Current:  Pristiq 24mg (from 19 May 2017)

 

Tapering history & graph

My website - includes my brief history + links to videos & information on the web

 

Podcasts:    Let's Talk Withdrawal

 

PLEASE NOTE:  I am not a medical professional.


#76 taperingdown

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Posted 19 March 2017 - 05:42 AM

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.c...TUKBmgQ6AEIHDAA

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."

#77 Altostrata

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Posted 19 March 2017 - 10:14 PM

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.


This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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#78 taperingdown

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Posted 20 March 2017 - 10:27 AM

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.

#79 scallywag

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Posted 20 March 2017 - 12:13 PM

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.


This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.
1997-1999 Effexor; 2002-2005 Effexor XR 37.5 mg linear taper, dropping same #beads/week with bad results
Cymbalta (brand name), 60 mg 2012 - 2015; 20 mg to 7 mg in 2016, exact doses and dates in this post;
2017: 6.3 (58 beads) Feb. 1; 5.6 mg (52) Feb. 22; 5.4 mg (50) Mar. 15; 5.1 mg (47) Mar. 25; 4.9 mg (45) Apr. 5; 4.5 mg (42) Apr. 14; 3.5 mg (32) Apr. 26;
Current dose: 2.6 mg (24) 2017-May-17
+ Supplements: fish oil (1500 mg EPA/500 mg DHA), Vitamins: D3, K2, C; Minerals: Mg, Se, Cr, I, V
scallywag's Introduction
Online spreadsheet for dose taper calculations and nz11's THE WORKS spreadsheet


#80 gardenlady

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Posted 22 March 2017 - 07:50 AM

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?

Oct 2016 - crossed over from 20 mg Lexapro to generic Cymbalta 60 mg.  Long history of other ADs.

Mar 13 2017-Tapering 10 mg Valium

Mar 20  - 9 mg V

Mar 27 - 8 mg V

Apr 3 - 7mg V

Apr 10 - 6 mg V

Apr 17 - 5 mg V - Bad symptoms.  Hold V & start Cymbalta taper

May 11 - 54 mg Cymbalta

 

 

 


#81 ChessieCat

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Posted 22 March 2017 - 12:20 PM

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.


Reminder to self:      P A T I E N C E       I want to go faster    but I won't

 

Antidepressants:  25 years - 1 unknown, Prozac (caused muscle weakness), Zoloft; Cipramil CTed (very sick for 2.5 wks soon after)

Pristiq:  50mg mid 2012, 100mg beg 2014 (mild Serotonin Toxicity)     Current:  Pristiq 24mg (from 19 May 2017)

 

Tapering history & graph

My website - includes my brief history + links to videos & information on the web

 

Podcasts:    Let's Talk Withdrawal

 

PLEASE NOTE:  I am not a medical professional.


#82 Altostrata

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Posted 22 March 2017 - 09:09 PM

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.


This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

#83 gardenlady

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Posted 24 March 2017 - 11:19 AM

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


Oct 2016 - crossed over from 20 mg Lexapro to generic Cymbalta 60 mg.  Long history of other ADs.

Mar 13 2017-Tapering 10 mg Valium

Mar 20  - 9 mg V

Mar 27 - 8 mg V

Apr 3 - 7mg V

Apr 10 - 6 mg V

Apr 17 - 5 mg V - Bad symptoms.  Hold V & start Cymbalta taper

May 11 - 54 mg Cymbalta

 

 

 


#84 ChessieCat

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Posted 24 March 2017 - 01:56 PM

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


Reminder to self:      P A T I E N C E       I want to go faster    but I won't

 

Antidepressants:  25 years - 1 unknown, Prozac (caused muscle weakness), Zoloft; Cipramil CTed (very sick for 2.5 wks soon after)

Pristiq:  50mg mid 2012, 100mg beg 2014 (mild Serotonin Toxicity)     Current:  Pristiq 24mg (from 19 May 2017)

 

Tapering history & graph

My website - includes my brief history + links to videos & information on the web

 

Podcasts:    Let's Talk Withdrawal

 

PLEASE NOTE:  I am not a medical professional.






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