Drug interactions
Duloxetine + Pipemidic acid
Severity: Major
Duloxetine and Pipemidic acid: 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
Pipemidic acid is a quinolone that inhibits CYP1A2, the principal enzyme clearing duloxetine. Duloxetine levels may rise, increasing nausea, dizziness, and serotonergic effects.
What this interaction means in plain words
Duloxetine and Pipemidic acid 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
Pipemidic acid inhibits CYP1A2, reducing duloxetine clearance.
What to do
Avoid the combination where possible and choose a non-CYP1A2-inhibiting antibacterial. If it must be used, monitor for duloxetine adverse effects and consider reducing the dose.
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 Duloxetine with Pipemidic acid?
MediHelp rates the interaction as major. Duloxetine and Pipemidic acid 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. Pipemidic acid is a quinolone that inhibits CYP1A2, the principal enzyme clearing duloxetine. Duloxetine levels may rise, increasing nausea, dizziness, and serotonergic effects.
How serious is the interaction between Duloxetine and Pipemidic acid?
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 and choose a non-CYP1A2-inhibiting antibacterial. If it must be used, monitor for duloxetine adverse effects and consider reducing the dose.
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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