Duloxetine and supplements: 2 sourced interactions

SNRI antidepressant, also sold as Cymbalta and Drizalma Sprinkle. Of these, 2 named by an FDA label or NIH page. Plus 5 predicted from how each works (not established). Plus 1 food and drink line. Each links its source and the date it was checked.

From the Interaction Map Sources checked Oct 25, 2026

A combination missing here is not on our list; that does not mean it is safe together.

Duloxetine with supplements

Most serious first. Open a row for the mechanism, the source's words and the date checked.

Educational only. Check with your pharmacist or prescriber before changing anything you take.

Moderate

7
SAMeLabel or NIHAn NIH page names this pair (serotonin activity).

moderate · Named by an FDA label or NIH page · Serotonin activity

In the source’s own words; rated moderate from that wording, not from a study of the pair.

“It’s also possible that SAMe might interact with drugs and dietary supplements that increase levels of serotonin (a chemical produced by nerve cells), such as antidepressants, L-tryptophan, and St. John’s wort.”

St John's wortLabel or NIHThe FDA label names this pair (serotonin activity).

moderate · Named by an FDA label or NIH page · Serotonin activity

In the source’s own words; rated moderate from that wording, not from a study of the pair.

“The risk is increased with concomitant use of other serotonergic drugs (including triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, meperidine, methadone, tryptophan, buspirone, amphetamines, and St. John's Wort) and with drugs that impair metabolism of serotonin, i.e., MAOIs, [see Contraindications (4), Drug Interactions (7.13)].”

“The concomitant use of serotonergic drugs (including other SNRIs, SSRIs, triptans, tricyclic antidepressants, opioids, lithium, buspirone, amphetamines, tryptophan, and St. John's Wort) with duloxetine increases the risk of serotonin syndrome.”

  • FDA drug label (DailyMed) · DULOXETINE CAPSULE, DELAYED RELEASE [LUPIN PHARMACEUTICALS, INC.], section 7.14
  • Checked Oct 25, 2026
Asian ginsengPredictedBoth can affect clotting or platelets, so bleeding risk may add up.

moderate · Predicted from how each works, not established · Platelets and bleeding

Predicted from what each is known to do, not studied as a pair and not established.

Both can affect clotting or platelets, so bleeding risk may add up.

Fish oil (omega-3)PredictedBoth can affect clotting or platelets, so bleeding risk may add up.

moderate · Predicted from how each works, not established · Platelets and bleeding

Predicted from what each is known to do, not studied as a pair and not established.

Both can affect clotting or platelets, so bleeding risk may add up.

  • NIH Office of Dietary Supplements · Fish oil (omega-3): affects clotting or platelets (Office of Dietary Supplements · Omega-3 Fatty Acids: Fact Sheet for Health Professionals, Interactions with Medications > Warfarin (Coumadin) and similar anticoagulants)
  • FDA drug label (DailyMed) · Duloxetine: affects clotting or platelets (DULOXETINE CAPSULE, DELAYED RELEASE [LUPIN PHARMACEUTICALS, INC.], section 5.5)
  • Checked Oct 25, 2026
GarlicPredictedBoth can affect clotting or platelets, so bleeding risk may add up.

moderate · Predicted from how each works, not established · Platelets and bleeding

Predicted from what each is known to do, not studied as a pair and not established.

Both can affect clotting or platelets, so bleeding risk may add up.

Ginkgo bilobaPredictedBoth can affect clotting or platelets, so bleeding risk may add up.

moderate · Predicted from how each works, not established · Platelets and bleeding

Predicted from what each is known to do, not studied as a pair and not established.

Both can affect clotting or platelets, so bleeding risk may add up.

Vitamin EPredictedBoth can affect clotting or platelets, so bleeding risk may add up.

moderate · Predicted from how each works, not established · Platelets and bleeding

Predicted from what each is known to do, not studied as a pair and not established.

Both can affect clotting or platelets, so bleeding risk may add up.

  • FDA drug label (DailyMed) · Duloxetine: affects clotting or platelets (DULOXETINE CAPSULE, DELAYED RELEASE [LUPIN PHARMACEUTICALS, INC.], section 5.5)
  • NIH Office of Dietary Supplements · Vitamin E: affects clotting or platelets (Office of Dietary Supplements · Vitamin E, Interactions with Medications · Anticoagulant and antiplatelet medications)
  • Checked Oct 25, 2026

Duloxetine with food and drink

Food and drink

1
CoffeeLabel or NIHThe FDA label names this pair (breakdown by liver enzymes).

moderate · Named by an FDA label or NIH page · Breakdown by liver enzymes

In the source’s own words; rated moderate from that wording, not from a study of the pair.

“Therefore, an increase in the metabolism of CYP1A2 substrates (e.g., theophylline, caffeine) resulting from induction is not anticipated, although clinical studies of induction have not been performed.”

  • FDA drug label (DailyMed) · DULOXETINE CAPSULE, DELAYED RELEASE [LUPIN PHARMACEUTICALS, INC.], section 7.8
  • Checked Oct 25, 2026

How these lines are sourced

Three kinds of line

  • Studied in people (PubMed): PubMed records that were opened and read, graded A (several controlled studies, or a finding in the dosing guidance), B (at least one controlled human study) or C (case reports, observational data or mechanism only).
  • Named by an FDA label or NIH page: quoted word for word from that page. Its severity comes from the source’s wording, not from a study of the pair.
  • Predicted from how each works, not established: built from sourced facts about each substance, such as the FDA’s table of enzyme roles. Never rated major.

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