Duloxetineinteractions

Strong CYP1A2 inhibitors: Avoid concomitant use. Potent inhibitors of CYP2D6 may increase Duloxetine Delayed-Release Capsule concentrations. Duloxetine Delayed-Release Capsule is a moderate inhibitor of CYP2D6.

7.1 Drugs Having

Clinically Important Interactions with Duloxetine Delayed-Release Capsules Table 6: Clinically Significant Drug Interactions with Duloxetine Delayed-Release Capsules Monoamine Oxidase Inhibitors (MAOIs) Prevention or Management Concomitant use of Duloxetine Delayed-Release Capsules is contraindicated in patients taking MAOIs, including MAOIs such as linezolid or intravenous methylene blue. Mechanism and Clinical Effect(s) Concomitant use of SSRIs and SNRIs, including Duloxetine Delayed-Release Capsules, with MAOIs increases the risk of serotonin syndrome. Other Serotonergic Drugs Prevention or Management Monitor for symptoms of serotonin syndrome when Duloxetine Delayed-Release Capsules is used concomitantly with other drugs that may affect the serotonergic neurotransmitter systems. If serotonin syndrome occurs, consider discontinuation of Duloxetine Delayed-Release Capsules and/or concomitant serotonergic drugs. Mechanism and Clinical Effect(s) Concomitant use of Duloxetine Delayed-Release Capsules with other serotonergic drugs increases the risk of serotonin syndrome. Alcohol Prevention or Management Avoid use in patients with chronic liver disease or heavy alcohol use. Mechanism and Clinical Effect(s) Concomitant use of Duloxetine Delayed-Release Capsules and alcohol may cause liver injury or aggravate pre-existing liver disease. Drugs that Interfere with Hemostasis Prevention or Management Closely monitor for bleeding for patients receiving an antiplatelet or anticoagulant drug when Duloxetine Delayed-Release Capsules are initiated or discontinued [Warnings and Precaution ]. Mechanism and Clinical Effect(s) Concomitant use of Duloxetine Delayed-Release Capsules with an antiplatelet or anticoagulant drug may potentiate the risk of bleeding. Strong CYP1A2 Inhibitors Prevention or Management Avoid concomitant use of Duloxetine Delayed-Release Capsules with strong CYP1A2 inhibitors. Mechanism and Clinical Effect(s) Concomitant use of Duloxetine Delayed-Release Capsules with CYP1A2 inhibitors increase the exposures of duloxetine. Strong CYP2D6 Inhibitors Prevention or Management Monitor for adverse events and adjust the dose of Duloxetine Delayed-Release Capsules as clinically appropriate when co-administering with strong CYP2D6 inhibitors. Mechanism and Clinical Effect(s) Concomitant use of Duloxetine Delayed-Release Capsules with CYP2D6 inhibitors increase the exposures of duloxetine. Greater degrees of inhibition are expected with higher doses of CYP2D6 inhibitors. CYP2D6 Poor Metabolizers Using Strong Inhibitor of CYP1A2 Prevention or Management Avoid co-administration of Duloxetine Delayed-Release Capsules and strong CYP1A2 inhibitors in patients who are CYP2D6 poor metabolizers. Mechanism and Clinical Effect(s) Concomitant administration of Duloxetine Delayed-Release Capsules with strong CYP1A2 inhibitors in patients who are CYP2D6 poor metabolizers results in increased duloxetine exposures. Drugs Metabolized by CYP2D6 Prevention or Management Monitor plasma concentrations of CYP2D6 substrate and reduce dosage of CYP2D6 substrate drug if necessary. Mechanism and Clinical Effect(s) Concomitant use of duloxetine increases exposures of a drug primarily metabolized by CYP2D6 which may increase the risk of toxicity of the CYP2D6 substrate drug. Drugs Metabolized by CYP1A2 Prevention or Management Monitor for adverse events and adjust the dose of Duloxetine Delayed-Release Capsules as clinically appropriate. Mechanism and Clinical Effect(s) Concomitant use of Duloxetine Delayed-Release Capsules with CYP1A2 substrates may increase the exposures of CYP1A2 substrate. CNS Drugs Prevention or Management Monitor for adverse events and adjust the dose of Duloxetine Delayed-Release Capsules as clinically appropriate. Mechanism and Clinical Effect(s) Concomitant use of Duloxetine Delayed-Release Capsules with other centrally acting drugs may increase the CNS effects of duloxetine. Drugs that Affect Gastric Acidity Prevention or Management Monitor for adverse events and adjust the dose of Duloxetine Delayed-Release Capsules as clinically appropriate. Mechanism and Clinical Effect(s) In patients with conditions that may slow gastric emptying (e.g., some diabetics) and drugs that raise the gastrointestinal pH may lead to earlier the release of duloxetine. Drugs Highly Bound to Plasma Protein Prevention or Management Monitor for adverse events and adjust the dose of Duloxetine Delayed-Release Capsules as clinically appropriate. Mechanism and Clinical Effect(s) Concomitant use of Duloxetine Delayed-Release Capsules with highly protein bound drugs may cause increased free concentrations of the other drug, potentially resulting in adverse reactions.