The Journey to Improvement

If you are concerned about some of your diabetic nerve pain symptoms, here are a few important first steps on the journey to improvement:

1. Learn more about diabetic nerve pain
Find out if you may have symptoms of diabetic nerve pain with the Diabetic Nerve Pain Impact Tool, and read about some of the treatments available before speaking with a healthcare professional. You can also make a list of questions to ask during your visit.

Review the Diabetic Nerve Pain Information Guide to get additional information about the condition and answers to questions you may have about Cymbalta.

2. Talk to your friends and family
One way to help prevent further nerve damage is to control your blood sugar. Some ways family and friends can play a role in helping you manage your diabetes and blood sugar include:

3. Make an appointment with a doctor
Talk to your doctor or other healthcare professional about your symptoms. Only he or she can tell you whether you have diabetic nerve pain and work with you to plan a course of action. Your doctor may also suggest you see a specialist, such as an endocrinologist or a neurologist.



Cymbalta® (duloxetine HCl) is approved for the treatment of depression and generalized anxiety disorder, 
  and for the management of diabetic peripheral neuropathic pain and fibromyalgia.

What should I talk about with my healthcare provider?

Patients on antidepressants and their families or caregivers should watch for new or worsening symptoms, unusual 
changes in behavior, thoughts of suicide, anxiety, agitation, panic attacks, difficulty sleeping, irritability, hostility, 
aggressiveness, impulsivity, restlessness, or extreme hyperactivity. Call your healthcare provider right away if you have 
thoughts of suicide or if any of these symptoms are severe or occur suddenly. Be especially observant within the first few 
months of antidepressant treatment or whenever there is a change in dose.

You should also know that:
Suicide is a known risk of depression and some other psychiatric disorders.
Antidepressants may increase suicidal thoughts or behaviors in some children, adolescents, and young adults 
especially within the first few months of treatment or when changing the dose. No increased risk has been shown for adults 
over age 24, and risk decreased for those over age 65.
All patients starting therapy should be monitored appropriately and observed closely for new or worsening 
depression symptoms, suicidal thoughts or behavior, or unusual changes in behavior.
Cymbalta is not approved for use in patients under age 18.
Who should NOT take Cymbalta?
You should not take Cymbalta if:
You have recently taken a type of antidepressant called a monoamine oxidase inhibitor (MAOI)
You have uncontrolled narrow-angle glaucoma (an eye disease)
You are taking Mellaril® (thioridazine)
What other important information should I discuss with my healthcare provider?
Before starting Cymbalta, tell your healthcare provider:
about all of your medical conditions, including kidney problems, glaucoma, or diabetes
about your alcohol use
if you are taking nonprescription or prescription medicines, including those for migraine, to address a possible 
life-threatening condition
if you are taking NSAID pain relievers, aspirin, or blood thinners. Use with Cymbalta may increase bleeding risk
if you are pregnant, plan to become pregnant during therapy, or are breastfeeding an infant
While taking Cymbalta, tell your healthcare provider:
if you have itching, right upper belly pain, dark urine, yellow skin/eyes, or unexplained flu-like symptoms, which 
may be signs of liver problems. Severe liver problems, sometimes fatal, have been reported
if you have high fever, confusion, and stiff muscles to address a possible life-threatening condition
before stopping Cymbalta or changing your dose
if you experience dizziness or fainting upon standing, especially when first starting Cymbalta or when increasing 
the dose. Your healthcare provider may periodically check your blood pressure while you are taking Cymbalta
If you have any questions, talk to your healthcare provider before taking Cymbalta.

What are the possible side effects of Cymbalta?
The most common side effect of Cymbalta was nausea. For most people who had it, the nausea was mild to moderate. 
Other common side effects included dry mouth, sleepiness, constipation, decreased appetite, and increased sweating. 
This is not a complete list of side effects.

Please read additional Safety Information and Boxed Warning for a complete list.
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