Side Effects:

Common Nausea, Headache, Dry mouth, Sleepiness, Dizziness.

Expert advice for Symbal Tablet
You may have to wait for 2 to 4 weeks to get the full effect. If your doctor asks you to stop Symbal, you should not discontinue it abruptly. Many patients tolerate decreasing 50% dose every 3 days however if the withdrawal symptoms emerge during tapering it would require more gradual tapering over few weeks. Inform your doctor if you have ever been diagnosed with any heart problems (heart attack, heart failure, slow or irregular heart rate). Inform your doctor if you have ever been diagnosed with kidney or liver problems. It can cause a sensation of restlessness or an inability to sit or stand still. This is most likely to occur within the first few weeks of treatment. You should tell your doctor if this happens to you. It may be more effective in some patients with depression who fails to respond to selective serotonin receptor inhibitors (SSRI) e.g. Fluoxetine. Monitor blood pressure (BP) frequently.

Frequently Asked Questions

Q. Is Symbal a non-steroidal anti-inflammatory drug (NSAID)?
No. Symbal is not a non-steroidal anti-inflammatory drug (NSAID). It belongs to the anti-depressant class of drugs, more specifically SNRI (Serotonin-Norepinephrine Reuptake Inhibitor). It works by increasing the levels of chemical messengers (serotonin and noradrenaline) in the nervous system.

Q. Is Symbal a steroid?
No. Symbal is not a steroid. It belongs to the anti-depressant class of drugs, more specifically SNRI (Serotonin-Norepinephrine Reuptake Inhibitor). It works by increasing the levels of chemical messengers (serotonin and noradrenaline) in the nervous system.

Q. Is Symbal a blood thinner?
No. Symbal is not a blood thinner. Blood thinners prevent the formation of harmful blood clots.

Q. Is Symbal a stimulant?
No. Symbal is not a stimulant. Stimulants are the medicines which activate the central nervous system.

Q. Is Symbal a pain killer?
No. Symbal is not a classical painkiller e.g. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs).Duloxetine is used for the treatment of chronic pain conditions like neuropathic pain, diabetic neuropathy or fibromyalgia.

Q. Is Symbal a tricyclic antidepressant (TCA)?
No. Symbal is not a tricyclic antidepressant (TCA). It belongs to a class of anti-depressants called SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors).

Q. Is Symbal a benzodiazepine?
No. Symbal is not a benzodiazepine. It belongs to a class of anti-depressants called SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors). Benzodiazepines belong to the sedative-hypnotic class of drugs and include agents like diazepam, lorazepam, alprazolam etc.

Q. Is Symbal a narcotic?
No. Symbal is not a narcotic. It means it does not have habit-forming potential. Narcotics are the substance which can cause addiction and dependence.

Q. Is Symbal a psychotropic?
Yes. A psychotropic is a medicine that affects mind, emotions, and behaviour. Symbal, being an anti-depressant agent reduces the symptoms of depression and is a psychotropic agent.

Q. Can I take Symbal if I have Hepatitis C virus infection?
Symbal should be used with caution in patients with Hepatitis C virus infection. Cases of liver injury, including severe elevations of liver enzymes (>10-times upper limit of normal), hepatitis, and jaundice have been reported with Symbal. Taking Symbal increases the risk of liver toxicity and fatty liver in Hepatitis C virus-infected patients.

Q. What is the peak plasma concentration [Cmax] of Symbal?
The maximum plasma concentration [Cmax] of Symbal is 6 hours post oral dose. Food taken with Symbal may delay the time to reach the peak plasma concentration from 6 to 10 hours. This may marginally decrease the extent of absorption (approximately 11%).

Q. Can I take Symbal with Vitamin D?
Yes. Symbalcan be taken with vitamin D. It does not have any known interaction with Vitamin D.

Q. What is half life of Symbal?
The elimination half-life of Symbal ranges from 8 to 17 hours (mean 12 hours).

Q. Which is better in depression, Symbal or fluoxetine?
Fluoxetine has not been found to be different in either tolerability or efficacy when compared with Symbal in major depression. Symbal is good for treating depression, anxiety and may help with chronic pain.

Q. Which is better Symbal vs sertraline?
Symbal and sertraline are found to be equally effective in the treatment of Major Depressive Disorder (MDD). Certain symptoms like agitation and anxiety are reduced better by sertraline. Symbal has been found to be better than sertraline for neuropathic pain.

Q. Which is better for chronic pain, Symbal or pregabalin?
In patients with fibromyalgia Symbal is found to be better than pregabalin in reducing depressed mood. Pregabalin is better in reducing fatigue. Symbal and pregabalin generally provide equally comparable pain relieving efficacy in the treatment of diabetic peripheral neuropathic pain (DPNP).

Q. Which is better Symbal or fluoxetine?
Symbal has been found to be better for the treatment of chronic pain than Fluoxetine. Fluoxetine is good for treating depression and anxiety.

Q. Which is better for depression, Symbal or mirtazapine?
Currently, there is not enough information to firmly recommend one antidepressant over another. However, both these drugs have been found to be safe and efficacious in the treatment of depression.

Q. Which is better for depression, Symbal or venlafaxine?
Currently, there is not enough information to firmly recommend one antidepressant over another. Many doctors favour Symbal over venlafaxine when pain conditions coexist with depression.

Q. Is Symbal a barbiturate?
No. Symbal is not a barbiturate. Barbiturates belong to the Sedative-Hypnotic class of drugs and are likely to have abuse potential.

Q. When to take Symbal?
Symbal can cause difficulty in sleep (insomnia). Hence, it is advised to be taken in the morning than at night.

Q. When does Symbal start working?
Usually, the action of Symbal takes about three to four weeks to appear. Do not discontinue the therapy in between, thinking that it is not effective.

Q. How much dose of Symbal can produce overdose?
Overdose can occur at a doses as low as 1000 mg. Signs and symptoms of overdose (duloxetine alone or in combination with other medicinal products) included somnolence, coma, serotonin syndrome, seizures, vomiting and tachycardia.

Q. How does Symbal work in urinary incontinence?
Symbal is thought to work by interfering with certain chemicals (called serotonin and noradrenaline) that are used within the nerves that send messages to your pelvic floor muscles. This helps the muscles around the bladder outlet to contract more strongly, and this in turn controls the flow of urine and helps to prevent any leakage.

Q. Can I take Symbal with amitriptyline?
It is better to avoid Symbal and amitriptyline together. It can increase the risk of a serious condition called the serotonin syndrome, with symptoms such as confusion, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea.

Q. Can I take Symbal with sertraline?
It is better to avoid Symbal and sertraline together. It can increase the risk of a serious condition called the serotonin syndrome, with symptoms such as confusion, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea.

Q. Can I take Symbal with tramadol?
Symbal and tramadol together can increase the risk of a serious condition called the serotonin syndrome, with symptoms such as confusion, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Please inform your doctor if you are taking any of these medicines before coming to him.

Q. Can I take Symbal with bupropion?
Bupropion can cause inhibition of metabolism of Symbal in the body, resulting in toxic effects of Duloxetine. The concomitant use of these two drugs can result in seizures. Mention it to your doctor if you are taking any of these medications from before.

Q. Which is better in diabetic neuropathy, duloxetine or pregabalin?
In patients with fibromyalgia, Symbal is found to be better than pregabalin in reducing depressed mood. Pregabalin is better in reducing fatigue. Symbal and pregabalin generally provide equally comparable pain relieving efficacy in the treatment of diabetic peripheral neuropathic pain (DPNP).

Q. Can Symbal get me high?
No. Symbal does not cause a high. It does not create a feeling of euphoria and has no recreational potential.

Q. Can I use Symbal for arthritis?
Symbal is not approved for the treatment of arthritis. It is used in the treatment of depression, anxiety disorder, diabetic nerve disease, neuropathic pain and overactive urinary bladder.

Q. Can I use Symbal for sciatica?
No, Symbal is not approved for the treatment of sciatica. It is used in the treatment of depression, anxiety disorder, diabetic nerve disease, neuropathic pain and overactive urinary bladder.

Q. Can I use Symbal for obsessive-compulsive disorder (OCD)?
Obsessive-compulsive disorder (OCD) is a type anxiety disorder. It is approved for the treatment of obsessive-compulsive disorder. Research studies suggest that Symbal may provide a significant reduction in symptoms for patients with obsessive-compulsive disorder.

Q. Can I use Symbal for hot flashes?
No. Symbal is not approved for use in hot flashes. It may be used in the treatment of depression in postmenopausal women suffering from menopausal vasomotor symptoms (hot flashes, night sweats) and insomnia.

Q. Can I use Symbal for headaches?
No, Duloxetine is not approved for use in headaches. It is used in the treatment of depression, anxiety disorder, diabetic nerve disease, neuropathic pain and overactive urinary bladder.

Q. Can I use Symbal for a migraine?
No. Symbal is not approved for use in a migraine. It is used in the treatment of depression, anxiety disorder, diabetic nerve disease, neuropathic pain and overactive urinary bladder.

Q. Can I use Symbal for chronic pain?
Symbal is approved for the treatment of chronic pain states including neuropathic pain (nerve pain) associated with Diabetes Mellitus and fibromyalgia.

Q. Can I use Symbal for nerve pain?
Yes. Symbal is approved for use in nerve pain or neuropathic pain conditions, most commonly seen in patients suffering from Diabetes Mellitus.

Q. Can Symbal raise blood sugar levels?
No. Symbal may affect blood sugar levels. If you are diabetic and notice a change in the results of your blood or urine sugar tests, check with your doctor.