From the Guidelines
It is strongly recommended to avoid drinking alcohol while taking duloxetine due to the increased risk of adverse effects and potential worsening of the underlying condition. Combining alcohol with duloxetine can increase the risk of side effects such as drowsiness, dizziness, and impaired coordination, as both substances can enhance the effects of each other 1. Alcohol can also worsen the potential liver effects of duloxetine, as both substances are processed by the liver, and duloxetine has been associated with hepatic failure presenting as abdominal pain, hepatomegaly, and elevation of transaminase levels 1.
Additionally, since duloxetine is often prescribed for depression or anxiety, alcohol (which is a depressant) may counteract the medication's therapeutic benefits and potentially worsen your underlying condition. The general recommendation for alcohol consumption is to drink less than 100 g/week of pure alcohol, but in the context of taking duloxetine, it is preferable to avoid alcohol consumption altogether to achieve the best health outcomes 2.
If you feel you must drink while on duloxetine, it's essential to discuss this with your healthcare provider first. They might recommend limiting alcohol consumption significantly or avoiding it completely depending on your specific health situation, medication dosage, and other factors. Some patients find that even small amounts of alcohol produce intensified effects when combined with duloxetine, so proceed with caution and be aware of how your body responds if your doctor approves limited consumption.
Key considerations when taking duloxetine include:
- Avoiding alcohol consumption to minimize the risk of adverse effects
- Being aware of the potential for increased liver effects when combining alcohol with duloxetine
- Monitoring for signs of hypersensitivity or severe skin reactions
- Discussing any concerns or questions with your healthcare provider to ensure safe and effective treatment.
From the FDA Drug Label
Instruct patients to talk to their healthcare provider about their alcohol consumption. Use of duloxetine delayed-release capsules with heavy alcohol intake may be associated with severe liver injury [see WARNINGS AND PRECAUTIONS (5. 2)] . Alcohol — Although duloxetine delayed-release capsules does not increase the impairment of mental and motor skills caused by alcohol, use of duloxetine delayed-release capsules concomitantly with heavy alcohol intake may be associated with severe liver injury [see Warnings and Precautions (5.2) and Drug Interactions (7. 15)]. Other Clinically Important Drug Interactions Alcohol — Use of duloxetine delayed-release capsules concomitantly with heavy alcohol intake may be associated with severe liver injury. For this reason, duloxetine delayed-release capsules should not be prescribed for patients with substantial alcohol use [see WARNINGS AND PRECAUTIONS (5.2) and DRUG INTERACTIONS (7. 15)] . Because it is possible that duloxetine delayed-release capsules and alcohol may interact to cause liver injury or that duloxetine delayed-release capsules may aggravate pre-existing liver disease, duloxetine delayed-release capsules should not be prescribed to patients with substantial alcohol use or evidence of chronic liver disease.
It is not recommended to drink heavily while taking duloxetine. Patients should talk to their healthcare provider about their alcohol consumption, as heavy alcohol intake may be associated with severe liver injury 3, 4, 5.
From the Research
Drinking While Taking Duloxetine
- It is generally recommended to avoid excessive alcohol consumption while taking duloxetine, as it may increase the risk of liver damage 6, 7.
- Studies have shown that patients with substantial alcohol use and/or preexisting liver disease are at a higher risk of developing idiosyncratic hepatic toxicity while taking duloxetine 6, 8.
- However, duloxetine-induced liver injury can also occur in patients without preexisting liver disease or chronic alcohol use 8.
- The hepatic safety profile of duloxetine is similar to that of other therapeutic agents, and systematic monitoring of liver aminotransferases is not typically warranted with routine duloxetine use 6, 9.
- Patients taking duloxetine should be educated on the risks and benefits of the medication, and physicians should follow prescribing guidelines to minimize the risk of liver damage 6, 7.
Key Findings
- Elevations of alanine aminotransferase to three times the upper limit of normal occur in 0.9-1.7% of duloxetine-treated patients versus 0.0-0.3% of placebo-treated patients 9.
- Hepatocellular, cholestatic, and mixed hepatocellular-cholestatic forms of hepatic injury have been described in patients taking duloxetine 7, 9.
- Duloxetine hepatotoxicity can develop within 2 months of drug intake and lead to clinically significant liver injury 10.