What is the maximum dose of Cymbalta (duloxetine)?

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From the Guidelines

The maximum dose of Cymbalta (duloxetine) is 120 mg per day. This dosage is based on the most recent and highest quality studies, including those that have evaluated the efficacy and safety of duloxetine in various conditions such as neuropathic pain, major depressive disorder, and generalized anxiety disorder 1. Most patients start at a lower dose, often 30 mg daily, which may be increased to 60 mg daily after one week. For some conditions, 60 mg daily is the standard target dose, but doctors may increase to 120 mg daily if needed for adequate symptom control.

Key Considerations

  • Doses above 120 mg daily haven't been systematically evaluated and aren't recommended due to increased risk of side effects without proven additional benefit.
  • Cymbalta should be taken exactly as prescribed, and patients should never adjust their dose without consulting their healthcare provider.
  • Side effects can include nausea, dry mouth, constipation, decreased appetite, fatigue, increased sweating, and dizziness, which often improve over time as the body adjusts to the medication.
  • Cymbalta should not be stopped abruptly as this can cause withdrawal symptoms; dosage should be gradually reduced when discontinuing treatment.

Dosage and Administration

  • The dosing of duloxetine is simple, with 60 mg once daily appearing to be as effective as 60 mg twice daily 1.
  • The most common adverse effect of duloxetine is nausea, which seems to be reduced by administering 30 mg once daily for 1 week before increasing to 60 mg once daily 1.

From the FDA Drug Label

The maximum dose studied was 120 mg per day The maximum dose of Cymbalta (duloxetine) is 120 mg per day 2.

  • This dose was studied in the treatment of Generalized Anxiety Disorder, Diabetic Peripheral Neuropathic Pain, Fibromyalgia, and Chronic Musculoskeletal Pain.
  • It is recommended to increase the dosage in increments of 30 mg once daily if a decision is made to increase the dose beyond 60 mg once daily.

From the Research

Maximum Dose of Cymbalta

The maximum dose of Cymbalta (duloxetine) is not explicitly stated in the provided studies. However, the recommended dosage of duloxetine is mentioned in one of the studies:

  • The recommended dosage of duloxetine is 40-80 mg daily, depending on the indication, preferably split into two doses per day 3.

Dosage Information

Additional information on the dosage of duloxetine can be found in the following studies:

  • 60 mg q.d. appears to be the optimum starting and therapeutic dose based on dose assessments 4.
  • Duloxetine demonstrated antidepressant efficacy at a dose of 60 mg qd in two placebo-controlled, randomized, double-blind studies 5.
  • Treatment with duloxetine 60 mg/day was associated with small-to-moderate effect sizes in the range of 0.12 to 0.72 for response rate and 0.07 to 0.65 for remission rate 6.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Duloxetine: a balanced and selective norepinephrine- and serotonin-reuptake inhibitor.

American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists, 2005

Research

Duloxetine: A New Treatment for the Emotional and Physical Symptoms of Depression.

Primary care companion to the Journal of clinical psychiatry, 2003

Research

Duloxetine in the treatment of major depressive disorder.

Neuropsychiatric disease and treatment, 2007

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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