Foods to Avoid While Taking Duloxetine

Introduction

Do you wonder what duloxetine is? Duloxetine belongs to the serotonin-norepinephrine reuptake inhibitors (SNRIs) class of drugs and is used in the management of mental health conditions like major depressive disorder (MDD) and generalised anxiety disorder (GAD) and other conditions like diabetic neuropathy¹, fibromyalgia², and chronic musculoskeletal pain. For individuals on duloxetine, it is vital to know about food and drug interactions of the medication and its side effects as these factors may influence the effectiveness of the medicine³. 

Before exploring which foods and substances to avoid when on duloxetine, let’s first understand how the medicine works and its interactions with other drugs, supplements and herbal products along with other considerations. Each person responds differently to a medicine, so you should consult your doctor before making any major changes to your medicine. 

How Does Duloxetine Work?

Duloxetine works by increasing the levels of serotonin and norepinephrine in the brain. These are important chemicals that affect mood and pain sensations. Duloxetine does not let these chemicals be reabsorbed, allowing them to stay active in the spaces between nerve cells. 

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

Foods to Avoid While Taking Duloxetine

If you’re on duloxetine, some foods and drinks are best avoided. Here’s some foods you should watch out for. 

1. Alcohol

It is safer to avoid alcohol if you are on duloxetine as the combination may increase some side effects of the drug and may lead to potentially harmful interactions. Both alcohol and duloxetine can cause CNS depression, potentially leading to excessive sedation. Alcohol may also interfere with duloxetine’s ability to improve mood, reducing its therapeutic benefit. Additionally, since both are metabolised in the liver, using them together increases the risk of liver toxicity⁴. 

Taking alcohol with duloxetine could cause: 

• Increased drowsiness or fatigue 
• Dizziness and impaired coordination 
• Nausea, vomiting, or feeling unwell 
• Worsening of depressive symptoms 
• Greater risk of liver damage, especially in those with existing liver conditions 

Both the manufacturer (FDA label) and doctors strongly recommend limiting or avoiding alcohol, particularly if you have a history of liver disease or depression. Always check with your doctor before consuming alcohol during duloxetine treatment⁴.

I want to emphasise that when prescribed to take duloxetine, 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. 

2. Caffeine

Keep an eye on your caffeine intake while taking duloxetine. Although caffeine doesn’t directly interfere with how the medicine works, it may worsen certain side effects, such as jitteriness, anxiety, or trouble sleeping, especially if you’re sensitive to stimulants. In some cases, too much caffeine may reduce duloxetine’s calming benefits by increasing restlessness or anxious feelings⁵. 

To manage your caffeine intake: 

• Track how much caffeine you consume each day. 
• Cut back on tea, coffee, and energy drinks gradually rather than stopping suddenly. 
• Switch to lower-caffeine or caffeine-free alternatives, if needed. 

3. High-Tyramine Foods

Although duloxetine is not a monoamine oxidase inhibitor (MAOI), some people worry about its interaction with high-tyramine foods. However, current research has not shown any significant risk, and duloxetine does not inhibit the MAO enzyme. That said, if you want to be cautious, it’s you may limit foods high in tyramine, such as: 

• Aged cheeses 
• Smoked or dried meats 
• Pickled vegetables 
• Fermented soy products like soy sauce and tempeh 
• Sauerkraut 

Drug Interactions With Duloxetine

If you are curious to know the drugs that may not work well with duloxetine, let’s find out. Always inform your doctor about all the medicines, supplements, or herbal products you currently take or are planning to take, to help avoid any possible interactions. 

1. Medications for Mental Health Concerns

Taking duloxetine with other medicines for mental health issues may increase side effects or cause complications. 

Some examples of such medicines include: 

• Other antidepressants such as fluoxetine, sertraline, or amitriptyline 
• Mood stabilisers like lithium or valproate 
• Medicines for anxiety, including benzodiazepines like clonazepam 
• Always check with your doctor before combining medications for mental health issues with duloxetine as it could lead to complications or side effects like: 
• Increased risk of serotonin syndrome (excessive serotonin levels in the body), leading to restlessness or confusion, fever, and fast heart rate. 
• Increased anxiety or mood-related side effects^4,6. 

How to manage drug interactions?

Here are a few simple precautions to help manage drug interactions while on duloxetine: 

• Consult your doctor about all the medicines you are taking. 
• Do not self-medicate. 

2. Nonsteroidal Anti-inflammatory Drugs (NSAIDs)

NSAIDs could increase the risk of gastrointestinal bleeding when used with duloxetine, which could lead to: 

• Ulcers or stomach bleeding 
• Worsening of existing kidney or liver issues⁶

How to manage this interaction? 

Here are a few precautions to manage the interaction of NSAIDs with duloxetine: 

• Speak to your doctor before taking duloxetine with any NSAIDs. 
• Be careful when using NSAIDs for a longer duration or in large doses if you are on duloxetine. 

3. Amphetamines

Combining amphetamines with duloxetine may lead to side effects like: 

• A faster heart rate, elevated blood pressure, anxiety, and trouble sleeping 
• One or both medicine may not be as effective 

How to manage this interaction? 

These precautions may help you manage the interactions of amphetamines with duloxetine: 

• If you are taking any amphetamines, consult your doctor before you start duloxetine. 
• Monitor your response to both drugs and quickly report any symptoms to your doctor. 

Supplement and Herbal Interactions with Duloxetine

You need to know how supplements and herbs can interact with duloxetine. So, always discuss all supplement and herbal product use with your doctor⁷. 

Vitamin and Mineral Supplements

There are no specific reported interactions between duloxetine and most vitamins or minerals. However, it’s still important to inform your doctor about any supplements you take, as certain combinations may affect how well the medicine works. 

Herbal Supplements

Some herbal supplements may not be safe to take with duloxetine. For example, combining St. John’s Wort with duloxetine may increase the risk of serotonin syndrome, a potentially serious condition linked to excess serotonin in the body⁶. Kava, another herbal product, may increase the risk of liver damage when taken with duloxetine. While there is no strong evidence that these herbs reduce the effectiveness of duloxetine, they can increase its side effects or lead to harmful interactions. 

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 duloxetine. 

If you feel nauseous or unwell while taking duloxetine, it is advisable to avoid heavy meals and spicy or greasy foods. Easily digestible foods can reduce stomach discomfort and make you feel more at ease. Always let your doctor know if your nausea persists or worsens. 

Other Factors That May Affect How Duloxetine Works

Certain factors like an individual’s vaccination status, laboratory test requirements, and health history can influence the effect of duloxetine. 

1. Vaccines

Based on available data, there are no known interactions between duloxetine and most vaccines. However, it is advisable to consult your doctor before taking a vaccine if you are on duloxetine. 

2. Lab Tests 

Duloxetine is not known to interfere with common lab test results. However, if you have been scheduled for any tests, let your doctor know you are taking duloxetine for better interpretation of your test results. 

3. Health History Considerations

Your past and present health conditions can influence the effect of duloxetine. It is advisable to share your full medical history with your doctor, especially if you are pregnant or plan to conceive or have or have had: 

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

Side Effects of Duloxetine

• Common Side Effects: Nausea, dry mouth, and drowsiness are some of the more common side effects that people may notice, especially when starting the medicine. These are usually mild and tend to improve as your body gets used to the medicine. Drinking enough water may help ease dry mouth. 
• Other General Side Effects: Some less common side effects of duloxetine include liver problems, allergic reactions, and increased blood pressure. If you already have high blood pressure or a family history of it, your doctor may recommend regular blood pressure monitoring or adjust your duloxetine dose. Always seek medical help if you notice signs of an allergic reaction or serious liver issues^7,8. 

Side Effects of Duloxetine in Women 

Some duloxetine side effects may specifically affect women and may vary from person to person: 

• Menstrual changes: Some women may notice changes in their periods. Tracking your cycle can help identify any changes in the pattern. 
• Weight changes: Weight gain has been reported with duloxetine in some women, which may be managed with a healthy diet and regular physical activity. 
• Breast tenderness: Rarely, some women may experience breast discomfort. If this occurs, speak to your doctor for personalised advice. 

Side Effects of Duloxetine in Men

Duloxetine may lead to certain side effects that are more commonly seen in men: 

• Erectile dysfunction concerns: Some men may have difficulty getting or maintaining an erection. 
• Ejaculation changes: Duloxetine may sometimes affect ejaculation. 
• Testicular discomfort: Testicular pain has been reported in rare instances. 

If you experience any of these symptoms, it is essential to consult your doctor and discuss your concerns openly.  

Duloxetine Sexual Side Effects

Duloxetine may affect sexual health in both men and women. These effects can vary but may include: 

• Lowered sexual desire: A decrease in libido may occur in some individuals. You can discuss the symptom and coping strategies with your doctor. 
• Difficulty reaching orgasm: Some individuals may find it harder to achieve orgasm. Adjusting the duloxetine treatment plan may help address this issue. 
• General sexual dysfunction: If sexual side effects impact your well-being, it’s important to consult your doctor for personalised support options⁴. 

Conclusion 

Understanding how duloxetine may interact with certain foods, beverages, drugs and more supports better health and more effective use of the medication. It is important to consider your overall health and lifestyle when taking medication. 

While on duloxetine, it is recommended you stay in touch with your doctor. Always share details of other medications and supplements you are taking with your doctor as they can influence your treatment. This allows your doctor to check for possible interactions, devise coping strategies, and adjust your treatment if needed. 

Frequently Asked Questions (FAQs)

References

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2. Gilron I, Chaparro LE, Tu D, Holden RR, Milev R, Towheed T, DuMerton-Shore D, Walker S. Combination of pregabalin with duloxetine for fibromyalgia: a randomized controlled trial. Pain. 2016 Jul;157(7):1532-40.  Available from: https://journals.lww.com/pain/abstract/2016/07000/combination_of_pregabalin_with_duloxetine_for.20.aspx 
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5. Hladun O, Papaseit E, Martín S, Barriocanal AM, Poyatos L, Farré M, Pérez-Mañá C. Interaction of Energy Drinks with Prescription Medication and Drugs of Abuse. Pharmaceutics. 2021 Sep 22;13(10):1532. doi: 10.3390/pharmaceutics13101532.  Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC8541613/ 
6. Duloxetine (Rx) [Internet]. Medscape. Cited 2025 Jun 27. Available from: https://reference.medscape.com/drug/cymbalta-irenka-duloxetine-342960#0
7. Duloxetine [Internet]. MedlinePlus. Cited 2025 Jun 27. Available from: https://medlineplus.gov/druginfo/meds/a604030.html 
8. Side effects of duloxetine [Internet]. NHS. Cited 2025 Jun 27. Available from: https://www.nhs.uk/medicines/duloxetine/side-effects-of-duloxetine/ 
9. MotherToBaby | Fact Sheets [Internet]. Brentwood (TN): Organization of Teratology Information Specialists (OTIS); 1994-. Duloxetine (Cymbalta®) 2023 Dec. Available from: https://www.ncbi.nlm.nih.gov/books/NBK582683/  
10. Ma SP, Tsai CJ, Chang CC, Hsu WY. Delirium associated with concomitant use of duloxetine and bupropion in an elderly patient. Psychogeriatrics. 2017 Mar;17(2):130-132. doi: 10.1111/psyg.12202. Epub 2016 Apr 5. Available from: https://pubmed.ncbi.nlm.nih.gov/27046219/ 

Disclaimer: The information provided here is for educational/awareness purposes only and is not intended to be a substitute for medical treatment by a healthcare professional and should not be relied upon to diagnose or treat any medical condition. The reader should consult a registered medical practitioner to determine the appropriateness of the information before consuming any medication. PharmEasy does not provide any guarantee or warranty (express or implied) regarding the accuracy, adequacy, completeness, legality, reliability or usefulness of the information; and disclaims any liability arising thereof. 

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