I am 75, diagnosed with Diabetes 2 mild, 2years ago. was prescribed

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I am 75, diagnosed with Diabetes 2 mild, 2years ago. was prescribed 30mg of cymbalta for depression, which was increased to 60mg. other meds had no adverse afffect to date: verapamil, lanoxin & plavix for slight heart murmur, also zetia, crestor, avandia for first year of diabetes then switched to glimperide (2mg), prilosec. increased to 60mg cym.experienced waves nauseau & dizziness. Neurologist suggested weaning by taking60 mg every other day.still experiencing increasingly severe dizziness & nausea

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Female, Age: 75, United States

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reduction of cymbalta from 60 to 30 mg.

Customer (name blocked for privacy)

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Hello Customer (name blocked for privacy),

Cymbalta commonly produces nausea and dizziness, especially in patients over the age of 50.

Usually, if the medication is taken once a day at bedtime and the dose is not increased until the side effects have diminished or disappeared older people can easily tolerate does as high as 60 mg. (Younger people generally go as high as 120 mg but most people over age 50 have difficulty tolerating doses above 60 mg.)

It would make more sense to lower the dose of Cymbalta, perhaps to its lowest dose of 20 mg. This could be taken at bedtime. With Cymbalta, the problems with side effects such as dizziness and nausea usually create more problems than tapering the medication fairly quickly.

If you want to try the Cymbalta again, I would suggest starting at 20 mg at bedtime until there are not problems with dizziness or nausea. Then increase to 30 mg at bedtime until no side effects occur. Finally, 60 mg can be taken once a day at bedtime.

Alternatively, you can take the 30 mg at bedtime for a few days and then stop taking it completely. Another medication may prove to have fewer side effects.

Good luck.

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do you think I may be overmedicated? what kind of test should i take to evaluate whether 1 or 2 baby aspirin could do the same work as plavix?
thanks again for your reply

Hello,

I do not think you are overmedicated, per se. However, as people get older their tolerance for medication often decreases. This is why very few individuals over the age of 50 can tolerate a dose of Cymbalta above 60 mg while most young adults in their 20's and 30's routinely take 120 mg a day.

It is the side effects of the medication that are the problem. So your choice is to lower the medication and start again but increase it very slowly if you are tolerating it or choose another medication that does not cause these same side effects.

Your other medications all do different jobs, and there is no single medication that is making you overmedicated. Each one has its purpose. Remember, it is not the number of pills you take a day that matters. It is wonderful that we have so many medications available to do so much (i.e., heartburn, cholesterol, blood pressure, blood sugar, blood clots, etc.)

You need to speak to your cardiologist about whether you should be taking aspirin or Plavix. Today, there is no easy or clear choice for everyone. When Plavix was first on the market it was believed to be superior to aspirin so everyone with a risk of stroke or heart attack was put on it. Today we know that in many cases aspirin is a far better choice.

If you do not have a cardiologist I recommend having a consultation with one. He/she can review all of your medications and all of your problems related to your heart. This is the person who can discuss with you whether aspirin or Plavix is a better choice for you.

Good luck.

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