Drug interactions
Cocaine + Duloxetine
Severity: Major
Cocaine 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
Cocaine blocks reuptake of serotonin, norepinephrine and dopamine, so systemic cocaine use with duloxetine may increase serotonin toxicity and cardiovascular stimulation. Topical medical cocaine has little systemic absorption, so the risk is mostly with illicit or high-dose use.
What this interaction means in plain words
Cocaine 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.
Cocaine belongs to Central Nervous System; Duloxetine belongs to Central Nervous System.
Why it happens
Additive monoamine reuptake inhibition causing serotonergic and sympathomimetic effects.
What to do
Counsel patients to avoid cocaine use and monitor for serotonin syndrome, hypertension and tachycardia if exposure occurs. For topical use, limit dose to the minimum needed.
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 Duloxetine
- Duloxetine + Isocarboxazid Contraindicated
- Duloxetine + Linezolid Contraindicated
- Duloxetine + Methylene blue Contraindicated
- Duloxetine + Phenelzine Contraindicated
- Duloxetine + Procarbazine Contraindicated
- Duloxetine + Rasagiline Contraindicated
Other interactions of Cocaine
- Cocaine + Isocarboxazid Contraindicated
- Cocaine + Phenelzine Contraindicated
- Cocaine + Procarbazine Contraindicated
- Amitriptyline + Cocaine Major
- Bisoprolol + Cocaine Major
- Citalopram + Cocaine Major
Frequently asked questions
Can I take Cocaine with Duloxetine?
MediHelp rates the interaction as major. Cocaine 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. Cocaine blocks reuptake of serotonin, norepinephrine and dopamine, so systemic cocaine use with duloxetine may increase serotonin toxicity and cardiovascular stimulation. Topical medical cocaine has little systemic absorption, so the risk is mostly with illicit or high-dose use.
How serious is the interaction between Cocaine 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: Counsel patients to avoid cocaine use and monitor for serotonin syndrome, hypertension and tachycardia if exposure occurs. For topical use, limit dose to the minimum needed.
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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