Coumadin and Cymbalta combo could hav...

Coumadin and Cymbalta combo could have been tragic

There are 24 comments on the Hampton Roads Daily Press story from Apr 20, 2007, titled Coumadin and Cymbalta combo could have been tragic. In it, Hampton Roads Daily Press reports that:

Q: My mother was admitted to the hospital a few weeks ago for dehydration, acute bronchitis and pneumonia. via Hampton Roads Daily Press

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Thomas Chapman

New Britain, CT

#1 Apr 23, 2007
My father nearly died from internal bleeding 4/13/07 after his doctor prescribed Cymbalta in addition to the coumadin he had been on for several years. My father had been admitted to a nursing home to recover from a compression fracture of a vertabra.His Doctor prescribed Cymbalta to releive depression. His coumadin level was out of sight. He nearly died.
Ira PharmD

Fort Lauderdale, FL

#2 May 2, 2007
There is only one case of this interaction documented in a medical journal, JAMA, which is a very noteworthy journal. I suggest your father's physician report the case to FDA's MedWatch so professionals can get a clearer picture of how frequently this interaction is occurring and how serious it may be.
Joyce italy

Apo, AE

#3 Jun 12, 2007
I am on Coumadin and Cymbalta right now! Oddly, my INR levels are really low. I didn't get a warning about a drug interaction from the doctor. I'll have to ask now.

Kent, OH

#4 Nov 1, 2007
I was recently put on Coumadin along with Rythmol for A-fib. My INR levels just kept dropping. My psych was the one who said I shouldn't be on those drugs along with the Cymbalta. She now has me on Lexapro- doesn't work as well and I feel like I have the flu constantly:(

United States

#5 Nov 18, 2007
I have a friend who nearly died from a massive thrombosis caused by Factor V Leiden. She spent over a month in the hospital (in and out for two months) and had three surgeries to open her arteries back up. Her doctors tried every blood thinning medication possible and still she clotted through every single one. Finally she tried nattokinase and she has not had any problems since. If you google "nattokinase" you will find information, including published studies on why it is better for you than Coumadin. It works by breaking up the clots before they have time to grow. It has also been proven effective for lowering blood pressure by as much as 10%. I believe the kind she uses is called NSK-SD. It is all natural and certainly can't hurt to do a trial with, of course, your doctor's oversight of your health. HTH!

Raleigh, NC

#6 Jun 10, 2008
My boyfriend has been on coumadin for over a year now for factor V, he also is on cymbalta.......he has had very eratic INR levels from way too thick to way to thin. His coumadin clinic specialist said that it was mainly due to Nexium. Since he went off the Nexium he has been very close to or has been theraputic. He also learned other things he didn't know.......we know about greens and most other things that affect him but we were amazed in how many things we were not told. Onion powder, garlic powder, mushrooms, etc....

Gilbert, AZ

#7 Nov 17, 2008
just out of hospital been on warfarin for years doctor just put me on cymbalta and i got acid real bad for a month then had to go to hospital with upper gi bleeding had to receive 3 units of plasma with platlets and 4 units of blood while in hospital no acid but after first pill tonite acid is comming back cymbalta is only thing thats changed in my meds so stopping to see if it stops

Fort Wayne, IN

#8 Jul 29, 2009
I just saw a commercial for cymbalta that said if taken with blood thinners side effects can be fatal! In April my mom passed away from a massive inner cranial hemorrhage, basically she was bleeding from her brain steam. Happened over night literally. The nurse did her INR Thursday and it was 6.0, they told me to hold the coumadin for a day then continue as normal. The next Wednesday she was in the hosp on a ventilator. At the hosp they told me her INR levels were 150+ I told my husband that day I knew the coumadin killed her but nobody could confirm nor deny, now that I saw that commercial I am wondering if the doctor just had her on a lethal combo to begin with! Please be careful people so you don't have to go through it! If anyone knows of anyone else who has gone through this or could offer advice please email me... I don't know if I just want to blame somebody, but I look back everyday and wonder what I could have done differently. Thank you!

Indianapolis, IN

#9 Sep 24, 2009
Wow. I have been on warafin for 6 months w/ an INR in the range of 1.8-2.2 My rheumatologist perscribed cymbalta for my fibromyalgia. Today, 10 days on the new med, my INR was 8.5 I received a vitamin K shot and a vitamin K pill before bed. Unfortuneatly, I took this evenings cymbalta. I talked w/ both the rheumatologist and hematologist, neither thought the combo would be a problem. I even talked w/ pharmacist. I will stop after reading these posts. I am so sorry to hear about your Mother.

Wesley Chapel, FL

#10 Jun 5, 2010
I've been on Cymbalta for a tear or more. Just had a Pulmanary Embolism and Dr's put me on Coumadin. I was in the hosp for 5 days and all im hearing about this drug is pretty bad stuff..including macular degeneration. Threr was blood in my urinr last night..not bad but not right. After reading this and finding a higher concentration of blood in urine this a.m. I guess I'll get off PC and start some serious questions... I should have asked more than I did but was just glad to be alive. I'll check in later.Spark

Wesley Chapel, FL

#11 Jun 7, 2010
Sparky here. Went to ER as I said I would.I am new on coumadine and I"ve taken Cymbalta for over a year. This site gave me cause for concern. They took plenty of blood and a urine sample..said I have a UTI.. I have no symptoms urgency to urinate,burning..yet im on antibiotics when the informational paper in Coumadin clearly said to call your Dr for brown or pink urine. I already feel like im falling into cracks in this profession and end up dead like so many others (not just because of this particular subject) People in my family have died because of medical neglect

Milford, CT

#12 Aug 1, 2010
My MIL suffered a stroke this past January..part of her drug therapy requires Coumadin...long story short...she was also prescribed Cymbalta for depression ......a few weeks ago she became extrmely agitated and her primary prescribed double doses AM and Pm

she now is in the trauma unit of the hospital because she is bleeding internally.

I realize the risks and benefits but a patinet needs to be monitored holistically 24/7 when using coumadin and cymbalta...IME
Profound changes in her mood brought on dementai that caused her to try to walk and subsequently she fell
I am not fond of her primary and feel that he advocated a dangerous cocktail...he knows she is on cymbalta but why prescribe 2 double doses of coumadin ?

Milford, CT

#13 Aug 1, 2010
corection...double doses of CYMBALTA


in addition to the Coumadin

she needed a blood transfusion as a result luckily she did not fx anything but has a massive hematoma on her left hip

United States

#14 Nov 3, 2011
my husband has factor v and has been on high thinners (plavix and coumadin) for few years now, fairly therapeutic.
to keep long story as short as possible will skip to main post....the back surgeon put him on cymbalta due to nerve pain. within 2 weeks he was in the hospital with extremely low hemoglobin and body was shutting down, bleeding internally. i have since learned cymbalta is NOT to be given with thinners as it is/can be fatal! both the dr (who KNEW my husbnad took high thinners) and the pharmacist missed this and i almost lost mu husband over it. PLEASE CHECK FOR YOURSELVES BEFORE TAKING MULTIPLE MEDICATIONS. the drs mean well but they see too many patients and forget things that can be fatal.
God Bless

Brandon, MS

#15 Feb 7, 2012
My mother is in the hospital due to extreme PT levels. Her Dr. had her on coumadin and cymbalta. Othopedic Dr. also added steroids and mobic. All of these exacerbate coumadin. Her entire body is a bruise. She bumped her leg and bled over a pint of blood into the muscle. I guess I will take my laptop to the Dr. when I take her so I can see if she is being prescribed lethal medications. Too many Dr.s seem to only care about the $$$ these days. P.S. Pharmacist did not catch it either.

Garland, TX

#16 Jun 30, 2012
Sparky, be careful! Antibiotics can thin your blood even more. They make your immunue system low so you are more susceptable to illnesses.
Sparky wrote:
Sparky here. Went to ER as I said I would.I am new on coumadine and I"ve taken Cymbalta for over a year. This site gave me cause for concern. They took plenty of blood and a urine sample..said I have a UTI.. I have no symptoms urgency to urinate,burning..yet im on antibiotics when the informational paper in Coumadin clearly said to call your Dr for brown or pink urine. I already feel like im falling into cracks in this profession and end up dead like so many others (not just because of this particular subject) People in my family have died because of medical neglect

Scottsdale, AZ

#17 Aug 4, 2012
Thanks for the shares. I am blessed that so far I lived through the Cymbalta and Coumadan crisis with a live discharge from the hospital by a good M.D. who when I was admitted to the hospital thru my PCP With an INR of 7.7. It did coincide with sn increas in the Cymbalta and my recovery resulted from 2 units of fresh frozen plasma and some Vit K. That is when I told the Dr of my theory of why my INR shot up. My main discharge diagnosis was Coagulopathy...what you are all referring to as internal bleeding. I believe the Dr and fsntastic RN's working with God saved my life.This information needs to be more than a passing commercial for a drug with s "by the way" re:Coumadan needs more serious warnings from the FDA especially so many of the folks on Coumadan are chronically ill with cardiac issues and need the Coumadan and are suffering from depression which is not an uncommon combo for them.God bless all of us who have to walk this tightrope and bless the MD's and RN's who treat us that they remain vigilisnt.And advocate for your family and friends who might be in this situation, It is OK to pass on accurste info as long as we don't tell people to stop either med. There are potential equally fatal side effects from stopping some meds like these rapidly. So just reccommend perhaps they talk to their DR.

San Bernardino, CA

#18 Aug 4, 2012
Hello Everyone...
I posted in November of 2011...when my husband was put in the hospital for internal bleeding. he was given cymbalta by his back surgeon...even though the dr KNEW myhusband was on 10X the average dose of blood thinners..he DID NOT even monitor his IN nor did he tell me (us) that the cymbalta would do that! my husband got out of Loma LInda hospital on November 11 and on December 1 he died in Palm Springs due to an intracranial bleed from anticoagulatory therapy!!!! His INR was 11 at Loma Linda and when he died his INR was a 6!!! I an in search of an attorney right now..because too many people are dying from this crap and seems no one cares enough to follow through!

Tomah, WI

#19 Dec 18, 2012
what really bothers me is i try to do my home work on the meds, my doctors put me on as i am new to warfarin myself and it seems to just insult them when you question weather i should b taking cymbalta while on blood thinners as in another post i read i listened to the commercial last nite n started doing my home work again this scares the hell out of me as doctors prescribe these meds, with no care to the life it may take ill be tossing this in the garbage !!!

Cornelius, NC

#20 Mar 16, 2013
I also have been on Coumadin for 2 years for PE and I was recently put on Cymbalta for nerve pain. After being on 30mg for 2 weeks I increased on Saturday to 60mg and on Sunday passed out at home 3 times. Went to hospital in ambulance at first thought was allergic reaction to Cymbalta next morning I was put in ICU with INR of 4.9 had a massive internal bleed that required 6 bags of blood and 4 of FFP. Spent 10 days in hospital total and was told I was very lucky!! Sad thing is I work in a pharmacy and our computers do NOT show a interaction between the two drugs. Please advise people you know who are on the two drugs to be careful. I am at that advantage that now I can tell customers be careful!!

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