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Drug Interactions between 5-HTP and duloxetine

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Major

5-hydroxytryptophan DULoxetine

Applies to: 5-HTP (5-hydroxytryptophan) and duloxetine

GENERALLY AVOID: Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors and tryptophan may potentiate the risk of serotonin syndrome, which is a rare but serious and potentially fatal condition thought to result from hyperstimulation of brainstem 5-HT1A and 2A receptors. Symptoms of the serotonin syndrome may include mental status changes such as irritability, altered consciousness, confusion, hallucinations, and coma; autonomic dysfunction such as tachycardia, hyperthermia, diaphoresis, shivering, blood pressure lability, and mydriasis; neuromuscular abnormalities such as hyperreflexia, myoclonus, tremor, rigidity, and ataxia; and gastrointestinal symptoms such as abdominal cramping, nausea, vomiting, and diarrhea.

MANAGEMENT: The concomitant use of serotonin reuptake inhibitors and tryptophan should be avoided.

References

  1. "Product Information. Zoloft (sertraline)." Roerig Division PROD (2001):
  2. "Product Information. Prozac (fluoxetine)." Dista Products Company PROD (2001):
  3. "Product Information. Effexor (venlafaxine)." Wyeth-Ayerst Laboratories PROD (2001):
  4. "Product Information. Paxil (paroxetine)." GlaxoSmithKline PROD (2001):
  5. "Product Information. Luvox (fluvoxamine)." Solvay Pharmaceuticals Inc PROD (2001):
  6. "Product Information. Celexa (citalopram)." Forest Pharmaceuticals PROD (2001):
  7. "Product Information. Lexapro (escitalopram)." Forest Pharmaceuticals (2002):
  8. "Product Information. Cymbalta (duloxetine)." Lilly, Eli and Company (2004):
  9. "Product Information. Pristiq (desvenlafaxine)." Wyeth Laboratories (2008):
  10. "Product Information. Savella (milnacipran)." Forest Pharmaceuticals (2009):
  11. "Product Information. Nucynta (tapentadol)." PriCara Pharmaceuticals (2009):
  12. "Product Information. Viibryd (vilazodone)." Trovis Pharmaceuticals LLC (2011):
  13. "Product Information. Fetzima (levomilnacipran)." Forest Pharmaceuticals (2013):
  14. "Product Information. Brintellix (vortioxetine)." Takeda Pharmaceuticals America (2013):
View all 14 references

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Drug and food interactions

Moderate

DULoxetine food

Applies to: duloxetine

GENERALLY AVOID: Use of duloxetine in conjunction with chronic alcohol consumption may potentiate the risk of liver injury. Duloxetine alone can increase serum transaminase levels. In clinical trials, 0.3% of patients discontinued duloxetine due to liver transaminase elevations. The median time to detection was about two months. Three duloxetine-treated patients had liver injury as manifested by transaminase and bilirubin elevations, with evidence of obstruction. Substantial intercurrent ethanol use was present in each of these cases, which may have contributed to the abnormalities observed. Duloxetine does not appear to enhance the central nervous system effects of alcohol. When duloxetine and ethanol were administered several hours apart so that peak concentrations of each would coincide, duloxetine did not increase the impairment of mental and motor skills caused by alcohol.

MANAGEMENT: Due to the risk of liver injury, patients prescribed duloxetine should be counseled to avoid excessive use of alcohol. Duloxetine should generally not be prescribed to patients with substantial alcohol use.

References

  1. "Product Information. Cymbalta (duloxetine)." Lilly, Eli and Company (2004):

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Therapeutic duplication warnings

Therapeutic duplication is the use of more than one medicine from the same drug category or therapeutic class to treat the same condition. This can be intentional in cases where drugs with similar actions are used together for demonstrated therapeutic benefit. It can also be unintentional in cases where a patient has been treated by more than one doctor, or had prescriptions filled at more than one pharmacy, and can have potentially adverse consequences.

Duplication

Antidepressants

Therapeutic duplication

The recommended maximum number of medicines in the 'antidepressants' category to be taken concurrently is usually one. Your list includes two medicines belonging to the 'antidepressants' category:

  • 5-HTP (5-hydroxytryptophan)
  • duloxetine

Note: In certain circumstances, the benefits of taking this combination of drugs may outweigh any risks. Always consult your healthcare provider before making changes to your medications or dosage.

See also

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer