11 replies to this topic

[jc619]

Hi,

 

Are there any members who can help me please? I'm really confused by the type of capsules I should use for tapering, and so may have bought the wrong type. I've been told that Cymbalta beads are pretty hard on the digestive system, and read that releasing medicine in the wrong place can cause an overdose. So which type should I buy? 

 

On the Cymbaltahurtsworse website, it clearly states: 

 

Enteric capsules should not be used. The beads already have an enteric coating.

 

 

However, my duloxetine capsules state on the packaging: gastro-resistant capsule, hard.

 

 

I've now found a place to buy gastro-resistant ones in the UK at reasonable quantity/cost: www.purecapsules.co.uk/index.php/product/index/mid/76

 

Are these the correct types? They are all acid-resistant. And they are all delay release - is that OK?#

 

Thanks in advance. 

[fishinghat]

This is the info we have collected (ebook) that may help. Please let us know if we can help in any way.

 

Brands of capsules that members mentioned they used

 

FH  ‐ These are the specific empty capsule brands that members have mentioned in

the past...

 

https://www.amazon.c...,aps,213&sr=8‐1

https://www.amazon.c...0?ie=UTF8&psc=1 

 

Other capsule info.

 

Cymbalta Capsules

Cymbalta capsules are not enteric coated, only the individual beads are. Eli Lilley

uses gel capsules. The basic gel capsules work fine and can not only be bought on

line but also through your local compounding pharmacy.

 

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

Section 11 of the data sheet that comes with Cymbalta says it is a gelatin capsule

with enteric coated beads and the beads are designed to prevent contact with

stomach acid.  

 

https://www.ncbi.nlm...les/PMC2695226/

"Duloxetine is rapidly hydrolyzed in acidic media to naphthol, which has no

antidepressant activity. To overcome this issue, the pellets inside the duloxetine

capsule are enteric coated, but the capsule is not. This enteric coating of the pellets

resists dissolution until pellets reach a segment of the gastrointestinal tract where

the pH is favorable. "

 

(Breckenridge)'s insert, which reads:  

"Each capsule contains enteric‐coated pellets of 22.4, 33.7, 44.9 or 67.3 mg of

duloxetine hydrochloride equivalent to 20, 30, 40 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

494

 

Summary of Cymbalta Withdrawal Information ‐ www.cymbaltawithdrawal.com

ammonium hydroxide, black iron oxide, hypromellose, methacrylic acid copolymer

dispersion (methacrylic acid‐ethyl acrylate copolymer, polysorbate 80, sodium lauryl

sulfate), potassium hydroxide, propylene glycol, shellac, sucrose, sugar spheres

(maize starch, sucrose), talc, titanium dioxide, triethylcitrate, and hard gelatin

capsules (gelatin, titanium dioxide). The 20 mg hard gelatin capsule colorant is

yellow iron oxide."  

 

Enteric coated capsules ‐ more information

 

https://www.research..._and_evaluation

_of_duloxetine_hydrochloride_enteric‐

coated_pellets_with_different_enteric_polymers/fulltext/57d6b57708ae0c0081ea6

6ff/307999093_Preparation_and_evaluation_of_duloxetine_hydrochloride_enteric‐

coated_pellets_with_different_enteric_polymers.pdf

 

Eli Lilley Patent information

https://patents.goog...t/US5508276A/en

The patent information for Cymbalta manufacturing.

https://dailymed.nlm...query=Cymbalta

pagesize=20&page=1

All "Duloxetine" data sheets say the capsules are hard gelatin except Activas, Teva,

Cipla, Heritage, Inventia, Lupin, Solco, Sun Phartmaceutical, Zydes and Ascend which

did not state the construction of the capsule. In addition, Camber brand is not

enteric coated PELLETS but are only film coated only. Film coated is made of the

same material but thinner and does not meet the FDA required digestion time to be

considered enteric.

[jc619]

Thanks Fishinghat. 

 

Wow - that's really extensive. I love how you know your stuff and are so helpful. You're a legend and I'm blown away by your generosity shown on the forum! 

 

In summary, are you saying that you don't need gastro/acid-resistant capsules as the small micro-beads are already coated? Does that mean you can use any capsules?

 

The two Amazon links aren't working for some reason. Can you post them again please? Then I'll try and find some equivalent capsules in the UK.

 

My UK duloxetine tablets are made by Glenmark. I'm not very good at this so can't find any info on the capsules. 

[fishinghat]

Be back with you in a few minutes JC

[fishinghat]

OK, had to do a little research on these capsules. In the USA there is no legal distinction between an acid resistant capsule or an enteric coated capsule that I can find. I do know that most brands here use a gelatin capsule when making there Cymbalta. I hope this helps. 

 

By the way, thank you very much for the nice compliments. i certainly had a lot of help when I went through my withdrawal and am glad to help in return. God bless and hang in there.

[invalidusername]

Hey...

 

https://www.amazon.c...89&sr=8-29&th=1

 

This is the sort of thing you want, and will be fine. Good quality vegan and EU approved and will be fine for the beads...

 

IUN

[invalidusername]

...having seen the delay in them being posted, eBay will be better;

 

https://www.ebay.co....tm/132574275905

 

Size is irrelevant, but the usual is size 00. Anything bigger may be an issue and cause a gag reflex.

 

Again, you can select vegan and do not have nasty bovine rubbish or substitutes.

 

From the site you cited - these ones would be fine;

 

https://www.purecaps...uct/show/id/161

 

IUN

[jc619]

Thanks guys, really useful. 

 

The ones I ordered which I thought were wrong because they weren't gastro-resistant were these:

 

www.amazon.co.uk/dp/B00SX4SJ7Q?ref=ppx_yo2ov_dt_b_product_details&th=1

 

With these capsules, my concern was that as these aren't gastro-resistant they will be released in the stomach. They will even dissolve in water according to the questions section. 

 

Will they be OK?

[fishinghat]

Not being acid resistant is not an issue as the beads are enteric coated. The only thing the FDA says here in the States is not to chew the beads as that will break the enteric coating and release them into the stomach. I could not access the ones you and IUN selected so I can not judge its adequacy. 

[invalidusername]

Just to confirm... the ones you have chosen are perfect.

 

Sometimes, one has to search Amazon for some time to find the best/cheapest combo.

 

"Bulk" are a very good and established company, so I would trust them. They are also free from all the cr@p that I spoke of before.

 

Good choice JC. Please keep us posted on how it goes and particularly if you need any help.

 

IUN.

[invalidusername]

Just to put your mind at ease, we had a massive research project going on years ago about the enteric capsule debate. 

 

It was thorough to say the least.

 

Whilst some pharmas used the enteric (acid-resistant) capsules, they were not necessary as the beads themselves are enteric coated, thus surviving this process.

 

So whilst the capsule itself may breakdown under the weight of your stomach acid excreted by the liver, the beads themselves will survive this acid and journey into the intestines where they need to break down as they reach their correct place in the blood stream to do their correct work.

 

Stuff you don't hear from your Doctor here in the UK... probably because they don't know!!! I have "informed" many a GP/psychiatrist of such issues believe me - and got a doctor struck off due to medical malpractice. 

 

(Careful IUN !!!!   LOL )

[jc619]

Thanks IUN,

 

Like Fishinghat, your help and generosity are awesome.

 

I'll move all further comments to the other thread.

 

JC619.