Shown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by slinky on May 1, 2008, at 10:25:59
Hi
I've recently tapered off effexor again...that was hell.
His starting dose of 60mg Cymbalta is one tablet EVERY OTHER DAY for 2 weeks, then starting one 60mg daily the following week.
Why has he done this, as I'm having the brain zaps and mood swings from effexor still and don't need that day without a med.
So last night as I was due to start Cymbalta I opened the capsule and split it into half thinking it better to take 30mg a day for 2 weeks.
Everything on the internet suggests taking the tablet daily not every 48 hours...and 60mg is not the usual starting dose.
I'm in the UK and I think I'm the first patient he's prescribed it for.
Is it wiser to continue taking 30mg daily for the first 2 weeks then, take the 60mg the following week or just follow his odd intructions.
Thanks for your help.
Slinky
Posted by SteelyDan on May 1, 2008, at 10:37:42
In reply to Pdocs crazy strartup dosage on Cymbalt-help, posted by slinky on May 1, 2008, at 10:25:59
> Hi
>
> I've recently tapered off effexor again...that was hell.
>
> His starting dose of 60mg Cymbalta is one tablet EVERY OTHER DAY for 2 weeks, then starting one 60mg daily the following week.
>
> Why has he done this, as I'm having the brain zaps and mood swings from effexor still and don't need that day without a med.
>
> So last night as I was due to start Cymbalta I opened the capsule and split it into half thinking it better to take 30mg a day for 2 weeks.
>
> Everything on the internet suggests taking the tablet daily not every 48 hours...and 60mg is not the usual starting dose.
>
> I'm in the UK and I think I'm the first patient he's prescribed it for.
>
> Is it wiser to continue taking 30mg daily for the first 2 weeks then, take the 60mg the following week or just follow his odd intructions.
>
> Thanks for your help.
>
> Slinky
>
>
I don't understand the 60mgs. every other day thing. If it was me i would do the 30mgs. every day.-Dan
Posted by Phillipa on May 1, 2008, at 10:47:50
In reply to Re: Pdocs crazy strartup dosage on Cymbalt-help » slinky, posted by SteelyDan on May 1, 2008, at 10:37:42
30mg every day is the usual doseage some even start at 20mg. Phillipa
Posted by Jamal Spelling on May 1, 2008, at 11:36:44
In reply to Re: Pdocs crazy strartup dosage on Cymbalt-help, posted by Phillipa on May 1, 2008, at 10:47:50
The half-life of Cymbalta is simply too short to take it every other day.
Posted by bleauberry on May 1, 2008, at 17:13:29
In reply to Pdocs crazy strartup dosage on Cymbalt-help, posted by slinky on May 1, 2008, at 10:25:59
I keep trying to pursuade myself that doctors know what they are doing. I know some of them are a lot more competent than others.
30mg per day is the official starting dose. The halflife is too short to extend it two days. The halflife is short enough that it barely makes one day if that.
I believe the halflife is 12 hours. If so, then 12 hours after a 60mg dose, it is 30mg. 24 hours after the 60mg dose it is 15mg. 36 hours it is 7.5mg. 48 hours it is 3.25mg. If the halflife is shorter, as I've seen it stated at 8 hours in some references, then the situation is even more compelling.
But more importantly, the idea is to get a steady blood level, which is done with overlapping halflives from previous doses. Kind of hard to do that with an every other day dosing schedule. The blood level would be up and down like a roller coaster.
Anyway, forget the math. I think it makes sense to follow the normal label instructions which is daily 30mg. If it were me, I'm sure I would be having some withdrawal type symptoms during that day without the dose if I followed your doc's instructions.
Posted by Phillipa on May 1, 2008, at 19:59:06
In reply to Re: Pdocs crazy strartup dosage on Cymbalt-help, posted by bleauberry on May 1, 2008, at 17:13:29
Blueberry thanks for explaining half-life in such a simplistic way. Wonder it that would be a good way to see what dose is correct for you. Say take a med one day and on what day do you feel best? If day two than maybe l5mg? Don't know if that would work or not. Just as an experiment. As the halflife would increase the longer on the same dose if daily right? Phillipa
Posted by slinky on May 2, 2008, at 6:55:02
In reply to Pdocs crazy strartup dosage on Cymbalt-help, posted by slinky on May 1, 2008, at 10:25:59
Is it safe to take Stablon 12mg twice a day whilst I'm on 30mg of the Cymbalta until I start taking 60mg of Cymbalta ?
Thanks for your replies...I'm going to continue with the 30mg.
Wishing you all well
Slinky
Posted by Nadezda on May 2, 2008, at 11:29:37
In reply to Re: Thanks everyone but I have another question, posted by slinky on May 2, 2008, at 6:55:02
You really need to check with your pdoc about why he suggested taking Cymbalta every other day. There may be things about your particular reactions that don't apply to others here.
I, for example, only took Cymbalta every other day, because I have a high reactivity to some of its effects. Maybe your pdoc is being cautious.
You should get his reasoning before you change the dosage.
Nadezda
Posted by Racer on May 2, 2008, at 12:00:52
In reply to Re: Thanks everyone but I have another question, posted by slinky on May 2, 2008, at 6:55:02
I agree that 60mg every other day doesn't sound like the choice I'd make, but I don't think you need to wait the two weeks -- you should be able to go to the full 60 sooner. How long did your doctor suggest taking it every other day?
Also, I strongly agree with Nadenzda -- ask your doctor why he suggested starting that way. He may have a compelling reason which none of us can know.
Good luck -- Cymbalta was a much friendlier drug for me than Effexor was.
Posted by undopaminergic on May 2, 2008, at 15:56:45
In reply to Re: Thanks everyone but I have another question, posted by slinky on May 2, 2008, at 6:55:02
> Is it safe to take Stablon 12mg twice a day whilst I'm on 30mg of the Cymbalta until I start taking 60mg of Cymbalta ?
>It's most probably safe. Whether it's a good idea is a different question, and the only way to find out is to test.
Posted by Slinky on May 3, 2008, at 10:21:34
In reply to Re: Thanks everyone but I have another question » slinky, posted by Racer on May 2, 2008, at 12:00:52
> I agree that 60mg every other day doesn't sound like the choice I'd make, but I don't think you need to wait the two weeks -- you should be able to go to the full 60 sooner. How long did your doctor suggest taking it every other day?
Hi Racer,
Pdoc suggested 60mg every other day for two weeks.I can't start the 60mg now because my script is only covering me until I see him again next month so I can't start the 60mg sooner.
> Also, I strongly agree with Nadenzda -- ask your doctor why he suggested starting that way. He may have a compelling reason which none of us can know.
Maybe because I have bipolar but I'd of thought that starting at 60mg every other day would have made it worse...I'd be climbing the walls.
> Good luck -- Cymbalta was a much friendlier drug for me than Effexor was.Thank you Racer, wishing you well and hoping this med will help me.
Slinky.
Posted by TatteredandTorn on May 5, 2008, at 18:27:54
In reply to Re: Pdocs crazy strartup dosage on Cymbalt-help » slinky, posted by SteelyDan on May 1, 2008, at 10:37:42
I was put on Cymbalta and my starting dose was 60mg...Your doc is probably telling you to take one every other day because of the effects you are still suffering from Effexor (was on that too nasty drug that is!)
I'm in the UK too so you aren't alone
TatteredandTorn
xxx
Posted by Slinky on May 6, 2008, at 8:28:14
In reply to Re: Pdocs crazy strartup dosage on Cymbalt-help, posted by TatteredandTorn on May 5, 2008, at 18:27:54
> I was put on Cymbalta and my starting dose was 60mg...Your doc is probably telling you to take one every other day because of the effects you are still suffering from Effexor (was on that too nasty drug that is!)
>
> I'm in the UK too so you aren't alone
Hi, TatteredandTorn
I'm sticking to taking the 30mg daily (couldn't be bothered to phone doc and say what I'd done -he wouldn't of minded anyway )
It's taken away the effexor withdrawal.
Docs just don't realise the agony of coming off effexor and other meds.
I think I'll notice more positive effects of Cymbalta when I switch to 60mg.
I'm taking klonopin and Gabapentin also.I take Stablon somedays to add a little serotonin and Provigil sometimes for daytime sleepyness - both drugs I bought from overseas...doc knows I do this...whatever gets me through the day , as long as I'm sensible it's ok.
Hope the Cymbalta is working for you.
Slinky
Posted by TatteredandTorn on May 9, 2008, at 13:14:53
In reply to Re: Pdocs crazy strartup dosage on Cymbalt-help » TatteredandTorn, posted by Slinky on May 6, 2008, at 8:28:14
If it's working for you then stick to it - I'm yet to find a combination that works for me to keep me stable enough. Unfortunately I had to be taken off Cymbalta due to the side effects I was getting, I react badly to a lot of meds.
Effexor was the worst though - I was ringing friends and the boyfriend I had at the time telling them I wouldn't see them again and I was begging my boyfriend not to go to work but to come and see me! It was awful - I seriously thought I was going to die - and the hallucinations were really bad!Anyhow hope you've found your combination =] and things are going well!
TatteredandTorn
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