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Drug Interactions between Cymbalta and Parnate

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

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Interactions between your drugs

Major

tranylcypromine DULoxetine

Applies to: Parnate (tranylcypromine) and Cymbalta (duloxetine)

Using tranylcypromine together with DULoxetine is not recommended. Combining these medications can increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. In general, you should wait at least 14 days after stopping tranylcypromine before you start treatment with DULoxetine. Conversely, if you have recently been on DULoxetine and are now starting treatment with tranylcypromine, you should check with your doctor or pharmacist to see how long you should wait before it is safe for you to use tranylcypromine, as some medications can take a while to clear from your body. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Drug and food interactions

Major

tranylcypromine food

Applies to: Parnate (tranylcypromine)

During and within two weeks after treatment with tranylcypromine, you must not consume any foods or beverages that are high in tyramine content. Doing so can raise your blood pressure to dangerous levels, a condition known as hypertensive crisis. The condition is potentially fatal and may cause symptoms such as severe headache, confusion, blurred vision, problems with speech or balance, nausea, vomiting, chest pain, convulsions, and sudden numbness or weakness (especially on one side of the body). You should seek immediate medical attention if you have any of these symptoms. Foods that are high in tyramine include, but are not limited to, air dried meats; aged or fermented meats; sausage or salami; pickled herring; anchovies; liver; red wine; beer; aged cheeses, including blue, brick, brie, cheddar, parmesan, romano, and swiss; sour cream; sauerkraut; canned figs; raisins; bananas or avocados (particularly if overripe); soy beans; soy sauce; tofu; miso soup; bean curd; fava beans; or yeast extracts (such as Marmite). You should avoid the use of alcohol while being treated with tranylcypromine, as alcohol may increase some of the nervous system side effects such as dizziness, drowsiness, and difficulty concentrating. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. Talk to your doctor or pharmacist if you have any questions or concerns.

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Moderate

DULoxetine food

Applies to: Cymbalta (duloxetine)

DULoxetine may cause liver damage, and taking it with alcohol may increase that risk. You should avoid or limit the use of alcohol while being treated with DULoxetine. Call your doctor immediately if you have fever, chills, joint pain or swelling, excessive tiredness or weakness, unusual bleeding or bruising, skin rash or itching, loss of appetite, nausea, vomiting, dark colored urine, or yellowing of the skin or the whites of your eyes, as these may be symptoms of liver damage. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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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:

  • Cymbalta (duloxetine)
  • Parnate (tranylcypromine)

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