Atomoxetine and Duloxetine interaction

Atomoxetine and Duloxetine: both prescribing labels flag this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.

Major

Do not combine without a prescriber's guidance. The label language below is the strongest FDA uses.

What the FDA labels say

From the Duloxetine (Cymbalta) label · effective 2025-07-21

Major

Serotonin Syndrome Serotonin-norepinephrine reuptake inhibitors (SNRIs), including CYMBALTA, can precipitate serotonin syndrome, a potentially life-threatening condition.

Warnings and precautionsby drug classView label on DailyMed
Minor

During marketing of other SSRIs and SNRIs (serotonin and norepinephrine reuptake inhibitors), there have been spontaneous reports of adverse events occurring upon discontinuation of these drugs, particularly when abrupt, including the following: dysphoric mood, irritability, agitation, dizziness, sensory disturbances (e.g., paresthesias such as electric shock…

Warnings and precautionsby drug classView label on DailyMed

From the Atomoxetine (Atomoxetine hydrochloride) label · effective 2026-04-03

Moderate

Strong CYP2D6 Inhibitors Prevention or Management With concomitant use of atomoxetine oral solution and a strong CYP2D6 inhibitor 1 , increase the titration interval [see Dosage and Administration (2.5) and Clinical Pharmacology (12.3) ] .

Drug interactionsby drug classView label on DailyMed
Moderate

Concomitant use of atomoxetine oral solution and a strong CYP2D6 inhibitor increases atomoxetine exposure [see Dosage and Administration (2.5) and Clinical Pharmacology (12.3) ] .

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Moderate

Strong CYP2D6 Inhibitors: With concomitant of atomoxetine oral solution and strong CYP2D6 inhibitors, increase the titration intervals.

Drug interactionsby drug classView label on DailyMed
Minor

See www.fda.gov/CYPandTransporterInteractingDrugs for examples of strong CYP2D6 inhibitors.

Drug interactionsby drug classView label on DailyMed

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Not medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.