Drug interactions
Duloxetine + Perhexiline
Severity: Major
Duloxetine and Perhexiline: 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 a moderate CYP2D6 inhibitor, and perhexiline is cleared mainly by CYP2D6 and has a narrow therapeutic index. Higher perhexiline concentrations may cause hepatotoxicity, peripheral neuropathy, hypoglycemia and ataxia.
What this interaction means in plain words
Duloxetine and Perhexiline 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
Duloxetine inhibits CYP2D6, reducing the metabolic clearance of perhexiline.
What to do
Monitor perhexiline plasma concentrations and reduce the dose as needed when duloxetine is started or stopped. Watch for neurological symptoms, liver enzyme elevation and hypoglycemia.
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
Frequently asked questions
Can I take Duloxetine with Perhexiline?
MediHelp rates the interaction as major. Duloxetine and Perhexiline 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 a moderate CYP2D6 inhibitor, and perhexiline is cleared mainly by CYP2D6 and has a narrow therapeutic index. Higher perhexiline concentrations may cause hepatotoxicity, peripheral neuropathy, hypoglycemia and ataxia.
How serious is the interaction between Duloxetine and Perhexiline?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor perhexiline plasma concentrations and reduce the dose as needed when duloxetine is started or stopped. Watch for neurological symptoms, liver enzyme elevation and hypoglycemia.
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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