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Foods to Avoid While Taking Cymbalta (Duloxetine) : A Comprehensive Guide

By Dr. Nikita Toshi +2 more

Key Highlights:

  • Alcohol and caffeine should be avoided while taking Cymbalta
  • High-tyramine foods have not shown any interactions
  • Some Mental health related  medications, and painkillers may interact with Cymbalta
  • Supplements and herbal interactions must be considered
  • Other factors, such as pre-existing medical conditions, vaccines, and lab tests may affect Cymbalta interactions

Introduction

Do you wonder what Cymbalta is? The generic name for Cymbalta is duloxetine, a medication commonly prescribed for managing various mental health conditions.If you are on Cymbalta (duloxetine), you know it is used in treating many health issues. As a patient, it is vital to know about food and drug interactions while using this medication. Right? This understanding may save you from nasty side effects of cymbalta and ensure it works well.

Let’s look at the different foods and substances to skip when on Cymbalta,but before that we’ll learn how cymbalta works. We will also touch on drug interactions, supplement and herbal mix-ups, and other factors that matter. Bear in mind that everyone is unique, so you should talk to your doctor before making big changes.


How does Cymbalta Work?

Cymbalta, also known as duloxetine, works by increasing the levels of serotonin and norepinephrine in the brain. These are important chemicals that affect mood and pain sensations. Cymbalta belongs to a class of drugs called serotonin and norepinephrine reuptake inhibitors (SNRIs). It prevents the reabsorption of these chemicals, allowing them to stay active in the spaces between nerve cells.

This action helps improve communication between nerve cells, positively influencing mood and reducing the perception of pain signals. Essentially, Cymbalta’s role is to enhance the effects of serotonin and norepinephrine, making it effective in treating conditions like major depressive disorder, generalized anxiety disorder, and certain types of chronic pain. Individual responses may vary, so it’s essential for individuals to consult their healthcare providers for personalized information and guidance regarding Cymbalta uses.

Did you know?

  • Duloxetine (Cymbalta) overdose can lead to serotonin syndrome, seizures, coma, and other symptoms. There is no antidote for duloxetine overdose. source: NCBI
  • Duloxetine should be avoided in patients with liver failure or severe renal dysfunction. source: NCBI
  • Common adverse effects of duloxetine include headache, drowsiness, fatigue, nausea, and xerostomia. source: NCBI
  • Duloxetine is most commonly administered in capsule form and can be taken with or without food. source: NCBI
  • Duloxetine also increases dopamine levels in the prefrontal cortex, contributing to its efficacy in the treatment of depression. source: NCBI

Foods to Avoid While Taking Cymbalta

Some foods and drinks aren’t a good match with Cymbalta. What are they? Let’s find out.

1. Alcohol

It is safer to avoid alcohol if you are on Cymbalta. Why? Because alcohol may magnify some drug side effects and may even lead to harmful interactions.

Combining alcohol with Cymbalta could cause:

  • More drowsiness or tiredness
  • Increase in depression symptoms
  • Greater risk of liver damage

What could happen if you mix alcohol and Cymbalta?

  • You could feel dizzy.
  • You might vomit or feel sick.
  • Your thinking or moving could be affected.

2. Caffeine

Keep tabs on how much caffeine you take. It may not directly interact with the drug, but it may impact Cymbalta’s efficacy and worsen side effects.

So, what does caffeine do to Cymbalta?

  • Boost anxiety level which might hinder Cymbalta’s soothing effects.

How do you manage your caffeine intake?

  • Drastically cut down on tea, coffee and energy drinks.
  • Keep a daily record of caffeine intake.
  • If you need to drink less caffeine, reduce it bit by bit.

3. Effects on High Blood Pressure

Cymbalta belongs to a group called SNRI (serotonin-norepinephrine reuptake inhibitor). It may push up your blood pressure. Patients with high blood pressure or history concerns should be closely watched by their healthcare provider while on Cymbalta. Your doctor may suggest medication adjustments due to possible complications.

4. High-Tyramine Foods

Even though Cymbalta isn’t a monoamine oxidase inhibitor (MAOI), eating high-tyramine foods might stir up negative interactions. Although studies have not shown strong evidences to support this.

Relationship between MAOI and Cymbalta:

  • Though Cymbalta isn’t an MAOI, it’s better to avoid excessive intake of high-tyramine foods if possible.

List of high-tyramine foods to avoid:

  • Old cheeses
  • Smoked or dry meats
  • Pickled vegetables
  • Fermented soy foods like soy sauce and tempeh
  • Sauerkraut

Let’s get more details from the table below:

Substances to avoidWhy avoiding them matters
AlcoholGreater risk of side effects and liver damage
CaffeineCould lead to more anxiety or lessen Cymbalta’s effects

I want to emphasise that when prescribed to take Cymbalta, it is important to especially avoid drinking alcohol as it may potentially increase the risk of liver damage. Prioritising your health and adhering to your doctor’s recommendations will ensure the safest and most beneficial use of this medication.

Dr. Siddharth Gupta, MD

Drug Interactions with Cymbalta

Interested in knowing the drugs that may clash with Cymbalta? Let’s find out. Remember to let your doctor know all drugs you take now or plan to take, to avoid interactions.

1. Mental Health Medications

Mixing Cymbalta with other mental health drugs may increase problems and side effects. Below are some examples:

  • Antidepressants like fluoxetine (Prozac) or sertraline (Zoloft) and tricyclic antidepressants like amitriptyline
  • Mood balancers
  • Anxiety medicines

What complications and side effects could occur?

  • More risk of serotonin syndrome, leading to disturbance, fever, and fast heart rate
  • Anxiety or mood-related side effects may increase

How to manage drug interactions?

  • Consult your doctor about all medicines that you may be taking. 
  • Do not self medicate

2. Nonsteroidal Anti-inflammatory Drugs (NSAIDs)

NSAIDs may not work well with Cymbalta. It could hike the risk of side effects and problems.

Possible risks and side effects:

  • Ulcers or stomach bleeding could occur
  • Existing kidney or liver issues could get worse

How to manage this interaction:

  • Speak to your doctor before mixing Cymbalta with any NSAIDs
  • Be careful when using NSAIDs for long or in large doses along with Cymbalta

3. Amphetamines

Amphetamines may not mix well with Cymbalta. More side effects and problems may occur.

What are the risks?

  • More risk of side effects like faster heart rate, anxiety, and disturbance
  • One or both medicine may not be as effective

Tips for managing this interaction:

  • Discuss all drugs, including those based on amphetamine, with your health provider before you start Cymbalta
  • Keep an eye on your response to both drugs and quickly report any odd signs to your health provider

Supplement and Herbal Interactions with Cymbalta

You need to know how supplements and herbs can interact with Cymbalta. So, always discuss all vitamins and minerals you’re taking with your doctor.

Vitamin and Mineral Supplements

No specific reports yet on vitamin or mineral ties with Cymbalta. Still, it’s safer to discuss all vitamins and minerals with your healthcare provider.

  • Herbal Supplements

Remember, some herbs may not mix well with Cymbalta. So, let your doctor know all herbal products you are taking. Below, we have more details in our table.

Herb to avoidWhat happens when mixed with Cymbalta
St. John’s WortGreater risk of serotonin syndrome or less effective Cymbalta
KavaPotential rise in liver toxicity

Some tips on safe herbal usage:

  • Talk to your doctor about all herbal supplements you take or plan to take
  • Monitor your reaction to any herbal supplement used along with Cymbalta

Here’s a brief of what we just discussed:

SupplementsRisks due to potential interaction
Vitamin and mineral supplementsNo known specific interactions; always talk to a healthcare provider
Herbal supplementsRisk of serotonin syndrome or liver toxicity

If you feel nauseous or sick while taking Cymbalta, I might advise you to stick to simple meals and avoid consuming heavy and spicy foods. Opting for simpler, easily digestible meals may help minimise digestive discomfort and promote overall comfort during your recovery or specific circumstances.

Dr. Rajeev Singh, BAMS

Other Factors Affecting Cymbalta Interactions

Vaccination status, laboratory tests, and health history can influence how Cymbalta interacts.

1. Vaccines

There are no known clashes between Cymbalta and vaccines. However, always speak with your doctor about vaccines during your Cymbalta treatment.

2. Lab Tests

As far as we know, there’s no tie between Cymbalta and lab tests. But, what if you need a lab test while on Cymbalta? Discuss with your doctor.

3. Health History Considerations

Your health history can affect how Cymbalta works. So always tell your doctor about your health past before you start Cymbalta. Things to consider include:

  • Pregnancy or plans to conceive
  • Liver or kidney disease
  • Heart or blood vessel conditions
  • High blood pressure (hypertension)
  • Seizure disorders like epilepsy

Take a look at this summary table:

FactorWhat to consider during Cymbalta treatment
VaccinesNo known interactions; talks to a healthcare provider
Lab testsNo known interactions; discuss with a healthcare provider
Health historyInform your doctor about pregnancy, breastfeeding, liver or kidney disease, heart conditions, hypertension, and seizure disorders.

Cymbalta (Duloxetine) Side Effects:

Common: 

  • Nausea, Dry Mouth, Drowsiness
  • These mild effects often diminish over time as the body adjusts to the medication. Staying well-hydrated can alleviate dry mouth.

General: 

  • Changes in Blood Pressure, Liver Problems, Allergic Reactions
  • Regular monitoring is essential to manage potential risks. Immediate medical attention is crucial if signs of allergic reactions or severe liver issues emerge.

Cymbalta Side Effects in Females:

  • Menstrual Changes

Women may experience alterations in their menstrual cycle. Tracking these changes can provide insights into how the medication affects individual hormonal patterns.

  • Weight Changes

Fluctuations in weight can occur. Maintaining a balanced diet and exercise routine is recommended.

  • Breast Tenderness

Some females may experience breast tenderness. Understanding this side effect can help individuals make informed decisions about their treatment.

Cymbalta Side Effects in Males:

  • Erectile Dysfunction

Men may encounter challenges with erectile function. Openly discussing this with a healthcare provider can guide suitable interventions.

  • Ejaculation Disorders

Cymbalta can sometimes affect ejaculation. Understanding these changes and seeking information from healthcare professionals is crucial.

  • Testicular Pain

Some males may experience testicular pain. Prompt reporting of this symptom is essential for personalized care.

Cymbalta Sexual Side Effects:

  • Decreased Libido

Changes in sexual desire can occur. Exploring coping strategies and seeking information from healthcare professionals is recommended.

  • Difficulty Achieving Orgasm

Challenges with orgasm may arise. Adjusting the medication or exploring alternative approaches can be discussed with healthcare professionals.

  • Sexual Dysfunction

Individuals experiencing sexual dysfunction should be aware of these potential effects and may consider discussing them with healthcare providers for suitable guidance.

Conclusion

Now we know how Cymbalta interacts with food, beverage, drugs and more. Understanding this helps to ensure better health and full benefit of the medication. Always remember your unique needs and circumstances when taking medication. Hence, always check in with your healthcare professional before making any big changes.

While on Cymbalta, keep in touch with your doctor. Share details of other medications, supplements, or lifestyle habits that can influence your treatment. Your doctor can help spot potential interactions, adjustments, or alternatives for a healthier outcome.

Frequently Asked Questions (FAQs)

Can you take duloxetine with pregabalin?

No known interactions between duloxetine and pregabalin. But it is safe to consult your doctor before using both drugs.

Is it safe to takeAlprazolam and duloxetine together?

Nothing links duloxetine and alprazolam in a direct way. But talk to your doctor about Xanax before starting duloxetine

Can Topiramate interact with duloxetine?

No known links between duloxetine and topiramat. However, always ask your doctor before using both drugs together.

Is it okay to drink coffee with Cymbalta?

You should control your intake of caffeinated drinks, like coffee, while on Cymbalta. While there’s no straightforward clash, caffeine could influence drug efficacy and worsen side effects. Ask your doctor about managing your caffeine intake.

How can I lose weight while taking Cymbalta?

Some people may gain weight as a side effect of Cymbalta. To lose weight, eat healthily and exercise often. Speak to your healthcare provider or a nutritionist for a suitable weight loss plan that matches your Cymbalta treatment.

What should not be taken with duloxetine?

Try not to mix alcohol, caffeine, and some medications, supplements, and herbs with duloxetine (Cymbalta). Always talk to your doctor about other drugs, supplements, or herbal stuff you are using or plan to use. They can tell you if it is safe to mix these with duloxetine.

 How long does it take for cymbalta to work?

The onset of Cymbalta’s therapeutic effects varies, but many individuals may start experiencing improvement in their symptoms within 1 to 4 weeks after initiating treatment. However, it’s crucial to consult with a healthcare professional for personalized guidance on the duration of Cymbalta’s effectiveness.

Can you drink on cymbalta?

It is advisable to avoid alcohol while taking Cymbalta, as it can increase the risk of side effects such as drowsiness or dizziness. Consult your healthcare provider for personalized advice regarding alcohol consumption during Cymbalta treatment.

Can you take cymbalta while pregnant?

It’s crucial to consult with your healthcare provider before taking Cymbalta during pregnancy. They can assess the potential risks and benefits, considering your specific medical history and the well-being of both you and your baby. Always prioritize professional medical advice in such matters.

Can you take cymbalta at night?

Taking Cymbalta at night is generally acceptable, but it’s advisable to follow your healthcare provider’s recommendation for the most effective and personalized dosing schedule. Always consult with your healthcare professional to ensure the proper timing aligns with your specific health needs.

Can you take duloxetine and wellbutrin together?

duloxetine and Wellbutrin should be used cautiously together because they affect different neurotransmitters in the brain. Combining them may increase the risk of side effects or adverse reactions. Consulting with a healthcare professional helps manage potential interactions, ensuring a safer and more effective treatment plan.

Can you take duloxetine and gabapentin together?

Taking duloxetine and gabapentin together requires caution because both medications can have central nervous system effects. The combination may increase the risk of side effects such as dizziness, drowsiness, or difficulty concentrating. Consulting with a healthcare professional is crucial to assess individual factors, minimize risks, and ensure a safe treatment plan.

Can cymbalta make you tired?

Yes, fatigue is a common side effect of Cymbalta. If you experience excessive tiredness or drowsiness while taking the medication, it’s essential to consult with your healthcare provider to discuss potential adjustments in dosage or alternative treatment options

Can cymbalta cause high blood pressure?

Cymbalta may lead to changes in blood pressure, and in some cases, it can cause an increase. It’s crucial to monitor blood pressure regularly while on Cymbalta and consult with a healthcare professional if any concerning changes occur.

Can cymbalta cause anxiety?

While Cymbalta for anxiety act as an antidepressant that can help manage anxiety, in some cases, it may initially cause increased anxiety as a side effect. If you experience heightened anxiety while taking Cymbalta, it’s essential to consult with your healthcare provider for potential adjustments to your treatment plan.

Can cymbalta cause diarrhea?

Yes, diarrhea is a reported side effect of Cymbalta. If persistent or severe, it’s advisable to consult with your healthcare provider for guidance on managing this side effect, which may involve adjusting the dosage or exploring alternative medications.

Can cymbalta cause insomnia?

Cymbalta can contribute to insomnia or sleep disturbances as a potential side effect. If you experience persistent sleep issues while taking Cymbalta, it’s important to discuss this with your healthcare provider to explore possible adjustments to your treatment plan.

Can cymbalta cause constipation?

Yes, constipation is a recognized side effect of Cymbalta. If you encounter persistent or bothersome constipation while using Cymbalta, it is recommended to consult with your healthcare provider for potential management strategies or adjustments to your treatment.

Does cymbalta give you energy?

Cymbalta may contribute to increased energy levels in some individuals as it affects neurotransmitters. However, individual responses vary, and if you experience concerns about energy levels or fatigue while taking Cymbalta, consulting with your healthcare provider is advisable for personalized guidance.

Does cymbalta help with pain?

Yes, Cymbalta is commonly prescribed to help manage chronic pain conditions, such as neuropathic pain and fibromyalgia, due to its effects on certain neurotransmitters. However, individual responses vary, and it’s crucial to consult with a healthcare professional to determine the appropriateness of Cymbalta for your specific pain management needs.

What is cymbalta used for?

Cymbalta, or duloxetine, is commonly prescribed to treat major depressive disorder, generalized anxiety disorder, and certain types of chronic pain conditions such as fibromyalgia and diabetic neuropathy. It belongs to a class of medications called serotonin-norepinephrine reuptake inhibitors (SNRIs), influencing neurotransmitters in the brain to alleviate symptoms associated with these conditions.

Are duloxetine and Pregabalin the same?

No, duloxetine and Pregabalin are not the same. They belong to different drug classes and have distinct mechanisms of action. Cymbalta is an antidepressant in the serotonin-norepinephrine reuptake inhibitor (SNRI) class, while Pregabalin is an anticonvulsant used to treat nerve pain and seizures.

Are duloxetine and Venlafaxine the same?

No, duloxetine (Cymbalta) and venlafaxine (Effexor) are not the same. While both are antidepressants, duloxetine is a serotonin-norepinephrine reuptake inhibitor (SNRI), whereas venlafaxine belongs to the same class but also has additional effects on dopamine, making them distinct in their mechanisms and potential side effects.

Can i take muscle relaxer with duloxetine?

Seek guidance from your healthcare provider before combining a muscle relaxer with duloxetine to assess potential interactions and ensure safety. It’s important to consider individual health factors and medical history. Always follow the advice of your healthcare professional for personalized recommendations.

Can duloxetine cause weight gain?

Yes, duloxetine (Cymbalta) can potentially cause weight gain as a side effect. Individuals should monitor changes and consult with their healthcare professional for personalized advice on managing potential side effects. 

Can duloxetine make bipolar worse?

Duloxetine (Cymbalta) may not be suitable for individuals with bipolar disorder, as it can potentially trigger manic or hypomanic episodes. It is crucial to discuss any history of bipolar disorder with a healthcare provider before starting duloxetine or any other medication to ensure an appropriate treatment plan.

Can cymbalta cause dyskinsesia?

Duloxetine (Cymbalta) is generally not associated with causing dyskinesia. However, individual reactions to medications can vary, and any unusual movements or symptoms should be promptly reported to a healthcare professional for proper evaluation and guidance.

References:

  1. PubMed. Combination of pregabalin with duloxetine for fibromyalgia: a randomized controlled trial [Internet]. [cited 2023 Aug 14]. Available from: https://pubmed.ncbi.nlm.nih.gov/26982602
  2. ScienceDirect. Duloxetine and pregabalin: High-dose monotherapy or their combination? The “COMBO-DN study” – a multinational, randomized, double-blind, parallel-group study in patients with diabetic peripheral neuropathic pain [Internet]. [cited 2023 Aug 14]. Available from: https://www.sciencedirect.com/science/article/pii/S0304395913002856
  3. National Center for Biotechnology Information (NCBI). Black Box Warning [Internet]. [cited 2023 Aug 14]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK538521

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