Duloxetine has 38 known drug interactions based on U.S. FDA drug labeling data. Of these, 9 are contraindicated combinations that should be avoided entirely. 6 are classified as major interactions requiring close medical supervision. Notable interactions include combinations with Cimetidine, Ciprofloxacin, Enoxacin. Patients taking Duloxetine should inform their healthcare provider of all current medications — including over-the-counter drugs and supplements — to avoid potentially harmful combinations. Data sourced from OpenFDA and the NIH National Library of Medicine.
- Total
- 38
- Contraindicated
- 9
- Major
- 6
- Moderate
- 19
- Minor
- 3
Contraindicated (9)
- Duloxetine + Cimetidine— Potent CYP1A2 inhibitor; should be avoided due to significant increase in duloxetine concentrations.
- Duloxetine + Ciprofloxacin— Quinolone antimicrobial that inhibits CYP1A2; should be avoided due to significant increase in duloxetine concentrations…
- Duloxetine + Enoxacin— Quinolone antimicrobial that inhibits CYP1A2; should be avoided due to significant increase in duloxetine concentrations…
- Duloxetine + Isocarboxazid— Concomitant use increases risk of serotonin syndrome. Use of isocarboxazid with duloxetine or within 5 days of stopping …
- Duloxetine + Linezolid— Concomitant use increases risk of serotonin syndrome. Use of linezolid with duloxetine or within 5 days of stopping dulo…
- Duloxetine + Methylene Blue— Intravenous methylene blue with duloxetine increases risk of serotonin syndrome and is contraindicated.
- Duloxetine + Phenelzine— Concomitant use increases risk of serotonin syndrome. Use of phenelzine with duloxetine or within 5 days of stopping dul…
- Duloxetine + Selegiline— Concomitant use increases risk of serotonin syndrome. Use of selegiline with duloxetine or within 5 days of stopping dul…
- Duloxetine + Tranylcypromine— Concomitant use increases risk of serotonin syndrome. Use of tranylcypromine with duloxetine or within 5 days of stoppin…
Major (6)
- Duloxetine + Dextroamphetamine Sulfate— SNRI concomitant use increases risk of serotonin syndrome. Monitor for signs and symptoms; discontinue if serotonin synd…
- Duloxetine + Fluoxetine— Potent CYP2D6 inhibitor; expected to increase duloxetine concentrations similar to paroxetine.
- Duloxetine + Fluvoxamine— Potent CYP1A2 inhibitor increased duloxetine AUC approximately 6-fold, Cmax about 2.5-fold, and half-life approximately …
- Duloxetine + Mirtazapine— SNRI concomitant use increases risk of serotonin syndrome. Monitor for signs/symptoms; consider discontinuation if serot…
- Duloxetine + Paroxetine— Potent CYP2D6 inhibitor; increases duloxetine AUC by approximately 60%, with greater inhibition expected at higher doses…
- Duloxetine + Quinidine— Potent CYP2D6 inhibitor; expected to increase duloxetine concentrations.
Moderate (19)
- Duloxetine + Acetylsalicylic Acid— Concurrent use may potentiate upper gastrointestinal bleeding risk due to serotonin reuptake inhibition effects on hemos…
- Duloxetine + Amphetamine— Concomitant use increases risk of serotonin syndrome. Monitor for symptoms during treatment initiation and dose increase…
- Duloxetine + Buspirone— Concomitant use increases risk of serotonin syndrome. Monitor for symptoms during treatment initiation and dose increase…
- Duloxetine + Citalopram— SNRIs increase risk of serotonin syndrome. Monitor for signs and symptoms, particularly during initiation and dosage inc…
- Duloxetine + Citalopram Hydrobromide— As an SNRI, concomitant use increases serotonin syndrome risk. Monitor for symptoms during initiation and dose increases…
- Duloxetine + Clozapine— CYP2D6 or CYP3A4 inhibitor that can increase clozapine levels and lead to adverse reactions. Close monitoring and dose r…
- Duloxetine + Darifenacin— CYP2D6 inhibitor; no dosing adjustments recommended for darifenacin when co-administered with duloxetine.
- Duloxetine + Deferasirox— Deferasirox inhibits CYP1A2 resulting in increased duloxetine concentration. Monitor for exposure related toxicity.
- Duloxetine + Fexinidazole— Fexinidazole inhibits CYP1A2, increasing duloxetine concentrations and risk of adverse reactions.
- Duloxetine + Leflunomide— Exposure to duloxetine may be reduced when coadministered with leflunomide. Monitor and adjust dose as required.
- Duloxetine + Leflunomide And Diclofenac Sodium Gel— Exposure of duloxetine may be reduced in patients taking leflunomide. Monitor and adjust dose as required.
- Duloxetine + Lithium— Concomitant use increases risk of serotonin syndrome. Monitor for symptoms during treatment initiation and dose increase…
- Duloxetine + Nsaids— Concurrent use may potentiate risk of upper gastrointestinal bleeding due to effects on serotonin-mediated platelet func…
- Duloxetine + Primaquine Phosphate— Primaquine may inhibit CYP1A2 and increase duloxetine exposure; increased monitoring for adverse reactions is recommende…
- Duloxetine + St. John'S Wort— Concomitant use increases risk of serotonin syndrome. Monitor for symptoms during treatment initiation and dose increase…
- Duloxetine + Teriflunomide— Teriflunomide may reduce exposure of duloxetine. Monitor patients and adjust dose as required.
- Duloxetine + Triptans— Concomitant use increases risk of serotonin syndrome. Monitor for symptoms during treatment initiation and dose increase…
- Duloxetine + Tryptophan— Concomitant use increases risk of serotonin syndrome. Monitor for symptoms during treatment initiation and dose increase…
- Duloxetine + Warfarin— Monitor carefully when initiating or discontinuing duloxetine. Altered anticoagulant effects and increased bleeding repo…
Minor (3)
- Duloxetine + Darifenacin Hydrobromide— CYP2D6 inhibitor; no dosing adjustments recommended.
- Duloxetine + Lorazepam— No significant pharmacokinetic interaction observed under steady-state conditions.
- Duloxetine + Temazepam— No significant pharmacokinetic interaction observed under steady-state conditions.