As with other medications, you may wonder how long Cymbalta remains in your body after taking it, even if normal drug screen tests typically do not test for Cymbalta.
Especially when your physician may order lab tests to monitor serum levels during therapy, evaluate potential toxicity of the medication, or determine patient compliance to the treatment regimen, the length of time that Cymbalta stays in your system is a valid question to ask.
The simple answer is 2 – 3 days according to the medication’s half-life, but this does not consider a host of other factors that play a role in affecting the time before Cymbalta is eliminated.
What is Cymbalta?
Cymbalta is a serotonin and norepinephrine reuptake inhibitor (SNRI) approved by the Food and Drug Administration (FDA) in 2004 to treat major depressive disorder in adults, generalized anxiety disorder in adults and pediatric patients at least 7 years old, diabetic peripheral neuropathic pain in adults, fibromyalgia in adults and pediatric patients at least 13 years old, and chronic musculoskeletal pain in adults.1
Low levels of both serotonin and norepinephrine have been linked to depression, so by blocking the reuptake of these neurotransmitters, this prescription medication can ease depression by increasing the amount available to regulate mood and anxiety.
Cymbalta is taken orally once daily with or without food at varying doses depending on the indication and the patient. It is marketed as a delayed-release capsule and should not be chewed, crushed, or opened and sprinkled onto food or liquid, as this manipulation may affect the enteric coating. Patients are often started on a lower dose of Cymbalta before increasing to the targeted dose, which is usually 60 mg/day.
How Long Cymbalta Stays in Your System
How long does Cymbalta stay in your blood?
The elimination half-life of Cymbalta is approximately 12 hours, with a range of 8 to 17 hours.1 This means that it would take 12 hours for the concentration of Cymbalta to decrease to half of its starting dose in your system after being orally administered. However, since it actually takes approximately 4 to 5 half-lives for a drug to be fully eliminated from the body, Cymbalta may remain in your system for up to 60 hours or 2.5 days.2
How long does Cymbalta stay in your urine?
The major metabolites of Cymbalta are renally excreted and therefore can be found in the urine for up to five days after the last dose taken.3
How long does Cymbalta stay in your saliva?
Cymbalta, as well as many other drugs, stay in the saliva and blood for approximately the same amount of time. Therefore, Cymbalta stays in the saliva for 2 – 3 days.4
How long does Cymbalta stay in your hair?
Unlike blood or saliva, it might be more difficult to comprehend why Cymbalta, or any other drug for that matter, would appear in your hair. However, drugs usually enter our hair by passively diffusing from blood capillaries to growing cells of the hair follicle.
Depending on the length of your hair, Cymbalta and other drugs can possibly be detected for more than three years after the last dose.5 However, in shorter hair that is not exposed to aggressive treatment such as dyeing or bleaching, drugs can normally detected for at least one year.5
What affects how long Cymbalta stays in your system?
Many patient factors will impact the elimination half-life of Cymbalta such as length of time that the patient has been taking Cymbalta for, their weight, or genetics. However, specific studies have been conducted on the effect of age and liver function on the elimination of Cymbalta, and have produced results indicating their role in increasing the half-life of Cymbalta.
After comparing the half-life of a single dose of 40 mg of Cymbalta in healthy elderly females aged 65 to 77 years old and healthy middle-aged females aged 32 to 50 years old, it was found that the half-life is about 4 years longer in elderly females.6
This study indicates that age plays a factor in increasing the half-life of Cymbalta; however, no dosage adjustments are necessary for geriatric patients. The older population may experience the lengthier half-life due to an altered hepatic clearance attributable to a decrease in liver size, blood flow and drug metabolizing enzyme activity. It can be assumed that this same trend would be reflected in males.
Another study compared the half-life of Cymbalta in subjects with moderate liver cirrhosis versus healthy subjects. Results showed that the half-life was three-times longer in cirrhosis patients compared to the healthy patients.7
This increased time in which Cymbalta stays in the systems of these patients is due to the extensive hepatic biotransformation and metabolism that the drug undergoes. Therefore, it is recommended that adults with hepatic impairment, heavy alcohol use, and chronic liver disease avoid using Cymbalta.
However, gender, smoking status, race, and renal impairment do not appear to affect the elimination half-life of Cymbalta.
What are the side effects of Cymbalta?
Cymbalta carries a black box warning for suicidal thoughts and behaviors in children, adolescients, and young adults. The most commonly observed side effects of Cymbalta include nausea, headache, dry mouth, somnolence, and fatigue.
More serious adverse effects that patients may experience while taking Cymbalta include hepatotoxicity, orthostatic hypotension, serotonin syndrome, and severe skin reactions.
Cymbalta should be discontinued in patients displaying evidence of clinically significant liver dysfunction, serotonin syndrome or skin hypersensitivity.
Abruptly discontinuing Cymbalta may lead to withdrawal symptoms such as dizziness,
headaches, nausea, diarrhea, or paresthesia. Therefore, patients should be monitored for these syndromes while discontinuing treatment and it is recommended to gradually reduce the dose instead of suddenly stopping Cymbalta.
How long do Cymbalta side effects last?
As some of the side effects experienced when first starting Cymbalta treatment may be unpleasant, a common question is how long the side effects will last. For most patients, side effects will subside within the first two weeks with the most common side effect being nausea.8
It may take several weeks for patients to experience the therapeutic effects of Cymbalta, so it is important to try to refrain from discontinuing Cymbalta in the beginning due to side effects.1
When should you consult a doctor?
Although rare, taking Cymbalta may cause serious side effects and if you experience symptoms of these side effects, you should inform your healthcare provider so that they can make the appropriate recommendations to your treatment regimen.
Families and caregivers, as well as patients themselves, should be made aware of how worsening of depression may present itself along with the emergence of suicidal or unusual behavior, which may warrant a change to therapy.
Patients should also speak to their physician if they develop signs of liver problems such as itching, right upper belly pain, dark urine, or yellow eyes while they take Cymbalta.
Serotonin syndrome is another concern, especially if other serotonergic agents like triptans, tricyclic antidepressants, or amphetamines are used at the same time. This syndrome may present as mental status changes, autonomic instability in the form of rapid heartbeat, dizziness, or hyperthermia, and seizures.
If patients experience allergic skin reactions such as blisters, a peeling rash, sores in their mouth, or hives, they should contact their doctor or get medical care as soon as possible.
Generally, patients should not alter their dosing regimen of Cymbalta or stop taking it without the advice of their healthcare provider. Furthermore, if they plan to take or begin to take any over-the-counter or additional prescription medications, patients should notify their doctor due to the risk of harmful drug interactions.
How can DrHouse help you?
If you are not currently taking Cymbalta, but think that Cymbalta might be right for you, the clinicians at DrHouse can evaluate your condition and determine the best course of care.
If Cymbalta is already part of your treatment regimen, online medical professionals at DrHouse are available to answer any questions you may have regarding how it works, side effects, or any other concerns.
While Cymbalta is primarily prescribed as an antidepressant, it is also indicated for a wide variety of other conditions due to its properties as a serotonin and norepinephrine reuptake inhibitor.
A common concern when taking any drug, but especially one like Cymbalta, is the length of time in which it will remain in your system even after discontinuing treatment. This consideration may be due to a required drug test taken via blood, urine, saliva, or hair, or just a general desire to be aware of how long a foreign substance is remaining in your body, especially with known side effects.
The short answer is 2-3 days, but the time differs based on the body part or substance and personal factors. It’s important to keep in mind that although side effects may be uncomfortable, they generally disappear within a couple weeks, at which point the therapeutic effects should begin to take effect.
However, if any alarming side effects indicative of a more serious condition should arise, you should seek medical help immediately.
- Cymbalta (duloxetine) package insert. Indianapolis, IN: Eli Lilly and Company; 2004. Revised 2021 Sept.
- Hallare, Jericho and Gerriets, Valerie. “Half Life.” Treasure Island, FL, StatPearls Publishing, 2022 Jan.
- Bedrock Recovery Center. “How Long Does Cymbalta Stay in Your System?” Bedrock Recovery Center, https://bedrockrecoverycenter.com/articles/cymbalta-in-your-system/.
- Kelley-Baker, Tara, et al. “Comparing drug detection in oral fluid and blood: data from a national sample of nighttime drivers.” Traffic Inj Prev, vol. 15,2 (2014): 111-118. Doi: https://www.doi.org/10.1080/15389588.2013.796042.
- Pragst, Fritz and Balikova, Marie, et al. “State of the art in hair analysis for detection of drug and alcohol abuse.” Clinica Chimica Acta, vol. 370,1 (2006): 17-49. doi:10.1016/j.cca.2006.02.019.
- Skinner, Michael, et al. “Effect of age on the pharmacokinetics of duloxetine in women.” Br J Clin Pharmacol, vol. 57,1 (2004): 54-61. Doi: https://www.doi.org/10.1046/j.1365-2125.2003.01963.x
- Suri, Ajit, et al. “Duloxetine pharmacokinetics in cirrhotics compared with healthy subjects.” Int J Clin Pharmacol Ther, vol. 43,2 (2005): 78-84. doi:10.5414/cpp43078.
- Johns Hopkins Medicine. “Duloxetine.” The Johns Hopkins University. 2007, https://www.hopkinsmedicine.org/neurology_neurosurgery/centers_clinics/peripheral_nerve/patient_info/duloxetine_2007.pdf