Does Cymbalta (Duloxetine) Interact With Berberine?

In our latest question and answer, our pharmacist discusses the potential interaction between berberine and Cymbalta (duloxetine).

Question

Can I take duloxetine with berberine?

Asked by CAJ On Feb 18, 2024

Answered by
Medical Content Reviewed By HelloPharmacist Staff

Published Feb 21, 2024
Last updated Apr 14, 2024

Key points

  • There is a theoretical risk that berberine might inhibit the metabolism of Cymbalta (duloxetine), which could potentially increase the risk of side effects. However, this effect has not been experimentally confirmed in human studies.

Answer

There is evidence to suggest a theoretical interaction between berberine and Cymbalta (duloxetine), based on findings that berberine may hinder the drug's metabolism, which may increase the risk of Cymbalta-related side effects.

The Impact of Berberine on Duloxetine Metabolism

Duloxetine, a commonly prescribed antidepressant, is primarily metabolized in the body by two enzymes, CYP2D6 and CYP1A2.

Early clinical research and laboratory studies have shown that berberine has the potential to inhibit the enzyme CYP2D6. This implies that when berberine is used alongside medications metabolized by CYP2D6, there's a probability of elevated levels of these drugs in the body. This can increase the chance of experiencing adverse effects from these medications.

Evidence of this was found in a recent study:

"Berberine, when administered repeatedly (300 mg, t.i.d., p.o.), was observed to decrease the activities of CYP2D6, 2C9, and CYP3A4 enzymes. Therefore, potential drug-drug interactions need to be considered when berberine is administered."

- Eur J Clin Pharmacol. 2012 Feb;68(2):213-7

So, in other words, berberine may reduce how quickly Cymbalta is metabolized via inhibition of its metabolizing enzyme (CYP2D6), increasing drug concentrations in the body.

Strategies for Managing The Cymbalta-Berberine Interaction

It's important to note that this potential interaction between berberine and duloxetine is theoretical. It's based on data suggesting that berberine might inhibit CYP2D6, hence increasing the risk of duloxetine-related side effects.

As far as I am aware, no specific study has examined the effects of combining duloxetine and berberine in humans and it's certainly possible their combination doesn't produce any clinically significant problems.

Nevertheless, it's crucial to be aware of this potential interaction. Before any changes to your medication are made, it's highly recommended that you consult your doctor to ensure proper monitoring.

Additionally, keep an eye out for any signs of duloxetine side effects which can include, but are not limited to, headaches, raised blood pressure, dizziness, or blurred vision.

Final Words

Thanks so much for reaching out to us, and please be sure to contact us again if anything else comes up!

References

  • Repeated administration of berberine inhibits cytochromes P450 in humans, PubMed
  • Human cytochrome p450 inhibition and metabolic-intermediate complex formation by goldenseal extract and its methylenedioxyphenyl components, PubMed

About the Pharmacist

Dr. Brian Staiger, PharmD

Dr. Brian has been practicing pharmacy for over 13 years and has wide-ranging experiences in many different areas of the profession. From retail, clinical, program development, and administrative responsibilities, he's your knowledgeable and go-to source for all your pharmacy and medication-related questions! Dr. Brian Staiger also has herbalist training and educational certificates in the field of medical ethnobotany. Feel free to send him an email at [email protected]! You can also connect with Dr. Brian Staiger on LinkedIn.

Recent Questions