Cymbalta Drug Interactions

If alcohol, certain antidepressants, or other medications are taken together with Cymbalta, interactions may occur. When a Cymbalta drug interaction occurs, the levels of Cymbalta and other medications in your blood can increase, potentially increasing your risk of side effects. Some of these drug interactions can also increase your risk of a dangerous arrhythmia called QT prolongation or a dangerous condition called serotonin syndrome, among other things.

• Alcohol
• Certain arrhythmia medications, including propafenone (Rythmol^®) and flecainide (Tambocor^®)
• Certain fluoroquinolone antibiotics, including ciprofloxacin (Cipro^®), norfloxacin (Noroxin^®), and ofloxacin (Floxin^®)
• Delavirdine (Rescriptor^®)
• Linezolid (Zyvox^®)
• Lithium (Eskalith^®, Lithobid^®)
• Medications that "thin" the blood (such as anticoagulant and antiplatelet drugs) or otherwise increase bleeding risk, such as:
   
  • Antithrombin (ATryn^®, Thrombate III^®)
  • Apixaban (Eliquis^®)
  • Argatroban
  • Aspirin (Bayer^® and others)
  • Bivalirudin (Angiomax^®)
  • Cilostazol (Pletal^®)
  • Clopidogrel (Plavix^®)
  • Dabigatran (Pradaxa^®)
  • Dipyridamole (Persantine^®)
  • Drotrecogin alfa (Xigris^®)
  • Eptifibatide (Integrilin^®)
  • Fondaparinux (Arixtra^®)
  • Heparin or heparin-like products, including dalteparin (Fragmin^®), enoxaparin (Lovenox^®), or tinzaparin (Innohep^®)
  • Lepirudin (Refludan^®)
  • Nonsteroidal anti-inflammatory drugs (NSAIDs), such as:

• • • Celecoxib (Celebrex^®)
    • Diclofenac (Cambia™, Cataflam^®, Flector^®, Pennsaid^®, Solaraze^® Gel, Voltaren^®, Voltaren^® Gel, Voltaren^®-XR, Voltaren Ophthalmic^®, Zipsor™)
    • Etodolac (Lodine^®, Lodine^® XL)
    • Ibuprofen (Motrin^®, Advil^®, Nuprin^®)
    • Indomethacin (Indocin^®, Indocin SR^®)
    • Ketoprofen (Orudis^®, Actron^®, Oruvail^®)
    • Ketorolac (Sprix™, Toradol^®)
    • Meloxicam (Mobic^®)
    • Nabumetone (Relafen^®)
    • Naproxen (Naprosyn^®) or naproxen sodium (Aleve^®, Anaprox^®, Naprelan^®)
    • Oxaprozin (Daypro^®)
    • Piroxicam (Feldene^®)
    • Others (see List of NSAIDs for a more complete list of these medications)

• • Pentoxifylline (Trental^®)
  • Prasugrel (Effient^®)
  • Rivaroxaban (Xarelto^®)
  • Thrombolytics, such as:

• • • Alteplase (Activase^®)
    • Reteplase (Retavase^®)
    • Streptokinase (Streptase^®)
    • Tenecteplase (TNKase^®)

• • Ticagrelor (Brilinta^®)
  • Ticlopidine (Ticlid^®)
  • Tirofiban (Aggrastat^®)
  • Warfarin (Coumadin^®, Jantoven^®)

• Miscellaneous antidepressants, such as:

• • Bupropion (Aplenzin™, Budeprion XL^®, Budeprion™ SR, Buproban^®, Forfivo™ XL, Wellbutrin SR^®, Wellbutrin XL^®, Wellbutrin^®, Zyban^®)
  • Mirtazapine (Remeron^®)
  • Nefazodone (Serzone^®)
  • Trazodone (Desyrel^®) or trazodone ER (Oleptro™)
  • Vilazodone (Viibryd™)

• Monoamine oxidase inhibitors (MAOIs), including:

• • Isocarboxazid (Marplan^®)
  • Phenelzine (Nardil^®)
  • Rasagiline (Azilect^®)
  • Selegiline (Eldepryl^®, Emsam^®, Zelapar^®)
  • Tranylcypromine (Parnate^®) 

• Pergolide (Permax^®)
• Phenothiazine medications, including:

• • Chlorpromazine
  • Fluphenazine (Prolixin^®)
  • Perphenazine
  • Promethazine (Phenergan^®)
  • Thioridazine (Mellaril^®)
  • Trifluoperazine 

• Quinidine
• Quinine
• Ritonavir (Norvir^®)
• Ropinirole (Requip^®)
• Other SSRI or SNRI antidepressants, such as:

• • Citalopram (Celexa^®)
  • Desvenlafaxine (Pristiq™)
  • Escitalopram (Lexapro^®)
  • Fluoxetine (Prozac^®, Sarafem^®, Selfemra™)
  • Fluvoxamine (Luvox^®, Luvox^® CR)
  • Levomilnacipran (Fetzima™)
  • Milnacipran (Savella™)
  • Paroxetine (Paxil^®, Paxil CR^®, Pexeva^®, Brisdelle™)
  • Sertraline (Zoloft^®)
  • Venlafaxine (Effexor^®, Effexor XR^®) 

• St. John's wort
• Terbinafine (Lamisil^®)
• Tramadol (Rybix™ ODT, Ryzolt^®, Ultram^®, Ultram^® ER) or tramadol/acetaminophen (Ultracet^®) 
• Tricyclic antidepressants, including:

• • Amitriptyline (Elavil^®)
  • Amoxapine (Asendin^®)
  • Clomipramine (Anafranil^®)
  • Desipramine (Norpramin^®)
  • Doxepin (Sinequan^®, Silenor^®) 
  • Imipramine (Tofranil^®)
  • Maprotiline (Ludiomil^®)
  • Nortriptyline (Pamelor^®)
  • Protriptyline (Vivactil^®)
  • Trimipramine (Surmontil^®) 

• Triptans, including:

• • Almotriptan (Axert^®)
  • Eletriptan (Relpax^®)
  • Frovatriptan (Frova^®)
  • Naratriptan (Amerge^®)
  • Rizatriptan (Maxalt^®)
  • Sumatriptan (Alsuma™, Imitrex^®, Sumavel^®, Zecuity™) or sumatriptan/naproxen sodium (Treximet^®)
  • Zolmitriptan (Zomig^®)

• Tryptophan.