Drug & supplement interaction

Simaruba + Duloxetine

Duloxetine brand names: Cymbalta, Drizalma Sprinkle, Irenka.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 13, 2026
The bottom line No known interaction

We found no known interaction between Simaruba 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

Simaruba 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 Simaruba 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.

Worth understanding: our licensed dataset holds no drug-interaction record for Simaruba at all — not against Duloxetine, and not against any other medication we track. This verdict therefore rests on the absence of any recorded data, not on research that looked at this combination and found nothing. We cannot rule an interaction out.

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.

Simaruba safety at a glance

Simaruba overall Use caution Human safety data are limited, so use cautiously and under professional guidance.
Pregnancy Likely Unsafe When used orally during pregnancy due to apparent abortifacient effects; avoid using. There is insufficient reliable information available about the safety of s... Read the full pregnancy detail
Breastfeeding Likely Unsafe When used orally during pregnancy due to apparent abortifacient effects; avoid using. There is insufficient reliable information available about the safety of s... Read the full breastfeeding detail

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 Simaruba? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
What to actually watch for

No Interaction Found — But Data Suggests Simaruba and Duloxetine May Share a Side Effect

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.

  • Vomiting Additional detail

    Simaruba

    “Orally, ingesting large amounts of simaruba can cause vomiting (18).”

    Simaruba · Natural Medicines adverse-effect record, reported in nausea and vomiting.

    1 source cited
    1. 18. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.

    Duloxetine

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

Effects for Duloxetine come from the ADVERSE REACTIONS section of its FDA label; effects for Simaruba 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

Simaruba in Pregnancy & Breastfeeding

Pregnancy And Lactation Likely Unsafe

When used orally during pregnancy due to apparent abortifacient effects; avoid using. There is insufficient reliable information available about the safety of simaruba during lactation.

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 Simaruba 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 Simaruba 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 Simaruba 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 Simaruba as Part of a Dietary Supplement Product? Check It for Interactions

We hold 2 real supplement products containing Simaruba, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Simaruba. Even though Simaruba 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 Simaruba 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 Simaruba
Top half

#499 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 Simaruba reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Simaruba and Duloxetine records this page draws on were last updated July 10, 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 Simaruba

What is Simaruba?

  • Diarrhea and dysentery
  • Digestive upset
  • Malaria and fevers (traditional)
  • Intestinal parasites
  • General antimicrobial use

Simaruba (Simarouba amara) is a tropical tree whose bark has long been used in folk medicine for diarrhea, dysentery, and fevers. Modern, high-quality human studies are very limited, so its benefits and safety are not well proven. Talk to a pharmacist or doctor before using it, and avoid it during pregnancy and breastfeeding.

Simarouba amara · Simaroubaceae · Bark (especially root and stem bark), sometimes leaves · Dried bark for tea or decoction, tincture, capsules, liquid extract

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

Simaruba: dosing

There is no standardized, well-established dose for Simaruba. Traditional preparations were usually water-based extracts (decoctions) of the bark, but these vary widely in strength.If you choose to use a commercial product, follow the directions on the label and do not exceed the recommended amount.

From our Simaruba monograph — the full record covers uses, side effects and every documented interaction.

Read the full Simaruba 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 & Simaruba

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

0Major
0Moderate
0Minor
2,829No known interaction
2,829 No interaction
No interaction 2,829 drugs checked — show the list

We also checked Simaruba against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,829 medications checked with no known interaction — see the full Simaruba list.

See the full Simaruba interactions page
See every supplement checked against Duloxetine, ranked by severity
Evidence & sources

Simaruba References

The 2 references that drive our Simaruba 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. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
  2. Hocking GM. A dictionary of natural products. 2nd ed. Medford, OR: Plexus Publishing, 1997.

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 Simaruba and Duloxetine Together: Common Questions

Is it safe to take Simaruba with Duloxetine?
We do not list a known interaction between Simaruba 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 Simaruba and Duloxetine have any of the same side effects?
Yes — our sources link each of them separately to one 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.
Does Duloxetine interact with any supplements?
Yes. Duloxetine has documented interactions with 132 supplements in our database — Simaruba 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

Where next

Keep Exploring

Simaruba monograph Uses, safety profile, and every drug interaction in one place Duloxetine drug information The full plain-English guide to this medication Duloxetine supplement interactions Every supplement checked against Duloxetine, ranked by severity Supplement interaction checker Check any supplement or product against your medications Browse medications A–Z Every drug we’ve checked against herbs & supplements References The 2 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Duloxetine and Simaruba?

Our pharmacists answer your medication & supplement questions — free.

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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.