Do not take duloxetine with
- fluvoxamine, another medicine for depression
- any of the other medicines listed in the table Medicines that may increase risk of serotonin toxicity, unless under careful medical supervision
- illegal drugs
- moclobemide and wait at least 2 days after stopping moclobemide before taking duloxetine, because it may cause serotonin toxicity or a serious reaction with severe high blood pressure.
- any monoamine oxidase inhibitor (MAOI); you must stop taking duloxetine at least 1 week before you start taking a MAOI antidepressant.
Tell your doctor if you are taking any of the following
Always tell your doctor about all other medicines you are taking, including over-the-counter and complementary or alternative medicines. You may need careful monitoring or a change in dose to avoid side effects if you are taking other medicines, including:
- other medicines used to treat panic disorder, anxiety or obsessive illnesses
- medicines used to treat stress urinary incontinence such as tolterodine (Detrusitol)
- medicines used to treat heart problems such as flecainide (Flecatab, Tambocor)
- antipsychotic medicines used to treat certain mental health conditions such as schizophrenia, eg, olanzapine (eg, Lanzek, Ozin, Zylap, Zypine, Zyprexa) and risperidone (eg, Ozidal, Resdone, Risperdal)
- medicines that increase the risk of gastrointestinal bleeding such as warfarin (Coumadin, Marevan), ticlopidine (Tilodene), aspirin (eg, Aspro) and NSAIDs, used to treat pain and inflammation
- the antibiotic linezolid (Zyvox)
- bupropion (Prexaton, Zyban), for stopping smoking.
Duloxetine and alcohol
Avoid excessive drinking if you are taking duloxetine — drinking large quantities of alcohol while taking duloxetine can cause severe liver damage. Drinking alcohol can also cause dizziness or drowsiness in some people taking duloxetine. Do not drive or operate machinery if you are affected.
Who can I ask about interactions?
Call the NPS Medicines Line on 1300 MEDICINE (1300 633 424) to get information about your prescription, over-the-counter and complementary medicines (herbal, ‘natural’, vitamins and minerals) from a pharmacist. Your call will be answered by healthdirect Australia.
Find out more about
- What duloxetine does and how effective it is
- Who duloxetine is for and who should be cautious
- Side effects of duloxetine
- Brands of duloxetine
If you are starting duloxetine, see 10 things you should know about antidepressants.
For more information
- Starting, switching and stopping antidepressants
- Managing side effects of antidepressants
- Psychological therapies
The consumer medicine information (CMI) for your brand of duloxetine is available from our website or a pharmacist. If you have any concerns about interactions, talk to your health professional. The CMI includes:
- how to take this medicine
- what to do if you forget to take it
- if you take too much (overdose)
- things you must and must not do while taking this medicine
- signs of severe reactions and what to do.
- Rossi S, ed. eAMH [online]. Adelaide: Australian Medicines Handbook, 2012. www.amh.net.au. (Accessed 9 February 2012).
- Psychotropic Expert Group. Therapeutic Guidelines: Psychotropic, Version 6. In: eTG complete [CD-ROM]. Melbourne: Therapeutic Guidelines Limited; 2008.
- Eli Lilly Australia Pty Limited. Cymbalta consumer medicine information. October 2010. (Accessed 22 March 2012).