Supplements and Duloxetine hydrochloride.
Duloxetine hydrochloride, sold under the brand names Cymbalta, Yentreve, is an antidepressant: depending on the agent, it acts on serotonin, noradrenaline, or both.
Duloxetine hydrochloride sits in the BNF "other antidepressants" group. The group includes the SNRIs (venlafaxine, duloxetine), the atypicals (mirtazapine, agomelatine, vortioxetine), and the older tetracyclics. The clinical class matters more than the BNF group, because the supplement profile differs sharply across it. SNRIs share the SSRI serotonergic concerns. Mirtazapine sits closer to the sedating, appetite-stimulating profile. Agomelatine is heavily liver-metabolised with mandatory LFT monitoring. Where these antidepressants share a supplement surface, it is St John's Wort (hard exclude across the class), 5-HTP (hard exclude on serotonergic grounds), rhodiola, and any supplement with significant sedating or activating effect depending on the agent. Discontinuation profiles differ too. Venlafaxine has the heaviest withdrawal syndrome of common antidepressants. Agomelatine probably the lightest.
Below are the 6 documented pairs we have explicitly assessed against Duloxetine hydrochloride in the Distil database: 2 severe and 4 caution. The pairs cluster around 1 mechanism: Additive serotonergic activity. Every call is cited to either a clinical reference (PMID) or the British National Formulary. Anything not on this list is either still to be assessed or beyond our database scope. The checker beneath surfaces assessments by supplement, and the missing-item form at the bottom of the page routes any uncatalogued supplement into our next curation pass.
Documented interactions
Last reviewed 21 June 2026. Each interaction below lists the evidence its assessment drew on: some rest on studies of the exact pair, others on mechanism evidence, where a citation may support one part of the reasoning rather than the exact combination. The evidence line on each entry says which.
Additive serotonergic activity
Severe Does 5-HTP interact with Duloxetine hydrochloride?
5-HTP raises serotonin levels. Combined with an SNRI like duloxetine, it can cause serotonin syndrome. Do not combine.
Evidence: Supported by human study data.
Severe Does St John's Wort interact with Duloxetine hydrochloride?
St John's Wort and duloxetine both raise serotonin levels. Combined, they can cause serotonin syndrome. Do not combine.
Evidence: Supported by human study data.
Caution Does L-Tryptophan interact with Duloxetine hydrochloride?
Tryptophan is the building block your body uses to make serotonin, so adding it to duloxetine raises serotonin from both directions. The combination can cause agitation, sweating, tremor, shivering, muscle twitching, or a racing heart. Do not stack them without your GP's involvement.
Evidence: Limited human data, from small studies or case reports.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Caution Does Rhodiola Rosea interact with Duloxetine hydrochloride?
Rhodiola has mild effects on serotonin pathways, and duloxetine raises serotonin as part of how it works. Taking them together may add to that effect. Most people tolerate the combination, but watch for restlessness, sweating, tremor, or a racing heart, and talk to your GP before stacking them, especially if your dose has recently changed.
Evidence: Limited human data, from small studies or case reports.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Caution Does SAMe interact with Duloxetine hydrochloride?
SAMe has its own antidepressant, serotonin-related activity, which may add to duloxetine's. Most people tolerate the combination, but watch for restlessness, sweating, tremor, shivering, or a racing heart, and tell your GP before stacking them, especially if your duloxetine dose has recently changed.
Evidence: Limited human data, from small studies or case reports.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Caution Does Saffron Extract interact with Duloxetine hydrochloride?
Saffron has its own antidepressant effect that may stack with duloxetine's serotonergic component. Most people tolerate the combination but discuss it with your GP, especially if your dose has recently changed.
Evidence: Limited human data, from small studies or case reports.
What this list does not say. Pairs not flagged here are not implicitly safe. They are either not yet in our database, or fall outside our inclusion scope (food-supplement interactions only; for drug-drug interactions, the BNF is authoritative). Use the checker below to surface any supplement, and submit a missing item if you take something we have not catalogued.
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How the checker decides
Every result has a source
Each pair we have assessed is cited to a published study (PMID) or the British National Formulary, so you can read the source yourself.
Four kinds of answer
Severe, caution, no known interaction, and not yet assessed. A pair we have not assessed is never shown as clear.
- Severe
- Caution
- No known interaction
- Not yet assessed
Nothing in our data is not a clearance
When nothing in our data records a problem with a pair, the result says no known interaction at typical doses, which is not a clearance: your pharmacist or GP can check the pair against your full medical history.
A full supplement review, built around you, not a generic stack.
The free checker answers one interaction question at a time. A Distil report reviews the bigger picture: your goals, diet, medications, current supplements and any blood results you provide, then shows what appears worth keeping, changing, adding or leaving out.
- what your diet already covers, so you are not adding a capsule for something food is already handling
- which evidence-graded compounds are worth considering for your goals, and which were considered but left out
- what to keep, change or stop from what you already take, plus the order to introduce anything new
- how your medications and complete supplement stack fit together, with daily timing and a clear point for reassessment
The interaction check is one section of the full report. You also get the reasoning behind each recommendation and the evidence references used.
£49 until 30 June 2027 · £79 from 1 July 2027.
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