Is Duloxetine Dangerous?

Some Precautions and Warnings With Duloxetine

Some warnings and precautions to be aware of with duloxetine include:
  • Antidepressants (including duloxetine) may increase the risk of suicidal thoughts or behavior in children, teenagers, and adults (see Depression and Suicide for more information). Therefore, if you notice any changes in symptoms or develop new symptoms, talk to your healthcare provider immediately. Some of these symptoms may include anxiety, hostility, agitation, panic, restlessness, hallucinations, extreme hyperactivity, and suicidal thoughts or behavior (see Cymbalta and Suicide for more information).
  • Before prescribing duloxetine for depression, your healthcare provider should make sure that you do not have bipolar disorder (instead of depression). Sometimes, the symptoms of bipolar disorder and depression are very similar, and duloxetine can cause problems in people with bipolar disorder.
  • Antidepressants can cause a group of dangerous symptoms known as serotonin syndrome. Taking duloxetine with other medications that affect serotonin can increase your risk serotonin syndrome. These other medications include other antidepressants, triptans (migraine medications), and several other medications (see Drug Interactions With Duloxetine for more information). Contact your healthcare provider immediately if you have any possible symptoms of serotonin syndrome, including:


    • Confusion
    • Seeing or hearing things that are not really there (hallucinations)
    • A fast heartbeat (tachycardia)
    • Feeling faint
    • Fever
    • Sweating
    • Muscle spasms
    • Difficulty walking
    • Diarrhea.
  • Duloxetine has been reported to cause liver problems, including hepatitis. Duloxetine is not recommended for people who have liver problems or who drink large amounts of alcohol regularly, due to an increased risk of liver damage.
  • Duloxetine can cause low blood pressure (hypotension). This may be more common if you are also taking other medications, especially high blood pressure medication. Tell your healthcare provider if you have symptoms of low blood pressure, including lightheadedness, dizziness, or fainting.
  • In studies, duloxetine was shown to slightly increase blood pressure and heart rate. Your healthcare provider should monitor your blood pressure and heart rate while you are taking duloxetine.
  • If you have a seizure disorder, there is a possibility that taking duloxetine may cause seizures. Talk to your healthcare professional before taking duloxetine if you have seizures.
  • Duloxetine can cause changes in blood sugar levels in people with diabetes. Your healthcare provider may monitor your blood sugar more closely and may suggest adjusting your dose of diabetes medications.
  • If you are stopping duloxetine, you should be monitored by a healthcare professional for withdrawal symptoms. If you do develop any symptoms of a duloxetine withdrawal, such as irritability, anxiety, confusion, headaches, lethargy, or insomnia, your healthcare provider may slow down the rate at which you are being weaned off duloxetine (see Cymbalta Withdrawal).
  • If you are elderly or taking a diuretic, duloxetine could cause low salt levels in the blood (hyponatremia). This generally returns to "normal" when duloxetine is discontinued.
  • Duloxetine can make narrow-angle glaucoma worse. If your glaucoma is under control, your healthcare provider should monitor your glaucoma to make sure it is not getting worse. If your glaucoma is not under control, you should not take duloxetine.
  • Duloxetine is not recommended for people with severe kidney problems, such as kidney failure (renal failure).


  • Duloxetine can cause difficulty passing urine. It may make some bladder conditions worse.


  • Duloxetine may affect your ability to perform complex tasks requiring mental and motor skills. Therefore, it is recommended that you become accustomed to its effect on you before becoming involved in activities requiring mental or motor concentration (such as driving a car or operating machinery). Taking duloxetine with alcohol or other medications that cause drowsiness can increase this effect.
  • Duloxetine is considered a pregnancy Category C medication. This means that duloxetine may not be safe to use during pregnancy. Talk to your healthcare provider about the risks and benefits of using duloxetine during pregnancy (see Cymbalta and Pregnancy for more information).
  • Duloxetine passes through breast milk. Therefore, if you are breastfeeding or plan to start breastfeeding, be sure to talk with your healthcare provider about using duloxetine.
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