Cymbata Dosage - What's right?

Discussion in 'Fibromyalgia Main Forum' started by Toga, Oct 5, 2005.

  1. Toga

    Toga Member

    I got my Cymbalta Rx today. I'm to take 20 mg. a day. There are 60 pills in the bottle.

    It cost $200.99. We still haven't gotten our ins numbers so we had to pay out of pocket and are to reimbursed, less copay later.

    I have just finished a Milnacipran Drug Study. I hurting pretty bad. Been off all meds (for FM) for only two days.

    Those of you on Cymbalta, did you start on this small a dose? I thought 30 mg. was the usual starting dose.

    Another question - The bottle says it may cause sleepiness. I had thought it might give me a little more energy.

    Thanks for the input.

    Toga
  2. JLH

    JLH New Member

    My doctor prescribed the Cymbalta for me. I started off at 30 mg/day for 2-3 weeks, then went up to 60 mg/day.

    However, when I went to the 60 mg, it started making me really sleepy all day. I stayed with it for 3 days, but I couldn't stand being so sleepy, even though I am retired and not working.

    So, what I did was .... take 30 mg in the morning, and take the other 30 mg at night. This worked for me! Not sleepy during the day and still getting the 60 mg in.

    To be able to do this, you have to ask your doc to write the prescription for 30 mg capsules, and to take them 2 x day -- otherwise, if he writes 60 mg daily, they will fill it with 60 mg capsules and you will not be able to take them morning and night, or just cut back to 30 mg only if you need to.

    I have a daughter who is a physician. I always check with her after EVERY doc visit that I go to!! Kind of for a second opinion!!

    Anyway, she OK'd the 60 mg dosage a day. In fact, that is what she said is the recommended dosage for fibro treatment.

    But .... if you have to pay SO MUCH MONEY for this prescription, you might want to wait until you get your insurance numbers where all you have to do is pay your co-pay!! You'll go broke fast paying for all your meds, even if you do get it back later!!! You probably still like to eat, don't you?!!!! LOL

    Ask your doc for a bunch of samples -- maybe he could tide you over until your insurance is through. I know when I tried the Cymbalta, my doc gave me a month's worth of samples to see if I could take it. ALWAYS ask for samples of new meds!!!!

    Have you tried Neurotin? It does basically the same thing as the Cymbalta does, but it doesn't have any anti-depressant med included in it -- it helps on the nerve pain. There is a generic available for it, so it might be cheaper. You might want to try this first, and then try the Cymbalta after your insurance is ready. Just a thought!

    I happen to take both.

    Hope it helps you!

    Hugs,
    Janet
  3. Toga

    Toga Member

    What you said sounds exactly like I had thought I had remembered from others on this board.

    I certainly agree that I wouldn't want to be sleepy during the day. I need that at night.

    I just wonder why he started me at 20 mg instead of 30 mg. I am going to take it like this for two weeks and then call and see if I can take 20 in the a.m. and 20 in the p.m.

    That may be what he has in mind since there are 60 pills in the bottle. Also it says no refills.

    As far as the insurance is concerned. We are supposed to get our cards tomorrow and then get reimbursed for the out of pocket expense.

    My husband has his own business and my daughter started working for him. So after talking to a broker, we decided to form a group to cover all of us.

    Our granddaughter who is at college has been sick with a horrible chest cold and has had to pay out of pocket for her rx also.

    But we'll get that all taken care of soon, I'm sure. Our broker is really nice and very apologetic. I'm sure she'll handle the reimbursement for us.

    I do have some Neurontin left from before I started the Milnacipran Drug Study. I also have some Prozac also. But I hate to start these without the doctor knowing. He'd probably be really upset if I even brought it up.

    I just finished a year-long Milnacipran Drug Study and he wanted me to go six weeks with nothing.

    But I had been led to believe that I would start Cymbalta immediately at the end of the study. I almost lost it because we are moving and I have a lot of packing to do. That's a big job under the best of conditions.

    Its almost 1:00 p.m. here (St. Louis, MO area) and I'm starting to hurt all over, especially my shoulders and across my upper back.

    Oh well, this too, will pass. Thanks goodness I do not retain anger very long. That would probably make me feel even worse.

    Thanks,

    Toga
  4. chp1298

    chp1298 New Member

    Hi,
    I just started last week and take 60 mg 1x day
  5. Toga

    Toga Member

    I just wish we knew the reasoning behind all of this.

    You started out with 60 mg. right away!

    I guess I'll wait a couple weeks and then call him.

    Thanks,

    Toga
  6. JLH

    JLH New Member

    Boy, moving right now! You probably do need the Cymbalta now!!!!! LOL

    Hope you recover from your moving. I think that's a good idea to call your doc after 2 weeks to see if you can take one capsule in the AM and one in the PM, then maybe on your next visit, if you are doing OK on the 20 mg 2 x day, he might up it to 30 mg 2 x day.

    The Cymbalta certainly did help me.

    Did you get any help from the Milnacipran while you were on that study? I am not familiar with that drug.

    I was on Prozac before I switched to the Cymbalta. The Prozac never did help me. I was on Neurootin before I started the Cymbalta. My doc seems to think taking both is OK. I was taking the Neurotin for neuropathy.

    I always have a lot of problems with my shoulders and across my upper back, too. Sometimes I will put an ice pack, or a bag of frozen peas!, between my shoulder blades to "numb the pain". But, what I like best is to let the shower water get as hot as I can possibly stand and let it pour over that area.

    Hope you get to feeling better.

    Hugs,
    Janet
  7. allicat1214

    allicat1214 New Member

    Does your body eventually get used to the cymbalta in your system and so does the sleepiness eventually go away?

    I started out taking 30 mg in the evening with dinner and the next day I was so wiped out! It really helped with the pain though. I get it really bad in the upper back/shoulder area, too! I didn't take any today because I had to drive 30 miles to a doctor's appointment. I see my neuro tomorrow and I will ask him but I wanted to know if I need to just give it more time or ask him to give me a lower dose to start.
  8. dunnlb

    dunnlb New Member

    Everything Janet says is right. That is exactly what I have done.

    You probably need to follow your own intuitions. Your doctor doesn't understand fibromyalgia if he wanted you to go 6 weeks w/out any medication. That is uncalled for.

    I think that with fibromyalgia, like diabetes, you have to learn to be your own doctor. NO doctor understands how we feel unless he has it himself. They will pretend to be all knowing, but most are pretty ignorant about the subject.

    You should be able take Neurontin with Cymbalta especially if you took it before with no problems. Just trust your own judgment and don't worry about what your doctor thinks.

    If it were me, I would take 20 mg./day of the Cymbalta for 2 weeks, then go up to 40 mg./day (20 mg. in a.m. and 20 mg. in p.m.)for two weeks. If you think you need more, you could go up to 60 mg./day. You could also take one of your Neurontin at night to help with sleep.

    Good luck and hope it works for you as good as it has for me.
  9. Bren5

    Bren5 New Member

    I just started on Rx for 20 mg Cymbalta, once a day. My doctor didn't say anything about increasing the dose, but I go back in 1 month. I had been on Lexapro 20 mg for over 1 year. The Lexapro made me very sleepy & gain weight.

    Since starting Cymbalta, I do have more energy during the day (I take it in the morning) and I only had the nausea for 2 days. I noticed that I'm not sleeping as well at night than I did while on Lexapro.

    I also have Multiple Sclerosis and take Neurontin 300 mg twice a day and Lorazepam at bedtime.

    Take care.
  10. Toga

    Toga Member

    Boy I like the sound of having more energy.

    I have a few hours in the morning where I feel sort of ok, even though I'm huring.

    I crash around lunch time. I usually take a nap and when I wake up I'm ok again for a couple hours. But then later I'm bad again.

    I try to accomplish something during the hours when I feel ok. Gone are the days when I could go from 7:00 a.m. until midnight.

    Toga