Drug interactions
Duloxetine + Trimipramine
Severity: Major
Duloxetine and Trimipramine: 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
Together they increase serotonergic activity and the risk of serotonin syndrome. Duloxetine inhibits CYP2D6, which can raise trimipramine levels and add to tricyclic toxicity.
What this interaction means in plain words
Duloxetine and Trimipramine 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; Trimipramine belongs to Central Nervous System.
Why it happens
Additive serotonin and noradrenaline reuptake inhibition, with CYP2D6 inhibition by duloxetine raising trimipramine concentrations.
What to do
Avoid the combination where possible. If it is necessary, reduce the tricyclic dose, consider monitoring tricyclic levels and the ECG, and watch for serotonin toxicity.
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 Trimipramine
- Disopyramide + Trimipramine Contraindicated
- Dofetilide + Trimipramine Contraindicated
- Ibutilide + Trimipramine Contraindicated
- Isocarboxazid + Trimipramine Contraindicated
- Pentamidine + Trimipramine Contraindicated
- Phenelzine + Trimipramine 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 Trimipramine?
MediHelp rates the interaction as major. Duloxetine and Trimipramine 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. Together they increase serotonergic activity and the risk of serotonin syndrome. Duloxetine inhibits CYP2D6, which can raise trimipramine levels and add to tricyclic toxicity.
How serious is the interaction between Duloxetine and Trimipramine?
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 necessary, reduce the tricyclic dose, consider monitoring tricyclic levels and the ECG, and watch for serotonin toxicity.
What other medicines interact with Trimipramine?
MediHelp also lists interactions of Trimipramine with, for example, Disopyramide, Dofetilide, Ibutilide. The full list is on the Trimipramine page.
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