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Do Cymbalta and the pain reliever Nucynta interact?

By June 22, 2010 - 3:08pm
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I take both Cymbalta 90 mg and Nucynta 50mg for the pain of fibromyalgia. Since both affect norepineprine levels, does that equal too much norepinephrine?? I am 42, also suffering from depression and anxiety.

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EmpowHER Guest

I take 90 mg Cymbalta and 100 mg Nucynta ER. The concern with taking these two medicines concurrently is the increased risk of serotonin syndrome, or seizures independent of serotonin syndrome. The onset of serotonin syndrome is rapid, usually within 24 hours. Although the symptoms can range from mild to severe, you would likely know rather quickly if you were affected.

Be sure not to take other serotonergic medicines such as antidepressants, triptans (for migraine headaches) or tramadol. The list of serotonergic compounds is rather long and includes some OTC natural supplements and illegal street drugs. You may want to review all of the medicines, supplements, and other drugs you take (even occasionally) with a pharmacist.

January 11, 2019 - 9:30pm
EmpowHER Guest

How do you take Cymbalta 90mg when the highest dose is 60mg?

July 14, 2018 - 10:32am

Thank you for that useful information and the warnings. I know that tapentadol is a strong medication, as is the methadone I take with it, so I absolutely do not drink alcohol or any longer drive.

June 22, 2010 - 9:02pm
Expert HERWriter Guide Blogger

Hi Rebecca - That would be a good question to ask your pharmacist or doctor, but I can provide you some general information.

Cymbalta, as you know, is an antidepressant. It falls into a group of drugs called selective serotonin and norepinephrine reuptake inhibitors (SSNRIs). There is another type of drug used to treat depression that falls into a category known as MAO Inhibitors. MAO stands for Monoamine Oxidase, which is an enzyme responsible for metabolizing neurotransmitors such as seratonin and norepinephrine.

The prescribing information for Nucynta, which is a brand name for
tapentadol, shows that it is a narcotic pain reliever in the same class as morphine. The prescribing information is clear that this drug should not be combined with an MAO inhibitor, but there is no such warning for SSNRI's.

Please also note that Nucynta/tapentadol is a strong medication. Do not drink alcohol while you are taking this medication. Dangerous side effects or death can occur when alcohol is combined with tapentadol. Check your food and medicine labels to be sure these products do not contain alcohol. Nucynta can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

Read more: http://www.drugs.com/nucynta.html
and http://www.drugs.com/cymbalta.html

June 22, 2010 - 6:26pm
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