Drug Combinations With Duloxetine to Avoid

Lithium (Eskalith, Lithobid)
Taking duloxetine with lithium can cause a group of symptoms called serotonin syndrome. Talk to your healthcare provider before taking these medications together. Call your healthcare provider right away if you have any symptoms of serotonin syndrome (see above), as it can be very dangerous.
 
Medications That Increase Bleeding Risk
Combining duloxetine with medications that increase the risk of bleeding can further increase the bleeding risk. This could potentially lead to dangerous internal bleeding. Check with your healthcare provider before combining such medications.
  
Miscellaneous Antidepressants
Combining duloxetine with other antidepressants may increase the risk of serotonin syndrome. Check with your healthcare provider before taking these medications together. Call your healthcare provider right away if you have any symptoms of serotonin syndrome, as it can be very dangerous.
  
Monoamine Oxidase Inhibitors (MAOIs)
Taking duloxetine and an MAOI together can cause life-threatening side effects. Do not take duloxetine if you have taken an MAOI within the past two weeks. Also, do not take an MAOI if you have taken duloxetine within the past five days.
 
Pergolide (Permax)
Taking pergolide with duloxetine can increase the level of duloxetine in your blood, increasing your risk of side effects. Your healthcare provider may need to decrease your duloxetine dose.
 
Phenothiazines
Duloxetine can increase the level of phenothiazine medications in your blood, increasing your risk of side effects. Also, taking these medications can increase your chance of drowsiness. Talk to your healthcare provider before taking these medications together.
 
One particular phenothiazine, thioridazine (Mellaril), should generally not be taken in combination with duloxetine due to the risk of a dangerous irregular heart rhythm called QT prolongation.
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