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Can you take Duloxetine with Thalidomide?

1 drug interaction and 21 additional warnings found for the following 2 drugs:

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Drug interactions

Moderate drug interactions

Moderate:

thalidomide DULoxetine

Applies to: thalidomide and duloxetine

Using thalidomide together with DULoxetine may increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. Talk to your doctor if you have any questions or concerns. 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.

Food/lifestyle interactions

Moderate food/lifestyle interactions

Moderate:

thalidomide Food/Lifestyle

Applies to: thalidomide

Alcohol can increase the nervous system side effects of thalidomide such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with thalidomide. Do not use more than the recommended dose of thalidomide, and 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.

Moderate:

DULoxetine Food/Lifestyle

Applies to: 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.

Disease interactions

19 potential interactions Applies to: 17 conditions, including High Blood Pressure, Depression, Bipolar Disorder, Urinary Tract Infection, and Seizures.

Bipolar Disorder

Major:

duloxetine

DULoxetine has a major potential interaction with Bipolar Disorder.

Adult and pediatric patients with depression and other psychiatric disorders may experience worsening of their symptoms and may have the emergence of suicidal thoughts and behavior. Patients should be monitored appropriately and observed closely for worsening of their symptoms, suicidality or changes in their behavior, especially during the first few months of treatment, and at times of dose changes. Discontinuing the medication should be considered if symptoms are persistently worse, or abrupt in onset. It may be prudent to refrain from dispensing large quantities of medication to these patients.

Moderate:

duloxetine

DULoxetine has a moderate potential interaction with Bipolar Disorder.

Therapy with SNRI antidepressants can cause activation of mania and hypomania and should be used with caution in patients with personal or family history of mania, hypomania, bipolar disorder, and other mood disorders.

Dehydration

Moderate:

duloxetine

DULoxetine has a moderate potential interaction with Dehydration.

Treatment with SNRI antidepressants can cause hyponatremia. Caution should be used when treating patients with hyponatremia or at greater risk of hyponatremia such as the elderly, patients taking diuretics or who are volume depleted.

Depression

Major:

duloxetine

DULoxetine has a major potential interaction with Depression.

Adult and pediatric patients with depression and other psychiatric disorders may experience worsening of their symptoms and may have the emergence of suicidal thoughts and behavior. Patients should be monitored appropriately and observed closely for worsening of their symptoms, suicidality or changes in their behavior, especially during the first few months of treatment, and at times of dose changes. Discontinuing the medication should be considered if symptoms are persistently worse, or abrupt in onset. It may be prudent to refrain from dispensing large quantities of medication to these patients.

Diabetes Mellitus

Moderate:

duloxetine

DULoxetine has a moderate potential interaction with Diabetes Mellitus.

In clinical trials, treatment with duloxetine delayed-release worsened the glycemic control in some patients with diabetes. Caution should be used when using duloxetine in diabetic patients and their glycemic levels should be checked regularly.

Glaucoma, Narrow Angle

Moderate:

duloxetine

DULoxetine has a moderate potential interaction with Glaucoma, Narrow Angle.

SNRI antidepressants cause pupillary dilation that may trigger an angle closure attack in patients with anatomically narrow angle without iridectomy.

High Blood Pressure

Moderate:

duloxetine

DULoxetine has a moderate potential interaction with High Blood Pressure.

Selective serotonin and norepinephrine reuptake inhibitor antidepressants (SNRIs) have been associated with sustained increases in blood pressure. Therapy with SNRI antidepressants should be administered cautiously in patients with preexisting hypertension. Blood pressure should be assessed prior to initiating treatment and monitored regularly. The dose should be reduced or discontinued if necessary.

HIV-1 Infection

Moderate:

thalidomide

Thalidomide has a moderate potential interaction with HIV-1 Infection.

In two separate studies involving HIV-seropositive patients, the use of thalidomide was associated with an increase in plasma viral RNA levels. The clinical significance of this finding is unknown. Both studies were published prior to the availability of highly active antiretroviral therapy, or HAART. Until more information is available, the interim recommendation is to measure the viral load after the first and third months of thalidomide treatment and every 3 months thereafter (or as often as indicated by the patient's antiretroviral regimen and clinical status).

Hyponatremia

Moderate:

duloxetine

DULoxetine has a moderate potential interaction with Hyponatremia.

Treatment with SNRI antidepressants can cause hyponatremia. Caution should be used when treating patients with hyponatremia or at greater risk of hyponatremia such as the elderly, patients taking diuretics or who are volume depleted.

Hypotension

Moderate:

thalidomide

Thalidomide has a moderate potential interaction with Hypotension.

The use of thalidomide has been associated with dizziness and orthostatic hypotension. Therapy with thalidomide should be administered cautiously in patients with preexisting hypotension. Rising slowly from a recumbent position is recommended.

Liver Disease

Major:

duloxetine

DULoxetine has a major potential interaction with Liver Disease.

Postmarketing studies have reported that duloxetine and some other SNRIs like milnacipran may aggravate preexisting liver disease. The use of duloxetine delayed-release and milnacipran should be avoided in patients with chronic liver disease or cirrhosis.

Mania

Moderate:

duloxetine

DULoxetine has a moderate potential interaction with Mania.

Therapy with SNRI antidepressants can cause activation of mania and hypomania and should be used with caution in patients with personal or family history of mania, hypomania, bipolar disorder, and other mood disorders.

Neutropenia

Moderate:

thalidomide

Thalidomide has a moderate potential interaction with Neutropenia.

The use of thalidomide has been associated with decreased white blood cells counts, including neutropenia. Therapy with thalidomide should be administered cautiously in patients with preexisting neutropenia. Treatment should not be initiated if absolute neutrophil count is below 750/mm3. Monitoring white blood cell count and differential routinely is recommended during treatment.

Peripheral Neuropathy

Moderate:

thalidomide

Thalidomide has a moderate potential interaction with Peripheral Neuropathy.

The use of thalidomide has been associated with the development of peripheral neuropathy, which is sometimes irreversible. Therapy with thalidomide should be administered cautiously in patients with preexisting neuropathy and only after the neuropathy has returned to baseline. Patients should be monitored routinely for early signs of neuropathy including numbness, tingling, pain, or a burning sensation in the hands or feet. If symptoms of drug-induced neuropathy develop, thalidomide should be discontinued immediately.

Renal Dysfunction

Major:

duloxetine

DULoxetine has a major potential interaction with Renal Dysfunction.

The use of duloxetine should be avoided in patients with severe renal impairment (GFR <30 mL/min).

Seizures

Moderate:

duloxetine

DULoxetine has a moderate potential interaction with Seizures.

SNRI antidepressants may trigger seizures and should be administered with caution in patients with a seizure disorder.

Moderate:

thalidomide

Thalidomide has a moderate potential interaction with Seizures.

Seizures, including grand mal convulsions, have been reported during post-approval use of thalidomide in clinical practice. Because these events are reported voluntarily from a population of unknown size, estimates of frequency cannot be made. Most patients had disorders that may have predisposed them to seizure activity, and it is not currently known whether thalidomide has any epileptogenic influence. During therapy with thalidomide, patients with a history of seizures or with other risk factors for the development of seizures should be monitored closely for clinical changes that could precipitate acute seizure activity.

Urinary Tract Infection

Moderate:

duloxetine

DULoxetine has a moderate potential interaction with Urinary Tract Infection.

SNRI antidepressants have a noradrenergic effect and can affect urethral resistance. Caution should be used in patients with a history of dysuria, prostatic hypertrophy, prostatitis, and other lower urinary tract obstructive disorders.

Urinary Tract Obstruction

Moderate:

duloxetine

DULoxetine has a moderate potential interaction with Urinary Tract Obstruction.

SNRI antidepressants have a noradrenergic effect and can affect urethral resistance. Caution should be used in patients with a history of dysuria, prostatic hypertrophy, prostatitis, and other lower urinary tract obstructive disorders.

More resources

duloxetine

A total of 654 drugs are known to interact with duloxetine.

thalidomide

A total of 862 drugs are known to interact with thalidomide.

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.