Moderate. These medicines may cause some risk when taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.
How the interaction occurs:
When duloxetine is taken with fluoxetine or paroxetine, your body may process duloxetine more slowly. In addition, both medicines can increase the level of serotonin in your body.
What might happen:
High serotonin levels may cause changes in body temperature, blood pressure, muscle movements and mood, leading to a medical condition called Serotonin Syndrome. Serotonin Syndrome may be life threatening.
What you should do about this interaction:
Make sure your healthcare professional (e.g.doctor or pharmacist) know that you are taking these medicines together.If you experience muscle twitching, tremors, shivering or stiffness, fever, heavy sweating, heart palpitations, restlessness, confusion, agitation, trouble with coordination, or severe diarrhea contact your doctor right away.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.
1.Cymbalta (duloxetine hydrochloride) US prescribing information. Eli Lilly and Company October, 2012.
2.Paxil (paroxetine hydrochloride) US prescribing information. GlaxoSmithKline December, 2012.
3.Prozac (fluoxetine hydrochloride) US prescribing information. Eli Lilly and Company January, 2013.
4.Boyer EW, Shannon M. The serotonin syndrome. N Engl J Med 2005 Mar 17; 352(11):1112-20.