Duloxetine

Potent CYP1A2 inhibitor; should be avoided due to significant increase in duloxetine concentrations.

Quinolone antimicrobial that inhibits CYP1A2; should be avoided due to significant increase in duloxetine concentrations.

Quinolone antimicrobial that inhibits CYP1A2; should be avoided due to significant increase in duloxetine concentrations.

Concomitant use increases risk of serotonin syndrome. Use of isocarboxazid with duloxetine or within 5 days of stopping duloxetine is contraindicated.

Concomitant use increases risk of serotonin syndrome. Use of linezolid with duloxetine or within 5 days of stopping duloxetine is contraindicated.

Intravenous methylene blue with duloxetine increases risk of serotonin syndrome and is contraindicated.

Concomitant use increases risk of serotonin syndrome. Use of phenelzine with duloxetine or within 5 days of stopping duloxetine is contraindicated.

Concomitant use increases risk of serotonin syndrome. Use of selegiline with duloxetine or within 5 days of stopping duloxetine is contraindicated.

Concomitant use increases risk of serotonin syndrome. Use of tranylcypromine with duloxetine or within 5 days of stopping duloxetine is contraindicated.

SNRI concomitant use increases risk of serotonin syndrome. Monitor for signs and symptoms; discontinue if serotonin syndrome occurs.

Potent CYP2D6 inhibitor; expected to increase duloxetine concentrations similar to paroxetine.

Potent CYP1A2 inhibitor increased duloxetine AUC approximately 6-fold, Cmax about 2.5-fold, and half-life approximately 3-fold. Should be avoided.

SNRI concomitant use increases risk of serotonin syndrome. Monitor for signs/symptoms; consider discontinuation if serotonin syndrome occurs.

Potent CYP2D6 inhibitor; increases duloxetine AUC by approximately 60%, with greater inhibition expected at higher doses.

Potent CYP2D6 inhibitor; expected to increase duloxetine concentrations.

Concomitant use increases risk of serotonin syndrome. Monitor for symptoms during treatment initiation and dose increases.

Concurrent use may potentiate upper gastrointestinal bleeding risk due to serotonin reuptake inhibition effects on hemostasis.

Concomitant use increases risk of serotonin syndrome. Monitor for symptoms during treatment initiation and dose increases.

SNRIs increase risk of serotonin syndrome. Monitor for signs and symptoms, particularly during initiation and dosage increases.

As an SNRI, concomitant use increases serotonin syndrome risk. Monitor for symptoms during initiation and dose increases.

CYP2D6 or CYP3A4 inhibitor that can increase clozapine levels and lead to adverse reactions. Close monitoring and dose reduction may be necessary.

CYP2D6 inhibitor; no dosing adjustments recommended for darifenacin when co-administered with duloxetine.

Deferasirox inhibits CYP1A2 resulting in increased duloxetine concentration. Monitor for exposure related toxicity.

Fexinidazole inhibits CYP1A2, increasing duloxetine concentrations and risk of adverse reactions.

Exposure to duloxetine may be reduced when coadministered with leflunomide. Monitor and adjust dose as required.

Exposure of duloxetine may be reduced in patients taking leflunomide. Monitor and adjust dose as required.

Concomitant use increases risk of serotonin syndrome. Monitor for symptoms during treatment initiation and dose increases.

Primaquine may inhibit CYP1A2 and increase duloxetine exposure; increased monitoring for adverse reactions is recommended.

Concomitant use increases risk of serotonin syndrome. Monitor for symptoms during treatment initiation and dose increases.

Teriflunomide may reduce exposure of duloxetine. Monitor patients and adjust dose as required.

Concomitant use increases risk of serotonin syndrome. Monitor for symptoms during treatment initiation and dose increases.

Concomitant use increases risk of serotonin syndrome. Monitor for symptoms during treatment initiation and dose increases.

Monitor carefully when initiating or discontinuing duloxetine. Altered anticoagulant effects and increased bleeding reported with SNRIs; however, duloxetine did not significantly affect INR or warfarin pharmacokinetics in clinical study.

CYP2D6 inhibitor; no dosing adjustments recommended.

No significant pharmacokinetic interaction observed under steady-state conditions.

No significant pharmacokinetic interaction observed under steady-state conditions.

Other drugs that inhibit CYP1A2 metabolism include cimetidine and quinolone antimicrobials such as ciprofloxacin and enoxacin [see Warnings and Precautions (5.12)] .