Does Cymbalta cause liver problems? (+5 factors)

In this article, we will discuss whether Cymbalta causes liver problems. We will also explore research studies linking the use of Cymbalta to the occurrence of liver issues. Additionally, we will discuss the factors that may increase the risk of liver problems while taking Cymbalta and explore alternatives to Cymbalta if it does cause liver problems.

Does Cymbalta cause liver problems?

Yes, Cymbalta can cause liver problems. However, the risk of liver issues is higher with a high dosage of Cymbalta and in the presence of underlying liver diseases. Cymbalta is metabolized by the liver, which may increase the burden on the organ; however, the exact mechanism of liver injury caused by Cymbalta is unknown.

Cymbalta is an antidepressant medication frequently employed in the management of various health conditions. It is used to treat fibromyalgia, depression, anxiety, and its associated symptoms. The mechanism behind its therapeutic effects may involve its interference with serotonin and norepinephrine in the brain (1).

While the side effects of Cymbalta are not typically serious, it may cause certain side effects in the initial phase of treatment, including headaches, drowsiness, sleep disturbances, gastrointestinal discomfort, and fatigue (1).

What does research suggest?

According to research, Cymbalta is most likely to cause liver injury in patients with underlying risk factors such as a higher dosage of Cymbalta and underlying liver diseases.

A research study reported that the use of Cymbalta in patients with pre-existing liver diseases resulted in liver problems in more than 80% of patients, including jaundice and elevated levels of liver enzymes (2).

Another research study found that liver problems occurred in a patient when the dosage of Cymbalta was increased from 30 mg daily to 60 mg daily. In this case, the patient was advised to stop taking the medication, and Effexor was prescribed. After the discontinuation of Cymbalta, the liver functions returned to normal after a few months (3).

However, the same research study reported another case where jaundice occurred in a patient with no history of liver diseases who was using Cymbalta (3).

What factors may increase the risk of Cymbalta-induced liver problems?

Several factors may increase the risk of liver problems while taking Cymbalta. These factors may include:

History of liver diseases: Pre-existing liver diseases in individuals, such as jaundice, hepatitis, and cirrhosis, elevate the risk of hepatic injury when using Cymbalta. Healthcare providers generally avoid prescribing Cymbalta to individuals with underlying liver diseases.

Higher dosage: The risk of liver injury with Cymbalta is also higher with increased medication dosage, as reported in research studies where the higher dosage of Cymbalta induced liver problems in individuals (3).

Concurrent medications: Concurrently using Cymbalta with medications known to potentially cause liver injury, such as isoniazid, sulphonamides, and metronidazole, raises the risk of serious liver problems (4).

Use of alcohol: Consuming alcohol with Cymbalta is likely to amplify the medication’s side effects, including liver injury, as both alcohol and Cymbalta can burden the liver and contribute to subsequent liver injury.

Individual factors: Individuals vary in their sensitivity to Cymbalta, increasing the risk of side effects, including liver problems, in certain cases. Genetic factors and old age are also potential contributors to an elevated risk of these side effects.

What to do if Cymbalta causes liver problems?

If you experience any symptoms of liver problems such as dark urine or abdominal pain after using Cymbalta, it is crucial to consult your healthcare provider immediately.

They will assess your condition and may recommend liver function tests to determine the cause of your symptoms. If the liver injury is associated with underlying risk factors, your healthcare provider will work to address these factors first.

If the current dosage of Cymbalta is deemed likely to cause severe liver injury, your healthcare provider may adjust the dosage to prevent the worsening of symptoms. In cases where even the lower dosage of Cymbalta causes liver problems, your healthcare provider may suggest discontinuing the medication and switching to another antidepressant that is less likely to cause liver problems.

However, it’s important to note that the discontinuation of Cymbalta should be done only under the guidance of your healthcare provider, as a sudden discontinuation of medications like Cymbalta may lead to withdrawal effects.

What are the alternatives to Cymbalta if it causes liver problems?

Alternatives to Cymbalta are prescribed in conditions where Cymbalta causes severe and unbearable side effects in individuals, including liver damage. Medications with a lower risk of causing liver damage compared to Cymbalta may include (5):

  • fluoxetine
  • desvenlafaxine
  • sertraline
  • citalopram
  • escitalopram

However, the selection of an appropriate medication should be based on the individual’s overall health status and underlying medical conditions. It’s important not to make a decision to switch medications without consulting your healthcare provider, as it may worsen your symptoms.

In my opinion, Cymbalta is more likely to cause liver problems in individuals with a history of liver disease or when combined with other medications that affect the liver. However, in any case, if you experience any symptoms of liver problems, you should consult your healthcare provider to prevent the worsening of your condition. 

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