Medications: Concerned about cymbalta and tramadol Interaction

Posted by longhorn1 @longhorn1, Oct 13, 2022

I’m in a lot of pain from a failed hip replacement and I find myself depressed and crying frequently. I take low dose Tramadol , 50 mg, once a day which at least allows me to sleep. My pcp wants me to start CYMBALTA which he thinks will help both the depression and pain. I read that the combination of Tramadol and CYMBALTA is potentially dangerous but my pcp tells me not to worry. Anybody have any insights on this issue?

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Sue, Volunteer Mentor | @sueinmn | Oct 14, 2022

@longhorn1 Medications are always a balancing act. And I hate it when doctors say "not to worry" - that's my job as the patient, especially when trying to solve a long-standing problem!

Side effects, interactions, changes in bodily functions, even our personal perception of being prescribed a particular class of medication are all things to be concerned about. Also, although we like to believe our medications, are safe, having been tested & approved by the FDA, they are seldom studied long-term or in combination so your are right to be cautious.

All that said, if my doctor prescribed this combination, here's what I would do:
Read about Cymbalta (duloxetine) and the potential for effect on any other condition - diabetes, high blood pressure, heart conditions...
I would talk to my trusted pharmacist (not the pharmacy tech) when picking up the prescription about their experience and any symptoms to watch for.
I would read about serotonin syndrome:
https://www.mayoclinic.org/diseases-conditions/serotonin-syndrome/symptoms-causes/syc-20354758
I would make sure a loved one or family member knows I am starting this new med, and what potential problems to watch for.

Finally, Cymbalta does not work instantly - I took it, along with several pain management techniques, plus dosage adjustments, for over a month before I thought I noticed any change whatsoever.

Have you sought treatment from a pain management specialist? Chronic pain needs a special, multi-focal approach to solve the puzzle.
Sue

Colleen Young, Connect Director | @colleenyoung | Oct 15, 2022

@longhorn1, I see you are concerned about possible drug interactions taking Cymbalta (duloxetine) and tramadol. Pharmacists are really helpful members of your health team. I might suggest talking to your pharmacist about your concerns.

trents | @trents | Oct 16, 2022

I quit Cymbalta cold turkey because it affected me so terribly. I now have chronic pancreatitis( not from drinking). Everything Cymbalta was supposed to help actually made it worse at an exponential level. Use with caution.

emil | @emil | Oct 17, 2022

Tramadol and Cymbalta both increase serotonin levels, and therefore serotonin syndrome becomes a concern. As others have recommended, please talk to your pharmacist and your prescriber so that you will know what serotonin syndrome symptoms to look out for, or if there’s a safer alternative.

You might also note that OTC cough preparations containing dextromethorphan also increase serotonin levels. Using this cough control substance at the same time as using Cymbalta and Tramadol can be hazardous.

Again, your PCP and pharmacist are the ones to best address drug interaction concerns.