There is a U.S. Patent 6150396 for the use of duloxetine for treatment of interstitial cystitis although one study found positive outcomes in only a small proportion of cases. Interstitial cystitisis a bladder and urinary tract disorder which presents as chronic pelvic and perineal pain. It is speculated that duloxetine suppresses neural impulses related to pain below a threshold level sufficient to alleviate some or all neurological pain symptoms.
On November 4, 2010, the U.S. Food and Drug Administration approved Cymbalta to treat chronic musculoskeletal pain, including discomfort from osteoarthritis and chronic lower back pain.
The following contraindications are listed by the manufacturer:
· Hypersensitivity - duloxetine is contraindicated in patients with a known hypersensitivity to duloxetine or any of the inactive ingredients.
· Uncontrolled narrow-angle glaucoma - in clinical trials, Cymbalta use was associated with an increased risk of mydriasis (dilation of the pupil); therefore, its use should be avoided in patients with uncontrolled narrow-angle glaucoma, in which mydriasis can cause sudden worsening.
· CNS acting drugs - given the primary central nervous system (CNS) effects of duloxetine, it should be used with caution when it is taken in combination with or substituted for other centrally acting drugs, including those with a similar mechanism of action.
· Cymbalta and thioridazine should not be co-administered.