Drug interactions
Duloxetine + Meperidine
Severity: Major
Duloxetine and Meperidine: 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
Duloxetine inhibits serotonin and norepinephrine reuptake, and with meperidine the combination can cause serotonin syndrome. Duloxetine also inhibits CYP2D6, but the key concern is serotonergic toxicity.
What this interaction means in plain words
Duloxetine and Meperidine 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 belongs to Central Nervous System; Meperidine belongs to Musculoskeletal.
Why it happens
Additive serotonergic effects through reuptake inhibition.
What to do
Avoid the combination and choose a non-serotonergic opioid. If given, monitor closely for clonus, agitation, hyperthermia and autonomic instability.
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 Meperidine
- Alvimopan + Meperidine Contraindicated
- Isocarboxazid + Meperidine Contraindicated
- Meperidine + Methylene blue Contraindicated
- Meperidine + Olanzapine / samidorphan Contraindicated
- Meperidine + Phenelzine Contraindicated
- Meperidine + Procarbazine 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 Duloxetine with Meperidine?
MediHelp rates the interaction as major. Duloxetine and Meperidine 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 inhibits serotonin and norepinephrine reuptake, and with meperidine the combination can cause serotonin syndrome. Duloxetine also inhibits CYP2D6, but the key concern is serotonergic toxicity.
How serious is the interaction between Duloxetine and Meperidine?
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 and choose a non-serotonergic opioid. If given, monitor closely for clonus, agitation, hyperthermia and autonomic instability.
What other medicines interact with Meperidine?
MediHelp also lists interactions of Meperidine with, for example, Alvimopan, Isocarboxazid, Methylene blue. The full list is on the Meperidine page.
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