Table 2 Partial results from Query 2

Duloxetine (Cymbalta, and generics) is a serotonin-norepinephrine reuptake inhibitor (SNRI) created by Eli Lilly. It is mostly prescribed for major depressive disorder, generalized anxiety disorder, fibromyalgia and neuropathic pain. Duloxetine failed to receive US approval for stress urinary incontinence amid concerns over liver toxicity and suicidal events; however, it was approved for this indication in the UK, where it is recommended as an add-on medication in stress urinary incontinence instead of surgery.

Food Interactions

Food does not affect maximum levels reached, but delays it (from 6 to 10 hours) and total product exposure appears to be reduced by only 10 percent. People taking this product who drink large amounts of alcohol are exposed to a higher risk of liver toxicity. Take without regard to meals.

Drug Interactions

Amitriptyline: Possible increase in the levels of this agent when used with duloxetine.

Ciprofloxacin: Ciprofloxacin increases the effect/toxicity of duloxetine.

Desipramine: Possible increase in the levels of this agent when used with duloxetine.

Flecainide: Possible increase in the levels of this agent when used with duloxetine.

Fluvoxamine: Fluvoxamine increases the effect and toxicity of duloxetine.

Imipramine: Possible increase in the levels of this agent when used with duloxetine.

Isocarboxazid: Possible severe adverse reaction with this combination.

Nortriptyline: Possible increase in the levels of this agent when used with duloxetine.

Phenelzine: Possible severe adverse reaction with this combination.

Propafenone: Possible increase in the levels of this agent when used with duloxetine.

Rasagiline: Possible severe adverse reaction with this combination.

Thioridazine: Increased risk of cardiotoxicity and arrhythmias.

Tranylcypromine: Possible severe adverse reaction with this combination