Drug & supplement interaction

Pau D'arco + Duloxetine

Duloxetine brand names: Cymbalta, Drizalma Sprinkle, Irenka.

No Known Interaction
The bottom line No known interaction

We found no known interaction between Pau D'arco and Duloxetine in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

Pau D'arco and Duloxetine

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Duloxetine and Pau D'arco in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Pau D'arco safety at a glance

Pau D'arco overall Use caution May cause side effects at higher doses and human safety data is limited.
Pregnancy Possibly Unsafe When used orally in typical doses. Animal studies have found that lapachol, a constituent of pau d'arco, has teratogenic and abortifacient effects; avoid using.... Read the full pregnancy detail
Breastfeeding Avoid Not enough safety information is available, so avoid while breastfeeding.

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center) — the full detail is in the Special populations card below. Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Duloxetine and Pau D'arco? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Duloxetine

Interactions in our licensed database are recorded against drug classes, not just single drug names. Duloxetine is filed under 8 classifications — including antidepressant drugs, cytochrome p450 2d6 (cyp2d6) inhibitors, serotonergic drugs. Pau D'arco has documented interactions with 1 drug class — the most serious being anticoagulant/antiplatelet drugs (moderate) — and none of Duloxetine’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

Pau D'arco Does Interact With Other Medications

Pau D'arco has 122 moderate known drug interactions in our database — Duloxetine isn’t one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Pau D'arco

Covers the 2,830 medications we’ve checked against Pau D'arco. Pick one to open its full report.

What to actually watch for

No Interaction Found — But Data Suggests Pau D'arco and Duloxetine May Share Several of the Same Side Effects

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do. One of them is worth acting on rather than waiting out — marked below.

  • Bleeding or bruising Worth acting on Additional detail

    Pau D'arco

    “Orally, the lapachol constituent of pau d'arco, taken in doses above 1.5 grams daily, may cause anemia and increased risk of bleeding.”

    Pau D'arco · Natural Medicines adverse-effect record, reported in anemia.

    1 source cited
    1. 91939. Block JB, Serpick AA, Miller W, Wiernik PH. Early clinical studies with lapachol (NSC-11905). Cancer Chemother Rep 2. 1974;4(4):27-8.

    Duloxetine

    Listed in the ADVERSE REACTIONS section of the FDA label for Duloxetine. Read the label on DailyMed ›

  • Dizziness Additional detail

    Pau D'arco

    “Orally, the lapachol constituent of pau d'arco, taken in doses above 1.5 grams daily, may cause dizziness.”

    Pau D'arco · Natural Medicines adverse-effect record, reported in vertigo.

    1 source cited
    1. 91939. Block JB, Serpick AA, Miller W, Wiernik PH. Early clinical studies with lapachol (NSC-11905). Cancer Chemother Rep 2. 1974;4(4):27-8.

    Duloxetine

    Listed in the ADVERSE REACTIONS section of the FDA label for Duloxetine. Read the label on DailyMed ›

  • Diarrhea / Vomiting / Nausea Additional detail

    Pau D'arco

    “Orally, the lapachol constituent of pau d'arco, taken in doses above 1.5 grams daily, may cause severe nausea, vomiting, and diarrhea.”

    Pau D'arco · Natural Medicines adverse-effect record, reported in diarrhea.

    1 source cited
    1. 91939. Block JB, Serpick AA, Miller W, Wiernik PH. Early clinical studies with lapachol (NSC-11905). Cancer Chemother Rep 2. 1974;4(4):27-8.

    Duloxetine

    Listed in the ADVERSE REACTIONS section of the FDA label for Duloxetine. Read the label on DailyMed ›

Reported for Pau D'arco but not commonly for Duloxetine: a skin rash, wheezing and anemia.

Effects for Duloxetine come from the ADVERSE REACTIONS section of its FDA label; effects for Pau D'arco come from the Natural Medicines adverse-effect record, quoted above. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

Special populations

Pau D'arco in Pregnancy & Breastfeeding

Pregnancy Possibly Unsafe

When used orally in typical doses. Animal studies have found that lapachol, a constituent of pau d'arco, has teratogenic and abortifacient effects; avoid using. There is insufficient reliable information available about the safety of pau d'arco when used topically in pregnancy; avoid using.

DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.© 2026 Therapeutic Research Center

From our Q&A

Questions About Pau D'arco or Duloxetine

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Pau D'arco or Duloxetine, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Duloxetine

This page covers Pau D'arco only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Duloxetine page lists 132 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Beer (major), Lithium (major), Siberian Cocklebur (major) and Wine (major).

By severity: 5 major · 107 moderate · 20 minor.

Open the Duloxetine interaction page

One more smart check

Taking Pau D'arco as Part of a Dietary Supplement Product? Check It for Interactions

We hold 707 real supplement products containing Pau D'arco, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Pau D'arco. Even though Pau D'arco itself has no known interaction with Duloxetine, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Pau D'arco and Duloxetine Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Pau D'arco
Top 25%

#300 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Duloxetine
Top 5%

#47 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Pau D'arco reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Pau D'arco and Duloxetine records this page draws on were last updated July 11, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
Supplement

About Pau D'arco

What is Pau D'arco?

Pau D'arco
  • Infections (bacterial, fungal, yeast)
  • Inflammation
  • Immune support
  • Digestive complaints
  • Skin conditions

Pau d'arco is a South American tree bark traditionally used for infections and inflammation, and it contains compounds like lapachol that show activity in lab studies. However, strong human evidence is lacking, and safety concerns exist at higher doses, so it should be used cautiously and discussed with a pharmacist or doctor first.

Handroanthus impetiginosus · Bignoniaceae · Inner bark · Tea (decoction), capsules, tablets, liquid extracts, tinctures

An interaction check asks whether these two react with each other — it does not ask whether Pau D'arco is a good idea for someone in your situation. Here is what our Pau D'arco record says about it on its own.

Pau D'arco: dosing

There is no well-established, standardized dose for pau d'arco. Products vary widely in strength and form, and the amount of active compounds can differ from one product to another.Because larger doses raise the risk of toxic effects, it is best to use the smallest reasonable amount, follow the directions on the product label, and not exceed them.

From our Pau D'arco monograph — the full record covers uses, side effects and every documented interaction.

Read the full Pau D'arco monograph & all interactions
Medication

About Duloxetine

What Is Duloxetine Used For?

Brand names: Cymbalta, Drizalma Sprinkle, Irenka

Duloxetine delayed-release capsules treat major depressive disorder (MDD) and generalized anxiety disorder (GAD) in adults. They also manage diabetic peripheral neuropathic pain (nerve pain from diabetes), fibromyalgia, and chronic musculoskeletal pain (such as chronic low back pain and pain from osteoarthritis) in adults.

GAD is also approved in pediatric patients 7 years and older for Cymbalta, Drizalma Sprinkle, and certain duloxetine delayed-release capsule products. Fibromyalgia is approved in patients 13 years and older for Cymbalta and some duloxetine delayed-release capsule products. Age-specific approvals vary by product — follow your prescriber's guidance on which product is right for your age group.

See full Duloxetine drug information
Keep checking

Other Drugs & Pau D'arco

Browse every other medication we’ve checked against Pau D'arco — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
122Moderate
0Minor
2,707No known interaction
Moderate

122 interactions

Showing 60 of 122 moderate interactions — see all 122 on the Pau D'arco page.

No interaction 2,707 drugs checked — show the list
Evidence & sources

Pau D'arco References

The 6 references that drive our Pau D'arco monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Gómez Castellanos JR, Prieto JM, Heinrich M. Red Lapacho (Tabebuia impetiginosa)--a global ethnopharmacological commodity? J Ethnopharmacol 2009;121:1-13. PubMed
  2. Guerra, Mde O., Mazoni, A. S., Brandao, M. A., and Peters, V. M. Toxicology of Lapachol in rats: embryolethality. Braz.J Biol. 2001;61(1):171-174. PubMed
  3. Felicio, A. C., Chang, C. V., Brandao, M. A., Peters, V. M., and Guerra, Mde O. Fetal growth in rats treated with lapachol. Contraception 2002;66(4):289-293. PubMed
  4. Son, D. J., Lim, Y., Park, Y. H., Chang, S. K., Yun, Y. P., Hong, J. T., Takeoka, G. R., Lee, K. G., Lee, S. E., Kim, M. R., Kim, J. H., and Park, B. S. Inhibitory effects of Tabebuia impetiginosa inner bark extract on platelet aggregation and vascular s
  5. Block JB, Serpick AA, Miller W, Wiernik PH. Early clinical studies with lapachol (NSC-11905). Cancer Chemother Rep 2. 1974;4(4):27-8.
  6. Algranti E, Mendonça EM, Ali SA, Kokron CM, Raile V. Occupational asthma caused by Ipe (Tabebuia spp) dust. J Investig Allergol Clin Immunol 2005;15(1):81-3.

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Pau D'arco and Duloxetine Together: Common Questions

Is it safe to take Pau D'arco with Duloxetine?
We do not list a known interaction between Pau D'arco and Duloxetine. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do Pau D'arco and Duloxetine have any of the same side effects?
Yes — our sources link each of them separately to 5 of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
How was the Pau D'arco and Duloxetine combination checked?
Interactions in our licensed database are recorded against drug classes. Duloxetine is filed under 8 classifications, and Pau D'arco has documented interactions with 1 drug class — none of Duloxetine's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.
Does Pau D'arco interact with any other medications?
Yes. Pau D'arco has 122 documented drug interactions in our database — Duloxetine is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.
Does Duloxetine interact with any supplements?
Yes. Duloxetine has documented interactions with 132 supplements in our database — Pau D'arco is not one of them. The Duloxetine interaction page linked on this page lists every one, ranked by severity.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Duloxetine and Pau D'arco?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.