A Risky Combination: The Dangers of Mixing Cymbalta and Metaxalone

Even the most effective and safest prescription medications can lead to a range of side effects that need to be closely monitored and that’s especially the case when it comes to how a medication might interact with other drugs or even over-the-counter herbal supplements. This includes frequently prescribed medications, such as Cymbalta and metaxalone, which can interact in unexpected ways if taken together. Before we explore these medications and how they can lead to problems if taken together, as well as look at the drugs individually, including the risks of withdrawal from Cymbalta, let’s look at what these medications are used for and why they’re prescribed.

Cymbalta is the brand name for a drug called duloxetine, which is most often prescribed as an antidepressant but also can be taken to address nerve pain, such as diabetic neuropathy, fibromyalgia, and pain in the muscles or bones. It is classified as a selective serotonin and norepinephrine reuptake inhibitor, or SNRI, that increases serotonin and norepinephrine neurotransmitters in the brain. Metaxalone, meanwhile, formerly was sold under the brand name Skelaxin and is prescribed as a muscle relaxer to address short-term muscle or bone pain or spasms in addition to rest, exercise, and physical therapy. While both medications are considered relatively safe, they can interact in powerful and potentially dangerous ways, which is why it’s important to understand how these two drugs work together and affect each other.

Can I Take Metaxalone with Cymbalta?

The neurotransmitter serotonin plays an important role in our moods, sleep, and digestion, and that’s why many types of antidepressant or anti-anxiety medications work by helping us boost the amount of serotonin in our brains. However, it’s dangerous and even potentially life-threatening if too much serotonin builds up in our bodies and that’s a possible risk of the combination of Cymbalta and metaxalone.

Metaxalone can interact with many types of antidepressants, including selective serotonin reuptake inhibitors, or SSRIs, such as Zoloft, as well as tricyclic antidepressants. It can also cause problems if taken with serotonin and norepinephrine reuptake inhibitors, including Cymbalta. This interaction can lead to a condition known as serotonin syndrome, which is rare but can be dangerous as the body has too much serotonin. This condition can cause mild symptoms like tremors or sweating but can also lead to more severe and even potentially life-threatening problems like hallucinations or seizures. That’s why it’s important to follow your doctor’s advice and ensure your prescriber knows about any other medication you’re taking, especially if you’re being prescribed Cymbalta and metaxalone.

What Drugs Interact Badly with Cymbalta?

In addition to the potentially serious serotonin syndrome that can be caused by Cymbalta and metaxalone, other medications can interact poorly with Cymbalta or duloxetine. According to Healthline, using Cymbalta with monoamine oxidase inhibitors (MAOIs), another type of antidepressant, can also cause serotonin syndrome. There are also some reports of liver damage or even liver failure if someone drinks excessively while taking Cymbalta. Cymbalta can even cause side effects if taken with common over-the-counter pain relievers like aspirin or ibuprofen and interact poorly with a whole host of prescription medications, including tramadol, trazodone, Ambien, and blood thinners, in addition to many kinds of mental health medications, including antidepressants and anti-anxiety medications.

Even over-the-counter herbs and supplements can interact with Cymbalta, especially the supplement St. John’s wort. If taken together, users are at a higher risk of serotonin syndrome, which is why many people who are prescribed this medication will be instructed to stop taking St. John’s wort.

Is Metaxalone a Strong Muscle Relaxer?

While metaxalone is considered to be a relatively moderate muscle relaxer that is often better tolerated than other drugs in its category, users can experience side effects from this medication. According to GoodRx, side effects can include:

• Fatigue, drowsiness, or dizziness
• Feeling irritated
• Headaches
• Upset stomach (vomiting or nausea)

However, metaxalone can be addictive if abused or taken too long. It can also rarely lead to more serious and even potentially life-threatening side effects, such as a decrease in certain blood cells. In addition, if it is taken with other substances, it can cause major problems. If combined with alcohol or other things that affect breathing, it can dangerously slow breathing in a user, for example. In addition, it can lead to a buildup of serotonin known as serotonin syndrome in certain interactions with other drugs.

What Drugs Should Not Be Taken with Metaxalone?

While metaxalone is considered to be one of the better-tolerated muscle relaxers available, it can interact poorly with many other drugs and not just the dangerous combination of Cymbalta and metaxalone. Unfortunately, it can raise the risk of serotonin syndrome if taken with other drugs that raise the level of serotonin in the brain, including common antidepressants like SSRIs and SNRIs as well as other substances like migraine medications, the herbal supplement St. John’s wort, and even ecstasy (MDMA).

In addition, metaxalone can interact and cause problems if taken with certain diet pills, attention-deficit/hyperactivity disorder (ADHD) medications, some opioid pain relievers, Parkinson’s disease medications, and supplements. It can cause serious interactions with some drugs like nasal decongestants and stimulants and cause severe high blood pressure, and it can also cause a fatal drug interaction if taken with MAO inhibitors.

Get Help with Avoiding Drug Interactions Like Cymbalta and Metaxalone

While the drugs are considered relatively safe on their own, prescription medications like Cymbalta and metaxalone can cause uncomfortable or even life-threatening problems if combined. That’s why it’s so important to talk with your doctor before beginning any new medication about any other drug you’re taking, including over-the-counter medicine or herbal supplements, to know about the potential risks for interaction and learn how to reduce your chances of problems. Drug interactions can be a major problem for people who are abusing medications, including older adults abusing prescription drugs. If you or a loved one is taking prescription medications recreationally or taking more than the prescribed dose, as well as combining drugs with other substances, the risks of problems substantially increase.

However, prescription drug addiction doesn’t need to go untreated, and help is available to show people like you how to overcome drug abuse and achieve a better, healthier future free from the risks of potentially serious or even life-threatening drug interactions. In California, Resurgence Behavioral Health’s team of experts knows what it takes to address the physical and mental components of prescription drug addiction and break the shackles of addiction once and for all. Learn more about how we can help by calling us at 855-458-0050 today.

External Sources

• GoodRx – 6 Metaxalone Side Effects and How to Manage Them
• Healthline – Cymbalta Interactions: Alcohol, Medications, and Others
• WebMD – Metaxalone – Uses, Side Effects, and More

David Rofofsky
After growing up in New York, David chose to get help with substance abuse in California because of the state's reputation for top-tier treatment. There, he found the treatment he needed to achieve more than nine years of recovery. He's been in the drug and alcohol addiction rehab industry for eight years and now serves as the Director of Admissions for Resurgence Behavioral Health. David remains passionate about the field because he understands how hard it is to pick up the phone and ask for help. However, once the call is made, someone's life can be saved.

Research | Editorial