What Is Duloxetine?

Duloxetine is a prescription medication in the Serotonin-Norepinephrine Reuptake Inhibitor (SNRI) class, used to treat depression, anxiety, fibromyalgia, chronic pain, and diabetic nerve pain.

You may know Duloxetine by its most common brand name, Cymbalta. It's also sold as Drizalma Sprinkle and Irenka. Originally developed and manufactured by Eli Lilly and Company, Duloxetine first received FDA approval in 2004. Today, generic versions are widely available from multiple manufacturers.

Duloxetine is not a controlled substance. It does not carry a DEA schedule, which means it's easier to prescribe and refill than controlled medications. However, it does require a prescription — you can't buy it over the counter.

What Is Duloxetine Used For?

Duloxetine is FDA-approved for five conditions:

1. Major Depressive Disorder (MDD) — Duloxetine helps improve mood, energy, and feelings of well-being in adults with depression.
2. Generalized Anxiety Disorder (GAD) — It reduces excessive worry and anxiety in adults and children aged 7 and older.
3. Fibromyalgia — Duloxetine helps manage the widespread pain, fatigue, and tenderness associated with fibromyalgia.
4. Chronic Musculoskeletal Pain — This includes chronic low back pain and chronic osteoarthritis pain.
5. Diabetic Peripheral Neuropathy — It relieves nerve pain caused by diabetes, typically felt in the feet and hands.

Duloxetine is also sometimes used off-label for chemotherapy-induced peripheral neuropathy and stress urinary incontinence, though these uses are not FDA-approved in the U.S.

To understand how it works for these conditions, read our guide on how Duloxetine works.

How Is Duloxetine Taken?

Duloxetine comes as a delayed-release oral capsule in strengths of 20 mg, 30 mg, 40 mg, and 60 mg. It's also available as a sprinkle capsule (Drizalma Sprinkle) for people who have trouble swallowing pills.

Typical Dosing

• Depression and anxiety: Usually start at 30 mg once daily, increasing to 60 mg once daily after one to two weeks.
• Fibromyalgia: Start at 30 mg daily for one week, then increase to 60 mg daily.
• Chronic pain: 60 mg once daily.
• Diabetic nerve pain: 60 mg once daily.
• Maximum dose: Up to 120 mg per day in some cases, divided into two doses.

Important Instructions

• Swallow the capsule whole. Do not crush, chew, or open it — except for Drizalma Sprinkle, which can be opened and sprinkled on applesauce.
• Take at the same time each day, with or without food.
• Do not stop abruptly. Duloxetine must be tapered gradually under medical supervision to avoid discontinuation symptoms like dizziness, nausea, and "brain zaps."

Who Should Not Take Duloxetine?

Duloxetine is not safe for everyone. You should not take it if you:

• Are taking or have recently taken (within 14 days) an MAO inhibitor — this combination can cause life-threatening serotonin syndrome.
• Are taking Linezolid or IV Methylene Blue.
• Have uncontrolled narrow-angle glaucoma.
• Have severe liver disease.
• Have severe kidney disease (creatinine clearance less than 30 mL/min).
• Have a known allergy to Duloxetine or any of its ingredients.

Use caution if you are elderly (increased fall risk), pregnant (third-trimester risks), or breastfeeding (Duloxetine passes into breast milk).

For a full list of medications to avoid, see our guide on Duloxetine drug interactions.

How Much Does Duloxetine Cost?

Cost varies widely depending on whether you use insurance, a discount coupon, or pay cash:

• Generic Duloxetine with a coupon: As low as $4 to $15 for a 30-day supply of 60 mg capsules (via GoodRx or SingleCare).
• Generic retail cash price: Approximately $130 to $230 for 30 capsules of 60 mg without coupons.
• Brand-name Cymbalta: Can exceed $400 per month.
• Insurance: Generic Duloxetine is typically on Tier 1 or Tier 2 formularies with most plans. Prior authorization is generally not required for the generic.

If cost is a concern, there are several ways to save. Learn more in our guide to Duloxetine coupons, discounts, and patient assistance programs.

Side Effects at a Glance

The most common side effects include nausea, dry mouth, drowsiness, constipation, decreased appetite, dizziness, sweating, and insomnia. Duloxetine also carries an FDA boxed warning about increased risk of suicidal thoughts in young adults under 25.

For the complete list and when to call your doctor, read our detailed Duloxetine side effects guide.

Final Thoughts

Duloxetine is a versatile, well-established medication that treats a range of conditions from depression and anxiety to chronic pain and fibromyalgia. It's available as an affordable generic, doesn't require prior authorization with most insurance plans, and can be prescribed by primary care doctors, psychiatrists, and many other providers.

If you're looking for a provider, read our guide on how to find a doctor who can prescribe Duloxetine. Ready to fill your prescription? Use Medfinder to find a pharmacy with Duloxetine in stock near you.