One of the things you have to worry about after being diagnosed with any condition, including lupus, involves side effects from drug interactions. After all, you have many options when it comes to treating lupus (the most common type is systemic lupus erythematosus), and some drugs can interact with each other or with other medications.

On MyLupusTeam, members regularly ask questions about drug interactions. One member asked about taking duloxetine (Cymbalta) and naproxen (Aleve) together. They said, “I am curious if anyone takes Cymbalta and naproxen. When I checked drug interactions, I saw it was not such 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.”

Here’s what you need to know about using these medications together. If you have questions, you should ask your health care provider about possible side effects. Together, you can figure out which medications are right for you.

When Is Duloxetine Used To Treat Lupus?

Because people with lupus are often living with chronic pain, they can become depressed. The connection between pain and depression is complex, and duloxetine can help with both. Because duloxetine is also an antidepressant, its effects may go beyond treating just one symptom. Duloxetine is unique because it not only helps with depression but also provides relief for specific types of pain, especially neuropathic pain (nerve pain) characterized by uncomfortable tingling sensations in the hands and feet.

When Is Naproxen Used To Treat Lupus?

People living with lupus often use naproxen as a pain reliever. It is one of several nonsteroidal anti-inflammatory drugs (NSAIDs), and it reduces the overall level of inflammation in your body. This can help with joint pain, inflammation, and other types of discomfort that you might be experiencing due to the way lupus affects your immune system.

Because naproxen and other NSAIDs (like ibuprofen, sold as Motrin) are available in various strengths over the counter, they are often used alongside other lupus medications. Some people only take them when they need them, while others use them every day. You and your rheumatology team can talk about how often you want to use naproxen if it is needed as part of your medication regimen.

What Interactions Can Duloxetine and Naproxen Have?

Taking duloxetine and naproxen together can raise your risk of bleeding. This includes external bleeding, which is what most people think of, but it can also lead to internal bleeding. If it is severe or left untreated, the bleeding can cause major adverse effects and can even become life-threatening in some cases.

Who Has the Most Risk of Experiencing These Interactions?

Bleeding can occur in anyone who takes the medications together, but it is more likely to happen if you have medical conditions like kidney disease or liver disease or if you are an older adult. If you have lupus that involves your kidneys (lupus nephritis), then you may have an increased risk of experiencing bleeding when you combine duloxetine and naproxen. Ask your health care professional whether you should take these medications together.

Signs of Bleeding You Need To Take Seriously

If you are taking duloxetine and naproxen together, it’s important to know what bleeding (especially internal bleeding) might look like or what you might experience if it happens. Keep your eye out for:

• Bruising, especially bruises that don’t stop getting bigger or bruises of unknown origin
• External bleeding, especially when it does not stop
• Black, tarry, or red bowel movements
• Feeling weak without a known cause
• Vomiting/coughing up fresh blood or dried blood that appears like coffee grounds
• Bad headaches
• Feeling light-headed or dizzy

If you experience any of these symptoms, see a doctor to get medical advice immediately. You may need urgent medical treatment. Talk to your doctor before you stop taking any of your medications or if you have questions about interacting medications.

Talk With Others Who Understand

MyLupusTeam is the social network for people with lupus and their loved ones. On MyLupusTeam, more than 223,000 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.