Drug interactions
Amoxapine + Duloxetine
Severity: Major
Amoxapine and Duloxetine: major interaction.
Last updated Sources: US FDA label
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Both drugs enhance serotonergic and noradrenergic transmission, which increases the risk of serotonin syndrome. Duloxetine inhibits CYP2D6 and may raise amoxapine levels, increasing anticholinergic, cardiac and seizure risk.
What this interaction means in plain words
Amoxapine and Duloxetine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Additive monoamine reuptake inhibition, with CYP2D6 inhibition by duloxetine reducing amoxapine clearance.
What to do
Avoid the combination where possible; if used, start amoxapine at a low dose and monitor ECG, seizures and serotonin toxicity.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
Other interactions of Duloxetine
- Duloxetine + Isocarboxazid Contraindicated
- Duloxetine + Linezolid Contraindicated
- Duloxetine + Methylene blue Contraindicated
- Duloxetine + Phenelzine Contraindicated
- Duloxetine + Procarbazine Contraindicated
- Duloxetine + Rasagiline Contraindicated
Frequently asked questions
Can I take Amoxapine with Duloxetine?
MediHelp rates the interaction as major. Amoxapine and Duloxetine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Both drugs enhance serotonergic and noradrenergic transmission, which increases the risk of serotonin syndrome. Duloxetine inhibits CYP2D6 and may raise amoxapine levels, increasing anticholinergic, cardiac and seizure risk.
How serious is the interaction between Amoxapine and Duloxetine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination where possible; if used, start amoxapine at a low dose and monitor ECG, seizures and serotonin toxicity.
What other medicines interact with Duloxetine?
MediHelp also lists interactions of Duloxetine with, for example, Isocarboxazid, Linezolid, Methylene blue. The full list is on the Duloxetine page.
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