After being diagnosed with any condition, including lupus, one of the key concerns is drug interactions. Because lupus symptoms vary widely, treatment plans are often personalized and involve multiple medications. This makes understanding drug interactions even more important.

On MyLupusTeam, members often ask about drug interactions. One member asked about taking duloxetine (Cymbalta) and naproxen (Aleve) together: “I am curious if anyone takes Cymbalta and naproxen. When I checked drug interactions, I saw it wasn’t a good combo. The doctor said it’s not a problem, the pharmacist said that they avoid prescribing both at the same time due to possible interactions … and I am left wondering what to do.”

If you have the same concerns, here’s what you need to know about these medications and their potential risks when used together. Always consult your healthcare provider to determine the safest treatment plan for you.

Understanding Lupus and Its Impact on the Body

Lupus is a chronic autoimmune disease that can affect multiple organ systems in the body, including the skin, joints, kidneys, heart, lungs, and brain. Symptoms range from mild to severe, with flare-ups and periods of remission. Here are some common symptoms of lupus:

Joint Pain and Stiffness

Lupus often causes arthritislike symptoms, making movement difficult. Over time, untreated inflammation can lead to long-term joint damage and deformities.

Fatigue

Fatigue is a hallmark symptom of lupus. It’s a constant feeling of tiredness that doesn’t improve after rest. Fatigue can be severe enough to disrupt daily life and activities, even when other symptoms are under control.

Skin Rashes

The butterfly-shaped rash across the cheeks and nose is a well-known lupus symptom. Some people also develop other rashes, which can happen anywhere on the body. In severe cases, these rashes can leave scars.

Kidney Problems

Lupus nephritis affects kidney function, potentially leading to swelling in the legs, high blood pressure, and, in severe cases, kidney failure. Effective lupus management is key to protecting kidney health.

Heart and Lung Involvement

Inflammation of the lining around the heart and lungs can cause chest pain, shortness of breath, and an increased risk of heart disease. These are among the more serious complications of lupus.

Brain Issues

Some people with lupus experience memory problems, difficulty concentrating, and brain fog. These issues can affect work, school, and daily responsibilities.

Understanding the full range of lupus symptoms highlights the importance of effective medication management and avoiding harmful drug interactions.

When Is Duloxetine Used To Treat Lupus?

People with lupus often live with chronic pain, which can lead to depression. Duloxetine, which is an antidepressant, can help with both pain and depression, making it a useful treatment option. Here’s how it helps:

• Relieves nerve pain caused by lupus
• Improves mood, addressing depression and anxiety common in chronic illness
• Promotes better sleep
• Reduces fatigue by managing pain and depression
• Serves as an alternative to opioids

When Is Naproxen Used To Treat Lupus?

Naproxen is commonly used to relieve pain in people with lupus. It’s a type of nonsteroidal anti-inflammatory drug (NSAIDs) that reduces inflammation in the body. Here’s how it can help with lupus:

• Eases joint pain and stiffness
• Improves mobility by reducing inflammation
• Provides an accessible over-the-counter pain relief option
• Offers an alternative to steroids

Naproxen and other NSAIDs (like ibuprofen, sold as Motrin or Advil) are available in various strengths over the counter. Some people take them as needed, while others use them daily. Talk to your rheumatology team about how often you should use naproxen as part of your treatment plan.

Risks of Combining Duloxetine and Naproxen

Taking duloxetine and naproxen together can increase your risk of bleeding and stomach problems.

Naproxen can irritate the stomach lining, leading to ulcers or bleeding. Duloxetine affects blood clotting, which can make bleeding more severe. Together, they raise the risk of dangerous bleeding events.

Who Is at Higher Risk?

• Older adults
• People with kidney or liver disease
• Those with lupus nephritis
• People taking blood thinners or corticosteroids

Ask your healthcare provider if it’s safe for you to take these medications together.

Signs of Bleeding You Need To Take Seriously

If you’re taking duloxetine and naproxen together, watch for signs of bleeding (especially internal bleeding). These include:

• Bruising, especially bruises that grow or have no clear cause
• External bleeding that doesn’t stop
• Black, tarry, or red stools
• Weakness without a known cause
• Vomiting/coughing up fresh blood or dried blood that looks like coffee grounds
• Severe headaches
• Lightheadedness or dizziness

If you experience any of these symptoms, seek medical advice immediately. You may need urgent treatment. Do not stop taking your medications without talking to your doctor first.

Alternative Treatment Options

If you’re concerned about interactions between duloxetine and naproxen, consider other pain management strategies.

Other Medications

• Acetaminophen (Tylenol) — Effective for pain relief without increasing bleeding risk
• Gabapentin (Neurontin) or pregabalin (Lyrica) — Used for nerve pain as alternatives to duloxetine
• Diclofenac topical gel (Voltaren) — Gels or creams applied to the skin may provide pain relief with fewer side effects throughout the body.

Natural and Nonmedication Approaches

• Physical therapy — This approach helps improve joint mobility and reduce stiffness.
• Anti-inflammatory diet — Foods rich in omega-3s, like fish and nuts, may lower inflammation and improve mental well-being.
• Acupuncture — Some experts suggest this practice can help relieve chronic pain in autoimmune conditions.

Understanding Your Medications

Understanding the risks and benefits of lupus medications like duloxetine and naproxen is key to safe treatment. Always consult your doctor before changing your medication regimen, especially when combining drugs that may interact. Being informed helps you take an active role in managing your lupus effectively.

Talk With Others Who Understand

MyLupusTeam is the social network for people with lupus and their loved ones. On MyLupusTeam, more than 235,000 members come together to ask questions, give advice, and share their stories with others who understand life with lupus.

Are you worried about using duloxetine and naproxen together to treat lupus? Share your experience in the comments below, or start a conversation by posting on your Activities page.