Drug interaction is defined as the changes in a drug’s effects due to recent or concurrent use of another drug or drugs (drug-drug interactions), ingestion of food (drug-nutrient interactions), or ingestion of dietary supplements (dietary supplement-drug interactions).
Drug-drug interactions result when two or more drugs react with each other. Such drugs can be from a combination of prescription drugs and/or over-the-counter (OTC) medications. Drugs with a narrow therapeutic range (little difference between therapeutic and lethal dose) are more likely to face incidents of serious drug interactions.
What is Duloxetine?
Duloxetine is used to treat depression in adults and generalized anxiety disorder (GAD; excessive worry and tension that disrupts daily life and lasts for 6 months or longer) in adults and children 7 years of age and older. Duloxetine is also used to treat pain and tingling caused by diabetic neuropathy (damage to nerves that can develop in people who have diabetes) in adults and fibromyalgia (a long-lasting condition that may cause pain, muscle stiffness and tenderness, tiredness, and difficulty falling asleep or staying asleep) in adults and children 13 years of age and older. It is also used to treat ongoing bone or muscle pain such as lower back pain or osteoarthritis (joint pain or stiffness that may worsen over time) in adults. Duloxetine is in a class of medications called selective serotonin and norepinephrine reuptake inhibitors (SNRIs). It works by increasing the amounts of serotonin and norepinephrine, natural substances in the brain that help maintain mental balance and stop the movement of pain signals in the brain.
Duloxetine may help control your symptoms but will not cure your condition. It may take 1 to 4 weeks or longer before you feel the full benefit of duloxetine. Continue to take duloxetine even if you feel well. Do not stop taking duloxetine without talking to your doctor. Your doctor will probably decrease your dose gradually. If you suddenly stop taking duloxetine, you may experience withdrawal symptoms such as nausea; vomiting; diarrhea; anxiety; dizziness; tiredness; headache; pain, burning, numbness, or tingling in the hands or feet; irritability; difficulty falling asleep or staying asleep; sweating; and nightmares. Tell your doctor if you experience any of these symptoms when your dose of duloxetine is decreased.
What is Prozac?
Prozac is a brand of fluoxetine, a medication used to treat depression, obsessive-compulsive disorder (bothersome thoughts that won’t go away and the need to perform certain actions over and over), some eating disorders, and panic attacks (sudden, unexpected attacks of extreme fear and worry about these attacks). Prozac is also used to relieve the symptoms of premenstrual dysphoric disorder, including mood swings, irritability, bloating, and breast tenderness. It is also used along with olanzapine (Zyprexa) to treat depression that did not respond to other medications and episodes of depression in people with bipolar I disorder (manic-depressive disorder; a disease that causes episodes of depression, episodes of mania, and other abnormal moods). Fluoxetine is in a class of medications called selective serotonin reuptake inhibitors (SSRIs). It works by increasing the amount of serotonin, a natural substance in the brain that helps maintain mental balance.
Can you take duloxetine and Prozac together?
No, duloxetine and Prozac should never be used together because it increases the risk of a rare but serious condition known as serotonin syndrome, which may occur with the use of certain serotonergic medications or drugs. The degree of symptoms can range from mild to severe, including a potentiality of death. Symptoms in mild cases include high blood pressure and a fast heart rate; usually without a fever.
Can I switch from Prozac to duloxetine?
Do not switch from Prozac to duloxetine without first discussing it with your doctor or healthcare provider. Generally, your doctor may suggest tapering the medication over 6–8 weeks to reduce the risk or severity of symptoms. Due to the long half-life of Prozac, some people may not need to taper off and can simply stop taking it. However, a person should only do this under the guidance of a doctor.
Stopping Prozac and switching to duloxetine
• Before day 1: reduce the dosage of Prozac to about 20 mg per week.
• Day 1: when a dosage of 20 mg/day is reached, stop Prozac.
Start duloxetine
No wash-out period is needed.
• Day 2: start duloxetine the next day in a low dosage of 30 mg/day.
• Day 29: increase dosage of duloxetine to normal, 60 mg/day.
