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Duloxetine (Cymbalta)

SNRIprescriptionoral · inferred

Balanced serotonin-norepinephrine reuptake inhibitor (SNRI) for depression, GAD, diabetic neuropathy, fibromyalgia, and chronic musculoskeletal pain. Inhibits both SERT and NET at therapeutic doses unlike venlafaxine which requires higher doses for NE effect. Metabolized by CYP1A2 and CYP2D6 to inactive metabolites. Avoid abrupt discontinuation.

Projected serum levels — 60 mg, once daily

Duloxetine (Cymbalta)
Duloxetine (Cymbalta) modeled serum levels, 60 mg once daily over 15 days Population-based pharmacokinetic estimate. Steady state reached after approximately 2 days. 0 1.3 2.5 3.8 5 Day 0 Day 4 Day 8 Day 11 Day 15 Time on a regular schedule ≈ steady state · day 2
Duloxetine (Cymbalta) modeled serum levels with a loading dose of 84.1 mg, then 60 mg once daily The first dose is larger so levels approach steady state faster. 0 1.3 2.5 3.8 5 Day 0 Day 4 Day 8 Day 11 Day 15 Time on a regular schedule

Maintenance schedule: 60 mg once daily (oral).

Loading schedule: 84.1 mg on day 1, then 60 mg once daily — reaching therapeutic levels sooner.

Modeled steady state after ~2 days: peak ≈ 4.7 mg, trough ≈ 1.9 mg body load. Population-based estimate over 15 days for a 60 mg dose at a 70 kg reference body mass — the interactive app scales curves to your doses, timing, and body mass.

Key facts

Category
SNRI
Route modeled
Oral
Model confidence
inferred
Half-life
12 h
Common dose
60 mg
Suggested maximum
120 mg/day
Reference dose range
20–120 mg (single dose)
Suggested cadence
once daily
Validated against
60 mg oral — Cmax 0.047 mg/L at 6 h

Documented interactions

  • danger
    1P-LSD (1-Propionyl-LSD) + Duloxetine (Cymbalta) Serotonin risk

    1P-LSD (1-Propionyl-LSD) and Duloxetine (Cymbalta) both have serotonergic activity. Risk of serotonin syndrome (hyperthermia, rigidity, autonomic instability, altered mental status).

  • danger
    25I-NBOMe + Duloxetine (Cymbalta) Serotonin risk

    25I-NBOMe and Duloxetine (Cymbalta) both have serotonergic activity. Risk of serotonin syndrome (hyperthermia, rigidity, autonomic instability, altered mental status).

  • danger
    2C-I (2,5-Dimethoxy-4-iodophenethylamine) + Duloxetine (Cymbalta) Serotonin risk

    2C-I (2,5-Dimethoxy-4-iodophenethylamine) and Duloxetine (Cymbalta) both have serotonergic activity. Risk of serotonin syndrome (hyperthermia, rigidity, autonomic instability, altered mental status).

  • danger
    2C-B (4-Bromo-2,5-dimethoxyphenethylamine) + Duloxetine (Cymbalta) Serotonin risk

    2C-B (4-Bromo-2,5-dimethoxyphenethylamine) and Duloxetine (Cymbalta) both have serotonergic activity. Risk of serotonin syndrome (hyperthermia, rigidity, autonomic instability, altered mental status).

  • danger
    4-AcO-DMT (Psilacetin) + Duloxetine (Cymbalta) Serotonin risk

    4-AcO-DMT (Psilacetin) and Duloxetine (Cymbalta) both have serotonergic activity. Risk of serotonin syndrome (hyperthermia, rigidity, autonomic instability, altered mental status).

  • danger
    4-MMC (Mephedrone) + Duloxetine (Cymbalta) CYP inhibition

    Duloxetine (Cymbalta) reversible_inhibitor of CYP2D6 predicted to change 4-MMC (Mephedrone) AUC by ~2.27x

Serum checks 340 modeled interaction pairings for duloxetine (cymbalta) across your whole stack — absorption conflicts, enzyme inhibition, and nutrient depletion included.

Research behind this entry

  1. Duloxetine in the management of diabetic peripheral neuropathic pain: a placebo-controlled trial Goldstein DJ et al. · Diabetes Care, 2005 DOI

    Pivotal RCT establishing duloxetine 60-120 mg/day as effective for diabetic neuropathic pain, with 50% pain reduction in significantly more patients versus placebo, starting as early as week 1.

  2. Efficacy of duloxetine in fibromyalgia: a comprehensive review of clinical evidence Arnold LM et al. · Journal of Women's Health, 2010 DOI

    Comprehensive review of four large RCTs confirming duloxetine 60-120 mg/day reduces fibromyalgia pain, improves function, and received FDA approval for this indication.

  3. A clinical pharmacokinetics review of duloxetine Lantz RJ et al. · Clinical Pharmacokinetics, 2003 DOI

    PK review establishing duloxetine half-life of 12 hours, delayed-release formulation with 2-hour lag time, CYP1A2/CYP2D6 metabolism, and approximately 50% oral bioavailability.

3 published studies referenced in the app, each with a plain-language summary.