The following conditions are treated with the prescription drug duloxetine.

Like other drugs, Cymbalta may have interactions.

One substance can cause another substance to have a different effect than expected. Alcohol, another drug, or a supplement can affect how a drug works in your body. If you have certain health conditions, interactions can occur.

Keep reading to learn about Cymbalta’s possible interactions. And for more information about Cymbalta, including details about its uses, see this article.

If you have a health condition, you could be at risk of harm if you take Cymbalta. Your doctor may not prescribe Cymbalta for you in that case. This is acontraindication. The list includescontraindications of Cymbalta.

If you take or have recently taken a monoamine oxidase inhibitor drug. Using Cymbalta with a type of antidepressant called a monoamine oxidase inhibitor (MAOI) raises your risk of serotonin syndrome. This is a serious side effect of Cymbalta that’s caused by too much serotonin building up in your body. Symptoms include agitation, fever, muscle twitches, and fast heart rate.

Examples of MAOIs that interact with Cymbalta include:

  • Zelapar is a sedegiline.
  • phenelzine is a drug.
  • Linezolid is a drug.
  • methylene blue is a blue color.

“Doctors won’t prescribe Cymbalta with an MAOI due to the risk of serotonin syndrome. After you stop taking MAOI, your doctor will likely tell you to stop taking Cymbalta. They will usually have you wait at least 5 days after your last dose of Cymbalta before you start taking MAOI. Talk to your doctor if you have questions.”

If you’ve had an allergic reaction. If you have had an allergic reaction to Cymbalta or any of its ingredients, your doctor likely won’t prescribe Cymbalta. You can ask them about other treatments that may be better options for you.

“If any of the factors above apply to you, talk with your doctor before you start taking Cymbalta. Your doctor can tell you if it’s safe to take it.”

Cymbalta and alcohol could interact with each other and cause damage to your liver.

Since Cymbalta was approved, there have been rare reports of it causing liver damage. This includes fatal liver failure.

Drinking alcohol, especially large amounts of alcohol, can also cause liver damage, including liver failure. Due to this risk, you should not take Cymbalta if you drink excessive amounts of alcohol.

“If you drink alcohol, you should tell your doctor about it. Your doctor can help determine if it’s safe to take.”

Before you start using Cymbalta, you should tell your doctor and pharmacy about any drugs you take. Sharing this information with them may help prevent future interactions.

If you have questions about drug interactions, talk to your doctor or pharmacist.

The drugs that may interact with Cymbalta are listed in the chart. The chart does not include all drugs that may interact with Cymbalta. The “Drug interactions explained” section gives more information about some of the interactions.

Drug class or drug name Drug examples What can happen
nonsteroidal anti-inflammatory drugs (NSAIDs) • aspirin
• ibuprofen (Advil)
• naproxen (Aleve)
can increase the risk of side effects from NSAIDs and Cymbalta
tramadol (Ultram) • can raise the risk of side effects from Cymbalta and tramadol
• can make tramadol less effective
trazodone can raise the risk of side effects from Cymbalta and trazodone
aripiprazole (Abilify) can increase the risk of side effects from aripiprazole
zolpidem (Ambien) can raise the risk of side effects from zolpidem
certain drugs for mental health conditions • other serotonin and norepinephrine reuptake inhibitors (SNRIs), such as venlafaxine extended-release (Effexor XR)
selective serotonin reuptake inhibitors such as sertraline (Zoloft)
• lithium (Lithobid)
buspirone
tricyclic antidepressants, such as amitriptyline
can increase the risk of side effects from Cymbalta and these mental health medications.
amphetamines, such as amphetamine/dextroamphetamine (Adderall) can increase the risk of side effects from Cymbalta and amphetamines
anticoagulants (blood thinners) warfarin (Jantoven)
rivaroxaban (Xarelto)
apixaban (Eliquis)
can increase the risk of side effects of Cymbalta and anticoagulants
certain drugs that affect how your body metabolizes (breaks down) Cymbalta • ciprofloxacin (Cipro)
• disulfiram
amiodarone (Pacerone)
bupropion (Wellbutrin)
• mirabegron (Myrbetriq)
can increase the risk of side effects of Cymbalta and these other drugs

There are certain drug interactions that can occur with Cymbalta.

Interaction with certain drugs used for mental health conditions

Certain drugs can interact with conjugates. The table below shows some examples of mental health medications that may interact with Cymbalta.

Depression, depression, depression, depression, depression, depression, depression, depression, depression, depression, depression, depression, depression, depression, depression, depression, depression, depression, depression, depression, depression, depression, depression, depression, depression, depression, depression, depression, depression, Talk to your doctor about the uses of drugs in this list and other drugs that may interact with Cymbalta.

What could happen Examples of mental health medications that can interact with Cymbalta
can cause serotonin syndrome • other serotonin and norepinephrine reuptake inhibitors (SNRIs), such as venlafaxine extended-release (Effexor XR)
selective serotonin reuptake inhibitors (SSRIs), such as sertraline (Zoloft)
• lithium (Lithobid)
buspirone
tricyclic antidepressants, such as amitriptyline

What you can do

If you and your doctor agree that you will take one of these medications, your doctor will keep an eye on you for symptoms of a mental illness. The highest risk is when you begin taking either medication or when the dose is increased.

Interaction with nonsteroidal anti-inflammatory drugs

Cymbalta may interact with nonsteroidal anti-inflammatory drugs (NSAIDs), as described in the table below.

What could happen Examples of NSAIDs
Can increase your risk of bleeding, including hemorrhage • aspirin
• ibuprofen (Advil)
• naproxen (Aleve)

What you can do

If you take a NSAID, watch for bleeding. If this happens, call your doctor.

Interaction with amphetamines

Cymbalta may interact with amphetamine medications, such as those used to treat attention deficit hyperactivity disorder (ADHD) or narcolepsy.

What could happen Examples of amphetamine medications
Can cause serotonin syndrome • amphetamine/
dextroamphetamine (Adderall)
dextroamphetamine (Dexedrine, Xelstrym)
methamphetamine (Desoxyn)

What you can do

If you and your doctor agree that you’ll take an amphetamine with Cymbalta, your doctor will monitor you closely for symptoms of serotonin syndrome. This risk is highest when you begin taking Cymbalta or any time the dose of either medication is increased.

There may be other interactions with Cymbalta. They could happen with a variety of things. See below for more.

Does Cymbalta interact with food?

There are currently no reports of Cymbalta interacting with food. If you have questions about eating certain foods during your treatment with Cymbalta, talk with your doctor.

Does Cymbalta interact with supplements?

Before you start taking Cymbalta, talk with your doctor and pharmacist about any supplements, herbs, and vitamins you take. Sharing this information with them may help you avoid possible interactions.

If you have questions about interactions, talk to your doctor or pharmacist.

Cymbalta interactions with herbs

The herbal supplement St. John’s wort can interact with Cymbalta. Taking this supplement with Cymbalta may raise your risk of serotonin syndrome, which is a serious side effect. This risk is highest when you first begin taking Cymbalta or any time your dose is increased.

“Let your doctor know if you use St. John’s wort. They may want you to stop taking it. If you and your doctor agree that you will use St. John’s wort with Cymbalta, your doctor will keep an eye on you. A lot of symptoms include fast heart rate, muscle twitches, and a lot of symptoms of a fever.”

If you develop a syndrome called Serotonin Syndrome, your doctor will likely stop you from taking drugs. They will recommend a treatment for your symptoms. You may need to be in the hospital for treatment.

Cymbalta interactions with vitamins

There are currently no reports of Cymbalta interacting with vitamins. But this does not mean that vitamin interactions won’t be recognized in the future.

It is still important to check with your doctor or pharmacist before taking any of these products.

Does Cymbalta interact with vaccines?

No. Cymbalta hasn’t been reported to interact with any vaccines. If you have questions about getting vaccines during your Cymbalta treatment, talk with your doctor.

Does Cymbalta interact with lab tests?

No, Cymbalta is not used in lab tests. If you have questions about getting certain lab tests done, talk to your doctor.

Does Cymbalta interact with cannabis or CBD?

Cannabis (marijuana) and cannabis products, such as cannabidiol (CBD), have been specifically reported to interact with Cymbalta. CBD, a component of cannabis, may affect levels of Cymbalta in your body. This could raise your risk of side effects from Cymbalta or cause Cymbalta to be less effective.

If you use cannabis, tell your doctor and pharmacy about it. You may help prevent interactions by sharing this information with them.

Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.

There is a risk of interactions with Cymbalta for certain medical conditions. Talk to your doctor about your health history before you start taking Cymbalta. They will determine if Cymbalta is right for you.

Health conditions and other factors that might interact with Cymbalta include:

  • Heart problems, such as high blood pressure. Cymbalta may cause high blood pressure. If you already have high blood pressure or other heart problems, taking Cymbalta could make your condition worse. Talk with your doctor about whether it’s safe for you to take Cymbalta.
  • Diabetes. Cymbalta may increase blood sugar levels in some people. If you have diabetes, this can make it harder to manage your blood sugar. If you have diabetes and take Cymbalta, talk with your doctor about how to manage your blood sugar levels.
  • Severe kidney problems. Your kidneys are responsible for clearing Cymbalta from your body. Cymbalta levels may build up in your body if you have severe kidney problems, such as severe chronic kidney disease. This can raise your risk of side effects from the drug. Due to this risk, doctors typically won’t prescribe Cymbalta if you have severe kidney problems. They can discuss possible other treatments for your condition with you instead.
  • Liver problems. In rare cases, Cymbalta can cause liver damage. Due to this risk, doctors typically won’t prescribe Cymbalta if you have certain liver problems, such as chronic liver disease or cirrhosis. Talk with your doctor about other possible treatments for your condition that may be safer for you.
  • Narrow eye angles. If you have eye angles that are more narrow than usual, Cymbalta may cause closed-angle glaucoma. If left untreated, closed-angle glaucoma can lead to blindness. Your doctor may have you get an eye exam before prescribing Cymbalta for you.
  • Seizures. Cymbalta may cause seizures. The drug hasn’t been studied in people with seizure disorders such as epilepsy. If you’ve had seizures, tell your doctor before taking Cymbalta. Your doctor can determine whether the medication is safe for you.
  • Bleeding problems. Cymbalta can raise your risk for bleeding. If you already have a bleeding problem, such as hemophilia, Cymbalta may not be safe for you to take. Let your doctor know if you have a bleeding problem before you start taking Cymbalta. Your doctor can determine whether the drug is safe for you to take.
  • Pregnancy. Cymbalta may cause harm if used during pregnancy. Talk with your doctor before using Cymbalta if you’re pregnant or planning to become pregnant. You can also learn more about Cymbalta and pregnancy in this article.
  • Breastfeeding. Cymbalta passes into breast milk and may cause mild side effects, such as drowsiness, in a breastfed child. If you’re breastfeeding or planning to breastfeed, talk with your doctor about the risks and benefits of taking Cymbalta.
  • Allergic reaction. If you’ve had an allergic reaction to Cymbalta or any of its ingredients, your doctor will likely not prescribe Cymbalta. You can ask them about other treatments that may be better choices for you.

Find answers to questions about Cymbalta.

Can Lyrica interact with Cymbalta?

No, Lyrica and Cymbalta haven’t been reported to interact.

Lyrica and Cymbalta are both approved to treat diabetic nerve pain in adults. They’re also both used to treat fibromyalgia. Sometimes, these drugs may be used together to treat these conditions.

If you have questions about using both drugs, talk to your doctor.

Is it safe to take Xanax and Cymbalta together?

Yes, it should be. There haven’t been reports of interactions between alprazolam (Xanax) and Cymbalta.

Sometimes, doctors prescribe Cymbalta and Xanax together. Xanax is approved to manage anxiety disorders, including generalized anxiety disorder (GAD). Cymbalta is also prescribed to treat GAD.

You will take it every day. You could take the drug every day.

If you have questions about taking a drug, talk to your doctor or pharmacist.

Can Topamax interact with Cymbalta?

No, Topamax isn’t known to interact with Cymbalta. There haven’t been reports of an interaction between these medications.

Cymbalta can interact with phentermine/topiramate (Qsymia). This drug contains topiramate, which is also the active ingredient in Topamax. (The active ingredient is what makes a drug work). But topiramate isn’t known to interact with Cymbalta.

If you have questions about using Topamax with Cymbalta, you should talk to your doctor or pharmacist.

You can take steps to avoid interactions with Cymbalta. Talk to your doctor and pharmacist before treatment begins. Things to discuss with them.

  • You can use alcohol or cannabis.
  • Other medications you take, as well as any vitamins, supplements, and herbs. Your doctor or pharmacist can help you fill out a medication list.
  • If you start taking a new drug, what should you do?

It’s also important to read Cymbalta’s label and other paperwork that comes with the drug. You may see colored stickers on the label that describe interactions. And the paperwork (sometimes called the prescribing information) may have other details about interactions. If you need help understanding this information, your doctor or pharmacist can help.

Taking Cymbalta exactly as prescribed can help prevent interactions.

If you still have questions, you should talk to your doctor.

You may want to ask your doctor some questions.

  • Will my dose of Cymbalta affect my risk for interactions?
  • Do other drugs have the same interactions with Cymbalta?
  • I have a health condition that could affect my use of Cymbalta.

If you start taking a new medication or supplement while using Cymbalta, you should tell your doctor.

For personal stories and tips on managing your mental health, sign up for Healthline’s anxiety and depression newsletter.

If you take Cymbalta for diabetic nerve pain, you can also find support and advice from our Bezzy type 2 diabetescommunity.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.