Duloxetine Hydrochloride interactions
Checked as Duloxetine in this data source.
Full monograph for Duloxetine HydrochlorideCheck it against another medicine
Medicines
674 documented
| Medicine | Severity | Mechanism | Effect | Sources |
|---|---|---|---|---|
| Almotriptan | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1… | 100 sources — open the full entry |
| Amitriptyline Hydrochloride | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1… | 100 sources — open the full entry |
| Amitriptyline Hydrochloride + Chlordiazepoxide | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1…2 documented mechanisms | 144 sources — open the full entry |
| Brexpiprazole | Major | Metabolism | Coadministration with inhibitors of CYP450 3A4 and/or 2D6 may significantly increase the plasma concentrations of brexpiprazole, which is metabolized by these… | 5 sources — open the full entry |
| Bupropion Hydrochloride | Major | Metabolism | The use of bupropion is associated with a dose-related risk of seizures. The risk may be further increased when coadministered with other agents that can… | 23 sources — open the full entry |
| CiprofloxacinbaseOphthalmic | Major | Metabolism | Coadministration with potent inhibitors of CYP450 1A2 may significantly increase the plasma concentrations of duloxetine, which is a substrate of the… | 3 sources — open the full entry |
| Ciprofloxacin + Dexamethasone | Major | Metabolism · Unknown | Coadministration with potent inhibitors of CYP450 1A2 may significantly increase the plasma concentrations of duloxetine, which is a substrate of the…2 documented mechanisms | 3 sources — open the full entry |
| Ciprofloxacin + Hydrocortisone Acetate | Major | Metabolism | Coadministration with potent inhibitors of CYP450 1A2 may significantly increase the plasma concentrations of duloxetine, which is a substrate of the… | 3 sources — open the full entry |
| Citalopram Hydrobromide | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1… | 100 sources — open the full entry |
| Clomipramine Hydrochloride | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1… | 100 sources — open the full entry |
| Cyclobenzaprine Hydrochloride | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1… | 100 sources — open the full entry |
| Desvenlafaxine Succinate | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1… | 100 sources — open the full entry |
| Dextromethorphan + Bupropion | Major | Metabolism · Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1…2 documented mechanisms | 157 sources — open the full entry |
| Dextromethorphan + Phenylephrine + Triprolidine | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1…3 documented mechanisms | 190 sources — open the full entry |
| Dextromethorphan + Pseudoephedrine + Triprolidine | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1…3 documented mechanisms | 190 sources — open the full entry |
| Dextromethorphan Hydrobromide | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1… | 134 sources — open the full entry |
| Dextromethorphan Hydrobromide + Guaifenesin | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1… | 134 sources — open the full entry |
| Dextromethorphan Polistirex | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1… | 134 sources — open the full entry |
| Diphenhydramine + Dextromethorphan + Levomenthol | Major | Metabolism · Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1…2 documented mechanisms | 137 sources — open the full entry |
| Doxepin (Oral) | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1… | 100 sources — open the full entry |
| Doxepin (Topical) | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1… | 100 sources — open the full entry |
| Escitalopram Oxalate | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1… | 100 sources — open the full entry |
| Fentanyl Citrate | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1… | 100 sources — open the full entry |
| Fluoxetine Hydrochloride | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1… | 100 sources — open the full entry |
| Fluphenazine + Nortriptyline | Major | Metabolism · Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1…2 documented mechanisms | 103 sources — open the full entry |
| Fluvoxamine Maleate | Major | Metabolism | Coadministration with fluvoxamine may significantly increase the plasma concentrations of duloxetine. The mechanism is fluvoxamine inhibition of duloxetine… | 15 sources — open the full entry |
| Granisetron | Major | Synergy | Concomitant use of 5-HT3 receptor antagonists with agents that possess or enhance serotonergic activity such as selective serotonin reuptake inhibitors… | 7 sources — open the full entry |
| Guaifenesin + Dextromethorphan + Menthol | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1… | 134 sources — open the full entry |
| Imipramine Hydrochloride | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1… | 100 sources — open the full entry |
| Iohexol | Major | Synergy | Intrathecal administration of iodinated contrast media may induce seizures. Although clinical data are generally lacking, there may be a theoretical risk of… | 5 sources — open the full entry |
| Iopamidol | Major | Synergy | Intrathecal administration of iodinated contrast media may induce seizures. Although clinical data are generally lacking, there may be a theoretical risk of… | 5 sources — open the full entry |
| Lasmiditan Hemisuccinate | Major | Synergy | Coadministration of lasmiditan and serotonergic agents may increase the risk of serotonin syndrome. Lasmiditan binds to the 5-HT(1F) receptor, where it… | 5 sources — open the full entry |
| Leflunomide | Major | Synergy | The recent, concomitant, or subsequent use (without the recommended leflunomide washout period or procedure) of other agents known to induce hepatotoxicity may… | 3 sources — open the full entry |
| Levomilnacipran Hydrochloride | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1… | 100 sources — open the full entry |
| Linezolid | Major | Synergy | Coadministration of linezolid with serotonergic agents may potentiate the risk of serotonin syndrome, which is a rare but serious and potentially fatal… | 52 sources — open the full entry |
| Lithium Carbonate | Major | Synergy | Lithium may enhance the pharmacologic effects of serotonin reuptake inhibitors (e.g., SSRIs, SNRIs, nefazodone, trazodone) and potentiate the risk of serotonin… | 22 sources — open the full entry |
| Maprotiline Hydrochloride | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1… | 100 sources — open the full entry |
| Milnacipran Hydrochloride | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1… | 102 sources — open the full entry |
| Mirtazapine | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1… | 100 sources — open the full entry |
| Nortriptyline | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1… | 100 sources — open the full entry |
| Ondansetron | Major | Synergy | Concomitant use of 5-HT3 receptor antagonists with agents that possess or enhance serotonergic activity such as selective serotonin reuptake inhibitors… | 7 sources — open the full entry |
| Palonosetron | Major | Synergy | Concomitant use of 5-HT3 receptor antagonists with agents that possess or enhance serotonergic activity such as selective serotonin reuptake inhibitors… | 7 sources — open the full entry |
| Paracetamol + Tramadol Hydrochloride | Major | Synergy · Unknown | Due to its serotonergic activity, coadministration of tramadol with serotonin-enhancing drugs such as SSRIs, SNRIs, nefazodone, trazodone, and mirtazapine may…2 documented mechanisms | 33 sources — open the full entry |
| Paroxetine Hydrochloride | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1… | 100 sources — open the full entry |
| Pentazocine | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1… | 100 sources — open the full entry |
| Pethidine Hydrochloride | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1… | 100 sources — open the full entry |
| Rasagiline | Major | Synergy | By inhibiting serotonin metabolism, monoamine oxidase inhibitors (MAOIs) may potentiate the pharmacologic activity of serotonergic agents such as serotonin… | 74 sources — open the full entry |
| Remifentanil Hydrochloride | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1… | 100 sources — open the full entry |
| Rizatriptan Benzoate | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1… | 100 sources — open the full entry |
| Safinamide Mesylate | Major | Synergy | By inhibiting serotonin metabolism, monoamine oxidase inhibitors (MAOIs), including safinamide, may potentiate the pharmacologic activity of serotonergic… | 93 sources — open the full entry |
Food & lifestyle
alcohol
ModerateSynergy
Use of duloxetine in conjunction with chronic alcohol consumption may potentiate the risk of liver injury.
What to do: Due to the risk of liver injury, patients prescribed duloxetine should be counseled to avoid excessive use of alcohol. Duloxetine should generally not be prescribed to patients with substantial alcohol use.
1 source
- "Product Information. Cymbalta (duloxetine)." Lilly, Eli and Company (2004):
Conditions
Conditions in which Duloxetine Hydrochloride needs care, as documented in this source.
Depressive Disorder
MajorAdult and pediatric patients with depression and other psychiatric disorders may experience worsening of their symptoms and may have the emergence of suicidal thoughts and behavior. Patients should be monitored appropriately and observed closely for worsening of their symptoms, suicidality or changes in their behavior, especially during the first few months of treatment, and at times of dose changes. Discontinuing the medication should be considered if symptoms are persistently worse, or abrupt in onset. It may be prudent to refrain from dispensing large quantities of medication to these patients.
5 sources
- "Product Information. Effexor (venlafaxine)." Wyeth-Ayerst Laboratories (2001):
- "Product Information. Cymbalta (duloxetine)." Lilly, Eli and Company (2004):
- "Product Information. Pristiq (desvenlafaxine)." Wyeth Laboratories (2008):
- "Product Information. Savella (milnacipran)." Forest Pharmaceuticals (2009):
- "Product Information. Fetzima (levomilnacipran)." Forest Pharmaceuticals (2013):
Kidney Diseases
MajorThe use of duloxetine should be avoided in patients with severe renal impairment (GFR <30 mL/min).
1 source
- "Product Information. Cymbalta (duloxetine)." Lilly, Eli and Company (2004):
Liver Diseases
MajorPostmarketing studies have reported that duloxetine and some other SNRIs like milnacipran may aggravate preexisting liver disease. The use of duloxetine delayed-release and milnacipran should be avoided in patients with chronic liver disease or cirrhosis.
2 sources
- "Product Information. Cymbalta (duloxetine)." Lilly, Eli and Company (2004):
- "Product Information. Savella (milnacipran)." Forest Pharmaceuticals (2009):
Diabetes Mellitus
ModerateIn clinical trials, treatment with duloxetine delayed-release worsened the glycemic control in some patients with diabetes. Caution should be used when using duloxetine in diabetic patients and their glycemic levels should be checked regularly.
1 source
- "Product Information. Cymbalta (duloxetine)." Lilly, Eli and Company (2004):
Glaucoma
ModerateSNRI antidepressants cause pupillary dilation that may trigger an angle closure attack in patients with anatomically narrow angle without iridectomy.
5 sources
- "Product Information. Effexor (venlafaxine)." Wyeth-Ayerst Laboratories (2001):
- "Product Information. Cymbalta (duloxetine)." Lilly, Eli and Company (2004):
- "Product Information. Pristiq (desvenlafaxine)." Wyeth Laboratories (2008):
- "Product Information. Savella (milnacipran)." Forest Pharmaceuticals (2009):
- "Product Information. Fetzima (levomilnacipran)." Forest Pharmaceuticals (2013):
Hypertension
ModerateSelective serotonin and norepinephrine reuptake inhibitor antidepressants (SNRIs) have been associated with sustained increases in blood pressure. Therapy with SNRI antidepressants should be administered cautiously in patients with preexisting hypertension. Blood pressure should be assessed prior to initiating treatment and monitored regularly. The dose should be reduced or discontinued if necessary.
5 sources
- "Product Information. Effexor (venlafaxine)." Wyeth-Ayerst Laboratories (2001):
- "Product Information. Cymbalta (duloxetine)." Lilly, Eli and Company (2004):
- "Product Information. Pristiq (desvenlafaxine)." Wyeth Laboratories (2008):
- "Product Information. Savella (milnacipran)." Forest Pharmaceuticals (2009):
- "Product Information. Fetzima (levomilnacipran)." Forest Pharmaceuticals (2013):
Hyponatremia
ModerateTreatment with SNRI antidepressants can cause hyponatremia. Caution should be used when treating patients with hyponatremia or at greater risk of hyponatremia such as the elderly, patients taking diuretics or who are volume depleted.
5 sources
- "Product Information. Effexor (venlafaxine)." Wyeth-Ayerst Laboratories (2001):
- "Product Information. Cymbalta (duloxetine)." Lilly, Eli and Company (2004):
- "Product Information. Pristiq (desvenlafaxine)." Wyeth Laboratories (2008):
- "Product Information. Savella (milnacipran)." Forest Pharmaceuticals (2009):
- "Product Information. Fetzima (levomilnacipran)." Forest Pharmaceuticals (2013):
Mania
ModerateTherapy with SNRI antidepressants can cause activation of mania and hypomania and should be used with caution in patients with personal or family history of mania, hypomania, bipolar disorder, and other mood disorders.
5 sources
- "Product Information. Effexor (venlafaxine)." Wyeth-Ayerst Laboratories (2001):
- "Product Information. Cymbalta (duloxetine)." Lilly, Eli and Company (2004):
- "Product Information. Pristiq (desvenlafaxine)." Wyeth Laboratories (2008):
- "Product Information. Savella (milnacipran)." Forest Pharmaceuticals (2009):
- "Product Information. Fetzima (levomilnacipran)." Forest Pharmaceuticals (2013):
Seizures
ModerateSNRI antidepressants may trigger seizures and should be administered with caution in patients with a seizure disorder.
5 sources
- "Product Information. Effexor (venlafaxine)." Wyeth-Ayerst Laboratories (2001):
- "Product Information. Cymbalta (duloxetine)." Lilly, Eli and Company (2004):
- "Product Information. Pristiq (desvenlafaxine)." Wyeth Laboratories (2008):
- "Product Information. Savella (milnacipran)." Forest Pharmaceuticals (2009):
- "Product Information. Fetzima (levomilnacipran)." Forest Pharmaceuticals (2013):
Urethral Obstruction
ModerateSNRI antidepressants have a noradrenergic effect and can affect urethral resistance. Caution should be used in patients with a history of dysuria, prostatic hypertrophy, prostatitis, and other lower urinary tract obstructive disorders.
5 sources
- "Product Information. Effexor (venlafaxine)." Wyeth-Ayerst Laboratories (2001):
- "Product Information. Cymbalta (duloxetine)." Lilly, Eli and Company (2004):
- "Product Information. Pristiq (desvenlafaxine)." Wyeth Laboratories (2008):
- "Product Information. Savella (milnacipran)." Forest Pharmaceuticals (2009):
- "Product Information. Fetzima (levomilnacipran)." Forest Pharmaceuticals (2013):
Therapeutic duplication
Drug classes that overlap with Duloxetine Hydrochloride, so taking both doubles up the same effect. This source publishes no per-row citations for duplication.
antidepressants
The recommended maximum number of medicines in the 'antidepressants' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antidepressants' category.
Example product in the source data (US market): Fluoxetine/olanzapine
antidepressants
The recommended maximum number of medicines in the 'antidepressants' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antidepressants' category.
Example product in the source data (US market): Limbitrol ds
antidepressants
The recommended maximum number of medicines in the 'antidepressants' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antidepressants' category.
Example product in the source data (US market): Amitriptyline/perphenazine
antidepressants
The recommended maximum number of medicines in the 'antidepressants' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antidepressants' category.
Example product in the source data (US market): Bupropion/naltrexone
antidepressants
The recommended maximum number of medicines in the 'antidepressants' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antidepressants' category.
Example product in the source data (US market): Bupropion/dextromethorphan