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Is Counting Beads The Right Method? Aren't The Beads Timed Release?


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#1 Sadiejane

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Posted 02 May 2017 - 09:05 PM

My doc says Cymbalta capsules contain beads of different timed release. So if you count beads you may get the wrong number of fast or slow release? Any comments on this?

#2 fishinghat

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Posted 03 May 2017 - 08:12 AM

I have heard this but can find no information on the subject anywhere, even in the medical journals. It has been a while since I looked so I will check again. I might even call Eli Lilley. I will let you know what I find out. It would still be a lot better than cold turkey.


#3 fishinghat

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Posted 03 May 2017 - 09:45 AM

Well here is what I found.

https://dailymed.nlm...f2-c185fbad64ba

Excerts from the drug insert for Cymbalta.

"Do not open the capsule and sprinkle its contents on food or mix with liquids. All of these might affect the enteric coating."
Note - This would be due to the enteric coating dissolving/softening with contact with moisture in the food.
"Each capsule contains enteric-coated pellets of 22.4, 33.7, or 67.3 mg of duloxetine hydrochloride equivalent to 20, 30, or 60 mg of duloxetine, respectively. These enteric-coated pellets are designed to prevent degradation of the drug in the acidic environment of the stomach. Inactive ingredients include FD&C Blue No. 2, gelatin, hypromellose, hydroxypropyl methylcellulose acetate succinate, sodium lauryl sulfate, sucrose, sugar spheres, talc, titanium dioxide, and triethyl citrate. The 20 and 60 mg capsules also contain iron oxide yellow. "

Note - There is no indication of different enteric coatings on the beads.

https://www.fda.gov/...e/UCM172866.pdf

 

From the FDA quidance on Cymbalta.

"Lilly does not offer small dose Cymbalta formulations to facilitate tapering
Patient required to open capsules and count drug beads
Patient may require compounding pharmacy services
At his/her expense
Tapering may take weeks or months"


https://www.cymbalta...g-beadspellets/
An interesting account of bead sizes that took place on this site a number of years ago. While bead size may vary some what these folks found was rather consistant.

The following information is from...

The Lilly Answers Center at 1-800-LillyRx (1-800-545-5979).
Spoke to Michelle S.
May 3rd, 2017 at 8:50 AM
Cymbalta capsules are filled by weight.
They will not give out any information on variation in size or enteric coating.

 

These answers were given I am sure for legal reasons. The company information on bead size and coating is proprietary and even though this information would give our members a clearer view of how to better wean off the product it would not be supplied to us. This lady also stated that that Eli Lilley will not provide a weaning protocol more detailed than what is described in their drug insert which basically says wean of the medication do not go cold turkey.


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