FDA recalls Duloxetine due to carcinogen

[soxman]

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I had a patient call telling me he didn't want to be on Duloxetine anymore as his pharmacist told him about the recall with "cancer causing ingredients".

https://www.google.com/amp/s/wgntv.com/news/recalls/over-7100-bottles-of-prescription-antidepressants-recalled-over-potentially-cancer-causing-substance/amp/

 

[Agast]

I very rarely put patients on the 20mg duloxetine. Usually start at 30 and then go to 60mg.

 

[bedrock]

I very rarely put patients on the 20mg duloxetine. Usually start at 30 and then go to 60mg.

I see a lot of patients with side effects at 30mg, so I start with 20mg in non obese individuals.

What percentage of your patients tolerate 60 of cymbalta?

 

[clubdeac]

Saw that too…think about potentially how many carcinogens are in the drugs we get from China. Scary stuff

 

[lobelsteve]

I see a lot of patients with side effects at 30mg, so I start with 20mg in non obese individuals.

What percentage of your patients tolerate 60 of cymbalta?

90%

 

[bedrock]

90%

Mine frequently get headaches, or feel jittery nauseous

 

[CleanUp]

Per my recall of the literature, there was no dose dependent efficacy for the treatment of chronic pain. However, the dose isolation was reserved for depression and other psych issues.

 

[Ducttape]

Saw that too…think about potentially how many carcinogens are in the drugs we get from China. Scary stuff

except that Towa Pharmaceutical makes medications in Japan, not China.

TOWA PHARMACEUTICAL CO.,LTD.

Stable supply system of 3 plants with high production capacity

www.towayakuhin.co.jp

 

[clubdeac]

Wonder how much we’re getting poisoned by other countries

 

[buddababa]

I see a lot of patients with side effects at 30mg, so I start with 20mg in non obese individuals.

What percentage of your patients tolerate 60 of cymbalta?

i have never prescribed 20, always start with 30mg , 90% tolerate 60

 

[buddababa]

Wonder how much we’re getting poisoned by other countries

forget other countries, we're getting poisoned by our own, look at orange juice in usa/england, cereal in both countries, the list goes on and on

 

[clubdeac]

forget other countries, we're getting poisoned by our own, look at orange juice in usa/england, cereal in both countries, the list goes on and on

Oh I’m well aware! It’s horrible. But if our own country doesn’t GAF think how much worse it probably is with products we’re buying from countries that hate us

 

[SSdoc33]

Oh I’m well aware! It’s horrible. But if our own country doesn’t GAF think how much worse it probably is with products we’re buying from countries that hate us

so, you are saying that you like the regulations we have here in the US?

 

[clubdeac]

so, you are saying that you like the regulations we have here in the US?

I think the FDA is overall doing a crappy job but they’re amazing compared to China. You think China cares if some cancer causing adulterant or toxin makes its way into their drugs made for the US? I mean they’re openly trying kill us with fentanyl. Chances are they’re doing it in a more clandestine way as well

 

[Agast]

I see a lot of patients with side effects at 30mg, so I start with 20mg in non obese individuals.

What percentage of your patients tolerate 60 of cymbalta?

I don’t start with 20 because few patients see enough improvement to want to continue dose adjustment. Therapeutic really seems closer to 60mg. I start 30 then go to 30 BID and if there’s room for improvement I go to 60.

If they have side effects at 30mg then I don’t think it’s the right med for them

 

[Ducttape]

I think the FDA is overall doing a crappy job but they’re amazing compared to China. You think China cares if some cancer causing adulterant or toxin makes its way into their drugs made for the US? I mean they’re openly trying kill us with fentanyl. Chances are they’re doing it in a more clandestine way as well

i think you should try to rethink the political overlays to your thought process.


i can tell you that Chinese people do not wish to poison Americans. China does not want to poison Americans. (okay, Xi may, but not China)


Chinese companies want to sell products to the US to make money. some may cut corners to save money that accidentally poison americans. but thats capitalism.


and of course there are unscrupulous drug dealers of any nationality that want to make money with drugs that will kill americans.

but that is not china nor the chinese people.

 

[clubdeac]

i think you should try to rethink the political overlays to your thought process.


i can tell you that Chinese people do not wish to poison Americans. China does not want to poison Americans. (okay, Xi may, but not China)


Chinese companies want to sell products to the US to make money. some may cut corners to save money that accidentally poison americans. but thats capitalism.


and of course there are unscrupulous drug dealers of any nationality that want to make money with drugs that will kill americans.

but that is not china nor the chinese people.

Ok let me rephrase, when I say China I’m speaking of the authoritarian CCP that has spies in the US, that steals trade secrets and intellectual property and attempts to kill 100k Americans annually through the smuggling of fentanyl across our southern border.

 

[au bon pain]

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I see a lot of patients with side effects at [emoji[emoji[emoji[emoji6][emoji6]][emoji[emoji[emoji6]][emoji[emoji6]]]][emoji[emoji6][emoji6]][emoji[emoji[emoji6]][emoji[emoji6][emoji6]]]][emoji[emoji[emoji6]][emoji[emoji6]]]mg, so I start with [emoji[emoji[emoji6][emoji6]][emoji[emoji[emoji6]][emoji[emoji6]]]][emoji[emoji[emoji6]][emoji[emoji6]]]mg in non obese individuals.

What percentage of your patients tolerate [emoji[emoji[emoji[emoji6][emoji6]][emoji[emoji[emoji6]][emoji[emoji6]]]][emoji[emoji[emoji[emoji6][emoji6]][emoji[emoji[emoji6]][emoji[emoji6]]]][emoji[emoji6][emoji6]][emoji[emoji[emoji6]][emoji[emoji6][emoji6]]]][emoji[emoji6][emoji6]][emoji[emoji[emoji[emoji6][emoji6]][emoji[emoji[emoji6]][emoji[emoji6]]]][emoji[emoji[emoji[emoji6][emoji6]][emoji[emoji[emoji6]][emoji[emoji6]]]][emoji[emoji6][emoji6]][emoji[emoji[emoji6]][emoji[emoji6][emoji6]]]][emoji[emoji6][emoji6]][emoji[emoji[emoji6][emoji6]][emoji[emoji[emoji6]][emoji[emoji6]]]]]][emoji[emoji[emoji6]][emoji[emoji6]]] of cymbalta?

I also start low because I’d rather take a little longer to titrate if needed vs have a spooked patient.

And of those who don’t tolerate [emoji[emoji[emoji[emoji6][emoji6]][emoji[emoji[emoji6]][emoji[emoji6]]]][emoji[emoji[emoji[emoji6][emoji6]][emoji[emoji[emoji6]][emoji[emoji6]]]][emoji[emoji6][emoji6]][emoji[emoji[emoji6]][emoji[emoji6][emoji6]]]][emoji[emoji6][emoji6]][emoji[emoji[emoji[emoji6][emoji6]][emoji[emoji[emoji6]][emoji[emoji6]]]][emoji[emoji[emoji[emoji6][emoji6]][emoji[emoji[emoji6]][emoji[emoji6]]]][emoji[emoji6][emoji6]][emoji[emoji[emoji6]][emoji[emoji6][emoji6]]]][emoji[emoji6][emoji6]][emoji[emoji[emoji6][emoji6]][emoji[emoji[emoji6]][emoji[emoji6]]]]]][emoji[emoji[emoji6]][emoji[emoji6]]], they are much happier/seem to do better dropping back down to the “middle dose” vs their “starting dose” if we only started at [emoji[emoji[emoji[emoji6][emoji6]][emoji[emoji[emoji6]][emoji[emoji6]]]][emoji[emoji6][emoji6]][emoji[emoji[emoji6]][emoji[emoji6][emoji6]]]][emoji[emoji[emoji6]][emoji[emoji6]]].

One month I got messages from [emoji[emoji[emoji[emoji6][emoji6]][emoji[emoji[emoji6]][emoji[emoji6]]]][emoji[emoji6][emoji6]][emoji[emoji[emoji6]][emoji[emoji6][emoji6]]]] patients initiated on cymbalta all reporting sensation (no objective evidence) of palpitations…turns out all [emoji[emoji[emoji[emoji6][emoji6]][emoji[emoji[emoji6]][emoji[emoji6]]]][emoji[emoji6][emoji6]][emoji[emoji[emoji6]][emoji[emoji6][emoji6]]]] had been seen/initiated by the same fellow who told them it could cause palpitations so “be on the lookout” (ie primed them)…power of suggestion (and placebo/nocebo) is powerful and I feel like particularly so with SNRIs/TCAs

 

[au bon pain]

lol [mention]lobelsteve [/mention] this seemed to be fixed but now happening again…what gives?

 

[lobelsteve]

lol [mention]lobelsteve [/mention] this seemed to be fixed but now happening again…what gives?

I can ask mods. Software glitch.

 

[lobelsteve]

lol [mention]lobelsteve [/mention] this seemed to be fixed but now happening again…what gives?

From the Mods:

It appears to be an issue between the newest version of iOS and the tapatalk app. Have them uninstall tapatalk and then install the latest version and it should be fixed.