From the FDA Drug Label
Administer duloxetine delayed-release capsules orally (with or without meals) and swallow whole. Duloxetine delayed-release capsules may be taken with or without food.
The best time to take Cymbalta is orally (with or without meals). It can be taken with or without food. Do not chew or crush, and do not open the delayed-release capsule and sprinkle its contents on food or mix with liquids. It is recommended to avoid heavy alcohol use while taking duloxetine delayed-release capsules. Some medicines may interact with duloxetine delayed-release capsules, including:
- triptans
- medicines used to treat mood, anxiety, psychotic or thought disorders
- tramadol and fentanyl
- amphetamines
- cimetidine
- the antibiotics ciprofloxacin, enoxacin
- medicine to treat irregular heart rate
- theophylline
- the blood thinner warfarin (Coumadin, Jantoven)
- non-steroidal anti-inflammatory drug (NSAID)
- over-the-counter supplements such as tryptophan or St. John’s Wort
- thioridazine (Mellaril) 1 1
From the Research
Cymbalta (duloxetine) can be taken at any time of day, with or without food, as its pharmacokinetics are not significantly affected by food intake 2. When deciding the best time to take Cymbalta, consider your individual side effect profile. If you experience drowsiness, taking it at bedtime may be preferable; if it causes insomnia, morning dosing is better. Some key points to consider when taking Cymbalta include:
- Taking it with food may help reduce stomach upset, although this is not necessary 2.
- Avoiding alcohol is recommended as it can increase the risk of liver damage and enhance side effects like drowsiness.
- Cymbalta should not be taken with MAOIs (monoamine oxidase inhibitors) as this can cause a dangerous serotonin syndrome, and you should wait at least 14 days after stopping an MAOI before starting Cymbalta.
- Be cautious with NSAIDs like ibuprofen or aspirin as they may increase bleeding risk when combined with Cymbalta.
- Certain supplements like St. John's Wort should be avoided due to potential serotonin syndrome risk. Always take the medication as prescribed, swallow the capsule whole without crushing or chewing it, and consult your healthcare provider before adding any new medications or supplements to your regimen. It's also important to note that Cymbalta is highly protein bound and is widely distributed throughout tissues, and its mean elimination half-life is approximately 12 hours 2. Additionally, Cymbalta is a substrate for CYP1A2 and CYP2D6 and a moderate inhibitor of CYP2D6, so concomitant use with potent CYP1A2 inhibitors should be avoided and caution should be used in patients receiving drugs that are extensively metabolized by CYP2D6, particularly those with a narrow therapeutic index 2.