Duloxetine drug interactions
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Authored by: Km39 15:24, 22 March 2007 (PDT) | |||
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Drug-drug interactions
Severity level | Drug and description of interaction |
| 4 | buspirone, cocaine, dexfenfluramine, dextroamphetamine, fenfluramine, fluvoxamine, ketoconazole, monoamine oxidase inhibitor (MAOI), nefazodone, phentermine, selective serotonin reuptake inhibitor (SSRI), venlafaxine: Taking these medications together with duloxetine increases the risk of serotonin syndrome. This may progress to hyperthermia, coma, delirium, and death.[1][2][3]
thioridazine: Increased the risk of QT prolongation, ventricular arrythmias, and death.[1] |
| 3 | almotriptan, amphetamine, dexmethylphenidate, eletriptan, frovatriptan, furazolidone, linezolid, methylphenidate, naratriptan, pentazocine, procarbazine, rizatriptan, sibutramine, sumatriptan, tramadol, trazodone, tricyclic antidepressant (TCA), zolmitriptan: Taking these medications together with duloxetine increases the risk of serotonin syndrome. This may progress to hyperthermia, coma, delirium, and death.[1][4]
chlorpromazine, flecainide, haloperidol, mesoridazine, perphenazine, propafenone: Duloxetine can increase the effect or toxicity of these drugs by elevating their concentration via inhibition of CYP 2D6.[1][3][5] |
| 2 | anagrelide, cimetidine, ciprofloxacin, enoxacin, tacrine: CYP 1A2 inhibitors may decrease the plasma concentrations of duloxetine due to inhibition of the CYP 1A2 isoenzyme.[1]
darifenacin: Duloxetine can increase the effect or toxicity of darifenacin by elevating its concentration via inhibition of CYP 2D6[1] doxercalciferol: Duloxetine may inhibit the transformation in the liver to 1,25- dihydroxyergocalciferol, leading to decreased efficacy of doxercalciferol.[1] lithium: Taking these medications together with duloxetine increases the risk of serotonin syndrome. This may progress to hyperthermia, coma, delirium, and death.[1] proton pump inhibitor: Duloxetine is enteric-coated, thus elevated gastric pH could lead to early release of duloxetine.[1] zolpidem: Use of zolpidem with duloxetine can result in hallucinations and disorientation.[1] |
| 1 | None known |
Drug-food/drug-herb interactions
| Severity level | Drug and description of interaction |
| 4 | St. John’s Wort, tryptophan: Taking these products together with duloxetine increases the risk of serotonin syndrome. This may progress to hyperthermia, coma, delirium, and death.[1][6] |
| 3 | ethanol: When used excessively, may lead to liver impairment.[4] |
| 2 | None known |
| 1 | echinacea: CYP 1A2 inhibitors may decrease the plasma concentrations of duloxetine due to inhibition of the CYP 1A2 isoenzyme.[1]
kava kava, valerian: Pharmacodynamic interaction with duloxetine.[4] |
References
- ↑ 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 Eli Lilly and Company. Duloxetine Package Insert. Indianapolis, IN 46285; 2007.
- ↑ Information for Healthcare Professionals Duloxetine (marketed as Cymbalta). FDA/Center for Drug Evaluation and Research July 2006 [cited 10 March 2007]; Available from: http://www.fda.gov/cder/drug/InfoSheets/HCP/duloxetineHCP.pdf
- ↑ 3.0 3.1 Criteria for nonformulary use of duloxetine. 17 October 2005 [cited 10 March 2007];Available from:http://www.pbm.va.gov/criteria/Duloxetine.pdf.
- ↑ 4.0 4.1 4.2 Duloxetine: Drug Information Provided by Lexicomp. Merck Manuals Online Medical Library Nov 2006 [cited 12 March 2007]; Available from: http://www.merck.com/mmpe/print/lexicomp/duloxetine.html
- ↑ Skinner MH, Kuan HY, Pan A, Sathirakul K, Knadler MP, Gonzales CR, et al. Duloxetine is both an inhibitor an a substrate of cytochrome P4502D6 in healthy volunteers. Clin Pharmacol Ther 2003;73(3):170-7.
- ↑ Duloxetine (Oral Route). Mayo Clinic.com Tools for healthier living 32 October 2005 [cited 12 March 2007]; Available from: http://www.mayoclinic.com/health/drug-information/DR601577
