Drug interactions
Bupropion-naltrexone + Duloxetine
Severity: Major
Bupropion-naltrexone and Duloxetine: major interaction.
Last updated
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
Duloxetine is partly metabolized by CYP2D6, and bupropion is a strong CYP2D6 inhibitor, so duloxetine exposure can rise. Both drugs also lower the seizure threshold, so the combination may increase seizure risk and serotonergic or noradrenergic adverse effects.
What this interaction means in plain words
Bupropion-naltrexone 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.
Bupropion-naltrexone belongs to Miscellaneous; Duloxetine belongs to Central Nervous System.
Why it happens
Bupropion (via hydroxybupropion) inhibits CYP2D6, raising duloxetine levels, with additive seizure-threshold lowering.
What to do
Avoid the combination where possible; if it is needed, start duloxetine at a low dose and titrate slowly. Monitor for seizures, serotonergic symptoms and blood pressure.
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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Other interactions of Bupropion-naltrexone
- Bupropion-naltrexone + Hydrocodone Contraindicated
- Bupropion-naltrexone + Hydromorphone Contraindicated
- Bupropion-naltrexone + Isocarboxazid Contraindicated
- Bupropion-naltrexone + Linezolid Contraindicated
- Bupropion-naltrexone + Phenelzine Contraindicated
- Bupropion-naltrexone + Rasagiline Contraindicated
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 Bupropion-naltrexone with Duloxetine?
MediHelp rates the interaction as major. Bupropion-naltrexone 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. Duloxetine is partly metabolized by CYP2D6, and bupropion is a strong CYP2D6 inhibitor, so duloxetine exposure can rise. Both drugs also lower the seizure threshold, so the combination may increase seizure risk and serotonergic or noradrenergic adverse effects.
How serious is the interaction between Bupropion-naltrexone 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 it is needed, start duloxetine at a low dose and titrate slowly. Monitor for seizures, serotonergic symptoms and blood pressure.
What other medicines interact with Bupropion-naltrexone?
MediHelp also lists interactions of Bupropion-naltrexone with, for example, Hydrocodone, Hydromorphone, Isocarboxazid. The full list is on the Bupropion-naltrexone page.
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