TAMOXIFEN & CYMBALTA
I read that Tamoxifen should not be taken with Cymbalta as the Cymbalta can make the Tamoxifen ineffective as well as increase the side effects. Is this true and if so, can someone recommend a replacement for Cymbalta?
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Hi @ruby_tuesday , You are correct that Cymbalta reduces the effectiveness of tamoxifen. You could ask a pharmacist which antidepressants don’t react with tamoxifen and have a discussion with your doctor about which one of those would be best for you. I hope you find one that works well.
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@ maggie15 , Thanks so much for your response! I have to find a new Oncologist as my insurance has changed. Then I will discuss this matter. I have been suffering through this for almost 2 years. Just now finding out that Cymbalta has made the Tamoxifen ineffective and was also increasing my side effects is infuriating! The first thing the nurse does at every appointment is review my list of medications yet the Dr. has never made this connection? I've been on Cymbalta for probably 15 years. I am dumbfounded. It has been beaten in my head at every appointment how important it is to take this medication yet two years pass without picking up on this.
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@ruby_tuesday, Pharmacists are good at noticing potential drug interactions but doctors don't seem to have the time to keep up with it. I was really annoyed when my insurance changed my inhaler to a different drug in the same class that I knew would interact with my blood pressure meds. My pulmonologist asked for an exception but was told I had to try it to see what happened. I ended up in the ER so the exception was granted. Here is a website where you can check for possible problems.
https://www.drugs.com/drug_interactions.html
I always ask when I'm going to be given a new med and my PCP will go to a site like this. She has had to change what she was going to prescribe twice. I hope your new oncologist comes up with a solution.
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Please don't get me started on insurance companies, lol. Thank you so much for that website. Very helpful! So sorry you had to go through that. I'm sure the insurance company wasn't held accountable for your hospital stay. That is unacceptable.
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@ruby_tuesday. My oncologist started weaning me off of my Cymbalta back in mid April about a month after I started taking Tamoxifen. It has been awful. I was unaware of how severe withdrawal would be. I have been on Cymbalta for a little over a decade.I am two months into the process. The first step was cutting my dosage in half. I went from 60 mg daily to 30 mg daily. After a month of this, she advised me to begin taking the 30 mg every other day. I only lasted a week and a half on this new dosage plan before the withdrawal became too much. So the new plan was for me to try to move to 36 hours between doses. This went better. After two weeks on this plan, I moved to taking my 30 mg every 48 hours. This is where I’m at now and I seem to be stuck. I make it about 40 hours and then I start to feel gross. I’m gonna try to push to every 60 hours in the next couple of days. Fingers crossed. Also my oncologist told me that my Tamoxifen side effects might increase as I withdrawal from the Cymbalta. She said the Cymbalta blocks how effective the Tamoxifen is and due to this, it might’ve been minimizing some of the Tamoxifen side effects.
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@mellynic. I am so sorry to hear what you are going through. I have also been on this medication for well over a decade and am currently weaning off.
As far as the side effects, Cymbalta is known to intensify them. I was on Cymbalta & Tamoxifen for nearly two years and I cannot imagine the side effects being any worse. I pretty much went into hibernation. If I wasn't at work I was sleeping, and to be honest, I was sleeping at work. It was dangerous for me to drive, the hot flashes were unbearable and due to all of the sleeping, I ended up at 225 lbs. (Normal weight being 115) Hopefully what she meant to say was that getting off of the Cymbalta should minimize the side effects of the Tamoxifen.
I am shocked that your Oncologist is weaning you off Cymbalta in the manner. My Nurse Practitioner, whom I trust completely, advised me that if you don't wean off this medication extremely slow, it can push you into a major depression and give you severe withdrawal. Cymbalta comes in 20, 30 and 60 mg. So far, I went from 60mg to 30 mg, to 20 mg., to 20 mg every other day. My next step is to go to 20mg every 3 days and so on. I haven't had any withdrawal symptoms until just recently and they are bearable. Clearly, she is having you move too quickly on this. Ask her to put you on 20mg for a few weeks then go to every other day, every 3 days, etc. Hope this helps and fingers crossed that we both successfully make it happen. I am feeling some depression coming on again so I am wondering what depression meds CAN be taken with Tamoxifen?
Best of Luck to you. Would love to hear how it does.
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