Duloxetine is an SNRI used for depression, generalised anxiety disorder, and diabetic neuropathic pain.
Also known as: duloxetine, cymbalta
SNRI + CYP inhibitor: fluconazole may increase duloxetine levels.
Duloxetine is metabolised by CYP1A2 and CYP2C19. Fluconazole is a potent CYP2C19 inhibitor. Co-administration may increase duloxetine levels 2-3-fold. Both drugs have hepatotoxic potential, and the combination increases the risk. Monitor liver function (AST/ALT) and serotonergic signs. Reduce duloxetine dose by 50% or switch to venlafaxine (less dependent on CYP2C19).
SNRI + CYP2C19 inhibitor: fluconazole may increase duloxetine levels. Risk of hepatotoxicity and serotonin syndrome.
Fluconazole inhibits CYP2D6 and CYP3A4, metabolic pathways for duloxetine. Clinically moderate effect.
Serotonergic signs.
Serotonin syndrome.
Monitor for serotonergic signs.
DailyMed/FDA
No documented food or drink interactions.
No documented disease interactions.
No documented pregnancy or breastfeeding information.
Clinical and educational support tool. The information does not replace a medical prescription or the opinion of a qualified healthcare professional.
SNRI with higher SERT than NERT affinity. Effect in neuropathic pain.
Inhibits serotonin (SERT) and noradrenaline (NERT) reuptake. Additional activity at σ1 receptors.
Oral absorption. Bioavailability: 70-80%. Food delays absorption.
Metabolised by CYP1A2 (induced by smoking) and CYP2D6.
12 h.
Medicines from the same therapeutic group (ATC classification) or the same pharmacological class.
