Dabigatran and Duloxetine: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Duloxetine
No brand names on recordDabigatran
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Altered anticoagulation effects, including increased risk of bleeding
Interaction Deep Dive
Concomitant administration of an anticoagulant, such as dabigatran and duloxetine may result in altered anticoagulation effects. Coadministration of the anticoagulant warfarin and SSRIs or serotonin norepinephrine reuptake inhibitors has resulted in altered anticoagulation effects, including increased bleeding. The release of serotonin by platelets is involved in hemostasis1. A population-based, case-controlled study of new coumarin users (acenocoumarol and phenprocoumon) receiving concomitant SSRIs suggested an increased risk of hospitalization due to nongastrointestinal bleeding; however, the risk of gastrointestinal bleeding was not significantly different 2 If concomitant use of an anticoagulant and duloxetine is required, closely monitor anticoagulation effects during initiation or discontinuation of duloxetine 1.
Why it happens (mechanism)
Unknown
Literature reports
1 report — tap to read
a) A population-based, case-controlled study of new coumarin users (acenocoumarol and phenprocoumon) receiving concomitant selective serotonin reuptake inhibitors (SSRIs) resulted in an increased risk of hospitalization due to nongastrointestinal bleeding. Using national pharmacy and hospitalization records, Netherlands researchers identified 1848 cases that were admitted for abnormal bleeding and compared them with 5818 control subjects also taking coumarins. Median duration of treatment in patients was 220 days (range, 1 to 4690 days). Patients on SSRIs showed greater risk for hospitalization for nongastrointestinal bleeding (adjusted odds ratio (OR) 1.7, 95% confidence interval (CI), 1.1 to 2.5), however, the rate of gastrointestinal bleeding (adjusted OR 0.8, 95% CI, 0.4 to 1.5) was not significantly different 2.
Common questions
Can I take Dabigatran and Duloxetine together?
Altered anticoagulation effects, including increased risk of bleeding Always confirm with your pharmacist or prescriber before making any change.
How serious is the Dabigatran and Duloxetine interaction?
It is rated moderate. Can be significant — usually manageable with monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Dabigatran or Duloxetine need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there anything you'd monitor while I'm on both?
References (2)
- Product Information: Cymbalta(R) oral delayed-release capsules, duloxetine HCl oral delayed-release capsules. Eli Lilly and Company, Indianapolis, IN, 2011. DailyMed
- Schalekamp T, Klungel OH, Souverein PC, et al: Increased bleeding risk with concurrent use of selective serotonin reuptake inhibitors and coumarins. Arch Intern Med 2008; 168(2):180-185. PubMed
Keep reading about Duloxetine
Keep reading about Dabigatran
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
Check another combination
Our instant two-drug interaction checker is almost here.
Still have questions about this combination?
Every question gets a real answer from a licensed pharmacist — free, and usually within a day.
Ask the pharmacist