Does Cymbalta cause nosebleeds? (3+ factors)

In this article, we will discuss whether Cymbalta causes nosebleeds, what research suggests, what factors contribute to Cymbalta-induced nosebleeds, and how to manage nosebleeds while taking Cymbalta.

Does Cymbalta cause nosebleeds?

Yes, Cymbalta may cause nosebleeds in individuals taking it for the treatment of their mental health issues and chronic pain. Cymbalta has a very low anticholinergic side effect profile, so the incidence of nosebleeds is relatively low. However, individuals’ responses to Cymbalta are different, and users have experienced nosebleeds while using Cymbalta. (1)

Cymbalta (duloxetine) is a medication that belongs to the class of serotonin-norepinephrine reuptake inhibitors (SNRI) used to treat depression, anxiety, fibromyalgia, and chronic pain disorders. (2)

What does research suggest?

Research on Cymbalta-induced nosebleeds is limited. However, research indicates the involvement of serotonin in causing nosebleeds. Serotonin causes nosebleeds by affecting platelet aggregation. Cymbalta, an SNRI, increases serotonin levels in the brain, which can also affect platelet function and cause abnormal bleeding, including nosebleeds. (3,5)

There have been reports of patients experiencing nosebleeds while taking Cymbalta for the treatment of their mental health issues, but the number is too low to point out Cymbalta (duloxetine) as a causative agent. (4)

What factors can contribute to Cymbalta-induced nosebleeds?

External factors mainly induce nosebleeds. While a direct causal link between Cymbalta and nosebleeds remains unproven, several factors could contribute to the development of nosebleeds in individuals taking Cymbalta:

  • Dryness: Dryness in the mucous membranes, including those in the nasal passages, can cause nosebleeds. A dry nasal canal is more prone to irritation and may be a cause for nosebleeds.


  • Blood clotting: Some studies suggest that antidepressants that influence serotonin levels may affect platelet function and blood clotting. These drugs can cause abnormal bleeding, including nosebleeds, as a side effect. (5)


  • Nasal trauma: While taking drugs that increase serotonin levels and increase the risk of bleeding, harshly picking your nose can also contribute to nosebleeds. (9)


  • Interactions: Concomitant use of medications like nonsteroidal anti-inflammatory drugs and anticoagulants with Cymbalta can increase the risk of abnormal bleeding, including nosebleeds. (6,8)


  • Underlying health conditions: Individuals suffering from conditions such as hypertension, nasal congestion, or blood clotting disorders may be more susceptible to nosebleeds when taking Cymbalta. (7)

How to manage nosebleeds while taking Cymbalta?

If you are taking Cymbalta and experiencing nosebleeds, it is crucial to consult your healthcare provider for an individualized treatment plan for your symptoms. However, the first step to managing a nosebleed is tilting your head forward to stop the blood from going into your throat and pinching your nose to stop the bleeding.

Here are some tips for managing nosebleeds while taking Cymbalta:

  • Stay hydrated: Staying hydrated while taking Cymbalta helps keep mucous membranes moisturized, reducing the risk of nosebleeds.
  • Use a humidifier: Adding moisture to the air by using a humidifier can prevent dryness in the nasal passages, preventing nosebleeds.
  • Use saline nasal spray: Saline nasal sprays can reduce dryness and irritation in the nasal canal and help reduce the risk of nosebleeds.
  • Avoid nasal trauma: Be gentle when blowing or picking your nose, and avoid inserting objects into the nasal passages to prevent nosebleeds.
  • Monitor blood pressure: Elevated blood pressure can contribute to nosebleeds. Manage your blood pressure if you are taking Cymbalta to reduce the risk of nosebleeds.

If your nosebleeding does not stop, your doctor may prescribe oxymetazoline spray or thrombogenic foams or gels to stop the bleeding. (9)

What are some common side effects of Cymbalta?

  • Nausea
  • Vomiting
  • Diarrhea
  • Constipation
  • Headache
  • Dry mouth
  • Insomnia
  • Fatigue
  • Tremors
  • Hyperhidrosis
  • Dizziness (1,2,4)


From my perspective, the evidence linking Cymbalta to nosebleeds is inconclusive. It is essential for individuals taking this medication to be aware of potential risks. Simple lifestyle adjustments and monitoring for underlying health conditions can manage nosebleeds.

As with any medication, I emphasized that open communication between patients and healthcare professionals is crucial for ensuring the best possible outcomes in managing side effects such as nosebleeds and overall well-being.

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AHFS Patient Medication Information [Internet]. Bethesda (MD): American Society of Health-System Pharmacists, Inc.; c2019. Duloxetine; [updated 2020 Jun 24; reviewed 2022 Mar 15; cited 2020 Jul 1]; [about 5 p.]. Available from:


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Meirinho S, Relvas R, Alves G. Drug-Induced Epistaxis: An Often-Neglected Adverse Effect. Curr Drug Saf. 2018;13(2):74-83. doi: 10.2174/1574886313666180213090943. PMID: 29437014.


Sarhan, N. A., & Algamal, A. M. (2015). Relationship between epistaxis and hypertension: A cause and effect or coincidence? Journal of the Saudi Heart Association, 27(2), 79-84.


Tay HL, Evans JM, McMahon AD, MacDonald TM. Aspirin, nonsteroidal anti-inflammatory drugs, and epistaxis. A regional record linkage case control study. Ann Otol Rhinol Laryngol. 1998 Aug;107(8):671-4. doi: 10.1177/000348949810700808. PMID: 9716869.


Tabassom A, Dahlstrom JJ. Epistaxis. [Updated 2022 Sep 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from:

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