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Horrible Heartburn And Pain


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#1 cookiecrumbs

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Posted 27 March 2007 - 11:10 PM

I looked through many of the posts but could not find any talking about this side effect (maybe I just didn't look in the right place). Ever since starting Cymbalta several weeks ago I have had horrible heartburn to the extent that I am burping up mouthfuls of acid (sorry, bad visual). There are times when the pain in my chest from this becomes so unbearable that it no longer feels like heartburn, but just a huge pain in the center of my chest. It gets so bad that I take the Extra Strength Vicodin that is prescribed for my disk degeneration and other issues. The Vicodin lessens the pain, but does not make it go away entirely.

I have been taking Zantac for about two weeks, but it hasn't helped much. I never had this problem while I was on Lexapro or Effexor.

Anyone else suffer from heartburn as a result of Cymbalta? If so, what did you do to deal with it?

Thanks!
Hope does not require a massive chain where heavy links of logic hold it together. A thin wire will do…just strong enough to get you through the night until the winds die down.” ~Charles Swindoll

"My grace is sufficient for you, for my power is made perfect in weakness." 2 Corinthians 12:9


When the world says, "Give up," Hope says, "Try it one more time."

#2 rattman

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Posted 28 March 2007 - 12:03 AM

Hi there,

I haven't taken Cymbalta.....yet... am waiting for my doctor to take me off Wellbutrin and transition to Cymbalta -- but.......

Are you taking the Cymbalta on an empty stomach? Also are you taking the Vicodin on an empty stomach? I know from personal experience that even with food Vicodin would really mess with my stomach so I can't even take that anymore.

The symptoms you are having sound like Acid Reflux (GERD). If you are taking your meds on an empty stomach -- make sure you take them with food (even if it's a piece of bread or crackers), and at least 8 ounces of water (preferably 16 ounces). It's strange because sometimes a medication won't bother me on an empty stomach, then one day it hits.

I've suffered from Acid Reflux for 3 years now and the symptoms you describe sound EXACTLY like the ones I was having back in December.

I just had a follow up appointment today and changes in diet or medications (my doctor said) can cause stomach upset. STRESS is the biggest. He told me that stress and certain foods and medications can cause the flap/muscle between the stomach and esophagus to relax -- and if you've got stress that causes your stomach to produce more acid -- combine the two and you get the symptoms you describe. It is nasty I know. Zantac won't even touch my acid reflux -- until you can get something for your stomach, you might consider Prilosec OTC that you can get at a pharmacy -- it works much better for most people.

I've always heard that chewing gum (non mint gum) could upset the stomach with acid and/or reflux -- but today my GI Specialist told me that it can actually help because the saliva created from chewing gum is alkaline which can help neutralize stomach acid, plus it will help wash down any acid that is left in your esophagus from the reflux.

Contact your doctor right away because if the symptoms continue it can cause damage to your esophagus and stomach.

I really feel for you because I have been there.

#3 cookiecrumbs

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Posted 28 March 2007 - 01:08 AM

Thanks so much for your help! Sometimes I take the Cymbalta on an empty stomach and sometimes I don't. I've been on Vicodin for a couple of years with no problems, but I could see that the two together on an empty stomach might be a problem. I'll make putting something in my stomach the first change I make. I tried Prilosec OTC and it did nothing. I would never had considered chewing gum, so that's another easy thing to try.

Stress is a big problem for me. I have Chronic Adrenal Insufficiency, which means that my body is no longer producing cortisol. Cortisol's most important job is to help the body respond to stress.

I have an appointment with my doctor April 9th. That seems like forever to have to put up with this kind of pain.

Thanks for the taking the time to respond!
Hope does not require a massive chain where heavy links of logic hold it together. A thin wire will do…just strong enough to get you through the night until the winds die down.” ~Charles Swindoll

"My grace is sufficient for you, for my power is made perfect in weakness." 2 Corinthians 12:9


When the world says, "Give up," Hope says, "Try it one more time."

#4 smithar

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Posted 28 March 2007 - 08:15 AM

I usually take Cymbalta in the mornings on an empty stomach. I do drink a big glass of water or some coffee. :hearts: Anyway, i have not had any heartburn/ burping symptoms and i have been on in for about 3-4 months now. Sorry i could not be of more assistance.

#5 rattman

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Posted 28 March 2007 - 11:55 AM

You're very welcome! :hearts:

Do you know your doctor well enough for him to call you in a prescription without seeing him/her first? As far as the stomach issues go sometimes they will call in something for you if you can't get in right away. I'd suggest you call and leave a message for him with a nurse or receptionist that you're having really bad acid reflux and that Zantac, Prilosec, and antacids are not helping - and ask if he can prescribe Protnoix or Aciphex for your stomach as you've heard that helps, at least until you get in to see him. I have taken both and Protonix saved my stomach's life. Nexium is just a different version of Prilosec so if he tries to give you Nexium I'd ask for something else. I get pretty pushy with my doctors when I can't get in for awhile, and 2 weeks to wait for an appt is ridiculous when you're having such bad stomach issues.

I've never heard of Chronic Adrenal Insufficiency -- it doesn't sound very fun at all. I didn't realize Cortisol played such a big part in helping the body manage stress. What type of blood test do the do to find that? I'd almost bet I'm a little low on it.

Anyway - hope the tips help and that your stomach is feeling better soon!

Have a great day :bump:

Thanks so much for your help! Sometimes I take the Cymbalta on an empty stomach and sometimes I don't. I've been on Vicodin for a couple of years with no problems, but I could see that the two together on an empty stomach might be a problem. I'll make putting something in my stomach the first change I make. I tried Prilosec OTC and it did nothing. I would never had considered chewing gum, so that's another easy thing to try.

Stress is a big problem for me. I have Chronic Adrenal Insufficiency, which means that my body is no longer producing cortisol. Cortisol's most important job is to help the body respond to stress.

I have an appointment with my doctor April 9th. That seems like forever to have to put up with this kind of pain.

Thanks for the taking the time to respond!



#6 rattman

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Posted 03 April 2007 - 02:00 PM

I am on day 5 of 30mg Cymbalta -- I had nausea the first 4 days, then last night I had acid reflux. This morning I felt better, ate breakfast and took my Cymbalta with a 16 ounce glass of water and 2 soda crackers. Within 20 minutes the acid ( heartburn ) was back and bad. It's been 2 hours and even taking antacids aren't helping.

So I did some reading on this -- I take Protonix (a proton pump inhibitor for stomach acid) and on a website for drug interactions it talks about the PH level that the Cymbalta dissolves at.

Apparently it starts dissolving at PH level above 5.5 (which I'm guessing is in the small intestine). So if you're on an acid reducing drug, the pill could start dissolving in your stomach causing the heartburn.

Since I have to take Protonix for Acid Reflux (GERD) I am now unsure if I can continue Cymbalta. I've contacted my doctor so am waiting to hear back.

A quote directly from www.drugs.com when checking interactions between Protonix (which I think might include Nexium and Aciphex) and Cymbalta as follows:

"Coadministration of enteric-coated duloxetine with substances that raise gastrointestinal pH may result in earlier release of duloxetine from the formulation. The enteric coating is intended to resist drug dissolution until reaching a segment of the gastrointestinal tract where the pH exceeds 5.5. However, coadministration with aluminum- and magnesium-containing antacids (51 mEq) or famotidine has been shown to have no significant effect on the rate or extent of duloxetine absorption following administration of a 40 mg oral dose. It is unknown whether concomitant administration of proton pump inhibitors would affect duloxetine absorption."

#7 lov4k9s

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Posted 03 April 2007 - 02:41 PM

I have never taken Cymbalta, but I am on week 3 of Prozac and I am suffering from heartburn in the worst way! This has happened to me before and know it will go away eventually, but it sure sucks for me now!

I hope you feel better soon!

lov :hearts:
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#8 rattman

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Posted 04 April 2007 - 03:26 PM

I was on Prozac years ago for about 6 months and it didn't bother my stomach at all -- I was lucky I guess!

Thanks for your support :hearts:

#9 Jkm

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Posted 05 April 2007 - 07:36 AM

My doc handed me a bottle of axidx samples when I complained of acid in my stomach, but it eventually went away. I know that it wasn't a pleasant experience, at all. I still have problems if I take it on an empty stomach and don't recommend this at all. I'm not a breakfast eater and will even wait until I'm ready to eat something, then take Cymbalta, even if it's just a peanut butter sandwich. I know that the contents of this cap will burn your throat as someone tried to break on open to try to split up the dose years ago and found that it really burned on the way down. Don't try this... You'll really be sorry!! I'd recommend drinking a big glass of water with this one! I drink big glasses of water throughout the day and think it may help this med work better, too.

I hope you can get this figured out, Rattman. The first month or so is really something else. I didn't notice it being any worse when the dose in doubled, early on. Maybe we need to go to a buffet and stuff ourselves to get the acid down, lol! Something else.... Depressed with a stomach ache from the meds. I don't think this is the same for all. It seems that if you have stomach problems prior to taking Cymbalta, like excess acid it really gets highlighted. I know I've been on Nexium and that's about the best med for me, although it's pricey!

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#10 rattman

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Posted 05 April 2007 - 12:33 PM

Hi Jackie --

I've never heard of Axidx -- I have heard of Aciphex (I used to take that). I've been taking Protonix for 3 years. My doctor recently prescribed me Nexium ($30 copay vs $20 copay for Protonix) and the Nexium gave me a headache and I noticed more acid. Funny how our body chemistries are so different -- guess that is why it's good there are multiple formulas for multiple body chemistries !

I DO think I figured out how to combat the heartburn/acid with the Cymbalta. I had been reading up on interactions between drugs. When I read the interaction between proton pump inhibitors like Protonix and Nexium, it said it 'might' dissolve in the stomach if the stomach meds bring the PH level in the stomach above 5.5. I guess the coating on Cymbalta is designed to dissolve in 5.5 or above PH (higher PH is less acidic) -- and with the normal stomach, the actual stomach is more acidic than the small intestine, so the enteric type coated pills will wait until they get into the small intestine to dissolve.

Long story short -- I thought, well coffee is acidic, so if I have my breakfast sandwich, take my pills with a small amount of water, than have a cup of coffee, maybe that will raise the acidic level just enough to cause the Cymbalta not to dissolve in my stomach and bother it. Well 2 days in a row now (coincidence??) I've done that with no heart burn, no nausea, no excess acid - YEAH!!!!!!!

Also in the arena of the constipation some people report with Cymbalta and Wellbutrin, I started taking a Magnesium supplement with my evening meal and that helped TREMENDOUSLY. Also I have 1 of those Dannon Activa Yogurts after dinner and it's really helped my digestive system overall regulate.

Each day on Cymbalta I'm sleeping better (not waking up as much), and I am noticing slight mood improvements. I'm remaining optimistic -- after the way I felt before I started the AD's again, I don't want to let myself go down that far again.

Thanks again for your suggestions and help -- they are GREATLY appreciated!!! :hearts:

John

#11 rattman

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Posted 05 April 2007 - 11:32 PM

Well I think I spoke too soon -- on the way home from work it felt like I had butterflies in my stomach (like before I had to give a speech in highschool) and then my stomach just kind of ached a bit and felt acidic again.

Does this stuff eat thru your intestines too? I'm just wondering how your body can get used to this medication if it burns the digestive track?

After 4 months of many tests and getting on the right medication to help my stomach, plus taking Wellbutrin -- my stomach was fine for a month, and now the Cymbalta has messed it up again. I'm afraid it may cause more damage to my stomach if I continue taking it -- it's just very discouraging and frustrating. I'm taking the maximum stomach meds I can so if the stomach issues don't go away from the Cymbalta soon, I will have to stop it -- and if they get worse I definitely will stop it.

I wonder why they couldn't have formulated it better? Of all the AD's I've been on, I have never had issues like this.

I sent an email to my doctor's office and he just replied "it may be a side effect that might go away" -- how lame is that response?

Ugh......... :hearts:

#12 Jkm

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Posted 06 April 2007 - 09:47 AM

I agree, it's lame, but I guess he doesn't know what else to say. I think some of these meds are tested for six months and then released to the public and we really get to see what happens for all people, along with their different physical issues, going through what really happens...... I know I was only the 2nd. person my doc tried Cymbalta on and the other lady had Diabetes and neuropathy and this med was supposed to help her with that, while I had the depression, anxiety and a pain disorder.

Anyhow, if it upsets your stomach to the point that the pain is out of control, I guess it's up to you to make a decision about what you are willing to do and how long you are going to give this side effect to go away. I know I tried 30mg. twice a day for the second month, to see if that would be any easier on my stomach and it seemed to alleviate the acid, some. The third month, I went back to 60mg., and still have to watch that I don't take it on an empty stomach or it messes with my ibs, too. I have had gastritis and have had to go right into the medical doc to get some drink they make with mylanta and some green stuff that tastes like wintergreen to pull me out of it. Stomach problems are no fun! Maybe mylanta before you take it? I don't know. I have the stuff on tap at my house, just in case. Anxiety gets me there and gives me tension headaches.

Wish you could get the stress down so you didn't have this going on. I know that this is a great med once you get past the side effects, and I really wanted to stick it out because I was so hopeful that there was something out there to treat the pain disorder, besides addictive meds, which I would never consider going on, and it really does help me.

Jackie
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#13 rattman

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Posted 06 April 2007 - 11:10 AM

I got a response back from the doctor this morning -- he obviously doesn't read all the way through the emails. He told me to take it with food (like DUH!!!) which I already told him I do -- and then he said to make sure I take my stomach medication an hour before the first meal of the day which I told him I already do. He ignored the information I gave him about the combination of my Protonix and Cymbalta.

Anyway, I just wrote back to them I already do what they suggested and that I'll just suffer through for 2 more weeks until my next appointment. I just don't know at what point I will give up. I've been eating rolaids also (the tasty vanilla chewy kind - Mylanta makes me gag ;).

Funny thing is in the morning when I wake up my stomach is fine. What I am 'hoping' is that the stomach distress is being caused by the changes in my body and that they'll calm down.

From what I've read, it seems that the people who have had stomach issues with Cymbalta say it goes away between 7 days and a month. I know there's no way I can go a month -- but I will try to make it 2 weeks.

Anyway.......thanks for the support -- much appreciated :hearts:

#14 grapeape

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Posted 16 April 2007 - 11:11 PM

I have had heartburn as a result of various SSRIs, including Cymbalta. The effects grow as my dosage grows. It can be treated somewhat with meds like Prilosec and various antacids, but not fully done away with for some people. Taking it with food and using those meds can often make it manageable.

I never had any problems whatsoever with acid reflux until I started SSRIs. It is one of several side effects that unfortunately prevents me from taking high doses of meds for long.

#15 Jkm

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Posted 16 April 2007 - 11:14 PM

I found that the chewable rolaids work fast and are not chalky. They're soft and the taste is not bad. I know if I take this med on an empty stomach, I'm in for it! I'm not a breakfast eater, but a peanutbutter sandwich is becoming part of my diet. I can put the kabosh on the stomach acid real quick.

Jackie
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#16 americandancer

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Posted 17 April 2007 - 02:03 PM

I don't seem to have any trouble with heartburn from taking cymbalta....just nausea and the bloated feeling. Just wanted to let you know, Jackie, that I eat a peanut butter sandwich almost every morning on the way to work after taking my cymbalta, lol! I had to laugh when I read your post!

#17 waterlover

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Posted 28 July 2008 - 11:29 AM

I was just recently put on Cymbalta and have discontinued because of horrible heartburn. I have GERD, which I regulate with appropriate diet but even when my GERD was at it's worst, I have never been unable to sleep because of reflux symptoms. But with the Cymbalta, I was awakened every night with horrible chest pains. I have not taken the med for four days now and I STILL have the terrible heartburn. I, too, have searched the literature and am not finding information about Cymbalta aggravating reflux conditions. I am relieved to know that I'm am not the only one experiencing this. I am waiting for the pain to go away before starting a new med. What did you end up doing about this? I certainly cannot take a chance on my GERD being worsened, but do feel the need for an effective antidepressant.

Thanks,
waterlover


I looked through many of the posts but could not find any talking about this side effect (maybe I just didn't look in the right place). Ever since starting Cymbalta several weeks ago I have had horrible heartburn to the extent that I am burping up mouthfuls of acid (sorry, bad visual). There are times when the pain in my chest from this becomes so unbearable that it no longer feels like heartburn, but just a huge pain in the center of my chest. It gets so bad that I take the Extra Strength Vicodin that is prescribed for my disk degeneration and other issues. The Vicodin lessens the pain, but does not make it go away entirely.

I have been taking Zantac for about two weeks, but it hasn't helped much. I never had this problem while I was on Lexapro or Effexor.

Anyone else suffer from heartburn as a result of Cymbalta? If so, what did you do to deal with it?

Thanks!



#18 MaddieLouise

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Posted 29 July 2008 - 09:59 PM

Waterlover,

If you might think this sort-of falls into the realm of stomach discomfort, then you can find a great many threads on how Cymbalta start up side effects have really bothered some people (nausea, stomach ache, etc.). They seemed to be able to resolve it with some sort of OTC antacid. Have you asked your Dr. about taking something to relieve these symptoms?

Sincerely,

Maddie

Edited by MaddieLouise, 29 July 2008 - 09:59 PM.

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