Taking Cymbalta With Vyvanse

In our latest question and answer, the pharmacist discusses the potential interaction between Cymbalta and Vyvanse.

Question

I am currently on Plaquenil and Cymbalta. I was considering asking my doctor to put me on Vyvanse. Is this safe?

Asked by Jack On Apr 19, 2018

Answered by
Medical Content Reviewed By PharmacistAnswers Staff

On Apr 19, 2018

There is not a known interaction between Plaquenil (hydroxychloroquine) and Vyvanse (lisdexamfetamine), but there is an interaction between Cymbalta (duloxetine) with Vyvanse. Caution is advised when using both of those medications together.


Vyvanse

Vyvanse is a CNS stimulant drug used to treat Attention Deficit Hyperactivity Disorder (ADHD) and binge eating disorder. Vyvanse is a prodrug of amphetamine considered a schedule II medication due to a risk of drug abuse and dependence. Vyvanse causes an increases levels of dopamine and norepinephrine in the brain. This will lead to a release of serotonin in the brain. 


Cymbalta

Cymbalta is commonly used to treat generalized anxiety disorder, major depressive disorder, fibromyalgia, and musculoskeletal pain. This drug is classified as a serotonin and norepinephrine re-uptake inhibitor (SNRI).


Taking Cymbalta With Vyvanse

As you can see, both of these medications will increase the amount of serotonin, which can potentially increase the risk of serotonin syndrome.


Symptoms of serotonin syndrome include:

  • Mental status changes (Including hallucinations, agitation, delirium, and coma)
  • Tachycardia
  • Labile blood pressure
  • Dizziness
  • Sweating
  • Flushing
  • Hyperthermia
  • Neuromuscular symptoms (e.g., tremor, rigidity, myoclonus, hyperreflexia, incoordination)
  • Seizures
  • Gastrointestinal upset


In addition, as both Vyvanse and Cymbalta increase norepinephrine, there is the potential that blood pressure can be increased.


There may be situations where both medications are the best therapy options for you, but be sure to talk to your doctor about your concerns.


Summary

  • It is recommended to avoid taking Cymbalta with Vyvanse because of the additive serotonin effects.
  • In addition, both Cymbalta and Vyvanse can increase blood pressure.


Talk to your doctor to determine what is best for you and the conditions that you are trying to treat. 

About the Pharmacist

Dr. Jennifer Oliver Pharm.D

Dr. Jennifer Oliver is a licensed immunizing pharmacist in Florida. She graduated from the University of South Florida with a Doctor of Pharmacy Degree in 2015. Other than her passion for pharmacy, she loves traveling and meeting new people.

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