From the Guidelines
No, you should not split Cymbalta (duloxetine) capsules. Cymbalta is a delayed-release medication designed to pass through the stomach intact before releasing the medication in the intestines. Opening or splitting the capsules disrupts this special coating and delivery system, which can lead to the medication being released too quickly in the stomach. This may increase side effects like nausea or reduce the effectiveness of the medication. Although the provided study 1 does not directly address the issue of splitting Cymbalta capsules, it does highlight the importance of proper dosing and administration of antidepressant medications, including duloxetine. The study lists duloxetine as a commonly used antidepressant medication with a specific dosage range and notes the importance of adjusting the dose in patients with renal or hepatic disease. If you're having difficulty swallowing the capsule or need a dose adjustment, consult your healthcare provider. They may recommend alternative formulations or different medications rather than splitting Cymbalta. Never modify your medication without medical guidance, as doing so can significantly alter how the drug works in your body. Key considerations include:
- The delayed-release mechanism of Cymbalta
- Potential for increased side effects or reduced efficacy if the capsule is split
- Importance of consulting a healthcare provider for alternative solutions
- Proper administration and dosing of antidepressant medications, as outlined in the study 1.
From the FDA Drug Label
Swallow duloxetine delayed-release capsules whole. Do not chew or crush duloxetine delayed-release capsules. Do not open the capsule and sprinkle on food or mix with liquids. Opening the capsule may affect how well duloxetine delayed-release capsules works
Do not split Cymbalta (duloxetine) capsules. The FDA drug label instructs to swallow the capsules whole and not to chew, crush, or open them, as this may affect how well the medication works 2.
From the Research
Splitting Cymbalta Capsules
- Cymbalta (duloxetine) capsules contain duloxetine HCl equivalent to 20,30,60 mg of duloxetine 3.
- There is no direct evidence in the provided studies regarding the splitting of Cymbalta capsules.
- However, studies on tablet and capsule splitting in general suggest that splitting can be problematic, especially with extended-release formulations 4, 5, 6.
- Splitting capsules can result in unequal quantities of the drug in each part, affecting the dosage 6.
- A systematic review on tablet splitting found that concerns regarding loss of mass, weight variability, chemical instability, or non-compliance are not substantiated by evidence, but splitting sustained-release preparations can alter the rate of drug release 7.
Considerations for Splitting
- Capsules should not be ordered to be split because the base of the capsule holds more of the drug powder than the top of the capsule 6.
- Patients should be cautioned not to split or crush a medication without checking with the healthcare provider or pharmacist 5.
- Clinicians managing patient care should discuss medication administration, clarify the dosing schedule, and clearly indicate the route of administration 5.