Does Cymbalta cause nosebleeds? (3+ factors)

By Ivan Kahwa
Page last updated: 02/02/2024 | Next review date: 02/02/2026
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Author bio

 

Mr Ivan Kahwa is a chemist and phytopharmaceutical scientist with expertise in chemistry, pharmacology, phytochemistry, and Nanobiotechnology. He writes and reviews content on these topics.

Mr Ivan Kahwa’s Highlights:

Guest Researcher at the University of Leipzig, Senior Research Fellow/Scientist, and Lecturer at the  Department of Pharmacy, Faculty of Medicine, Mbarara University of Science and Technology.

Professional Experience:

Mr Ivan joined PHARMBIOTRAC as a research fellow/scientist during his master of science tenure. He contributed to the development of most of the phytopharmaceutical products in the project. Furthermore, he participated in carrying out the pharmacological activities of the developed products in laboratory animals such as mice and rats in order to develop proper doses hence leading to pre-clinical studies.

With the above relevant research experience, Ivan started to work with the University of Leipzig on collaborative projects with Mbarara University to develop the chemistry of Ugandan Medicinal plants and their pharmacological activities. This was coupled with several consultative positions by different German NGOs. Mr. Kahwa is also a supporting in the teaching and learning at the Departments of Pharmacy and Pharmaceutical Sciences, Faculty of Medicine, Mbarara University of Science and Technology.

With the increase in antimicrobial resistance globally, Ivan retooled his thinking towards developing new naturally derived antibiotic regimens from Ugandan propolis with the assistance of nanotechnology to improve their delivery to microbial cells. Kahwa has also published over 28 articles in peer-reviewed journals and he is currently reviewing for many journals.

Education:

2023-2027: PhD in Pharmaceutical Sciences (ongoing) with a focus on Pharmaceutical Microbiology and Nanobiology at Mbarara University of Science and Technology.

2022: 2Msc. in Pharmacognosy and Natural Medicine Science at Mbarara University of Science and Technology.

2018: Bachelor of Science (Chemistry) at Mbarara University of Science and Technology.

Publications:

▪ Iqbal, S., Jabeen, F., Kahwa, I., & Omara, T. 2023. Suberosin Alleviates Thiazolidinedione-Induced Cardiomyopathy in Diabetic Rats by Inhibiting Ferroptosis via Modulation of ACSL4-LPCAT3 and PI3K-AKT Signaling Pathways. Cardiovascular Toxicology. https://doi.org/10.1007/s12012-023-09804-7 

▪ Gupta, A. K., Yadav, R., Sharma, S., Sawale, J., & Kahwa, I. 2023. Anti-ageing Activity and Antioxidant Activity of Methanol Extracts of Leaves and Flowers of Salvia officinalis and Rosmarinus officinalis. Journal of Young Pharmacists, 15(3), 448–455. https://doi.org/10.5530/jyp.2023.15.60 

▪ Tolo, C.U., Kahwa, I., Nuwagira, U., Weisheit, A. and Ikiriza, H., 2023. Medicinal plants used in treatment of various diseases in the Rwenzori Region, Western Uganda. Ethnobotany Research and Applications, 25, pp.1-16.

https://ethnobotanyjournal.org/index.php/era/article/view/4683 

▪ Kahwa, I., Ajayi, C.O., Yadav, R., Chauhan, N.S., Shah, K., Abdelgadir, A.A., Shegena, E.A., Daniel, S., Omara, T., Asiimwe, J.B. and Ikiriza, H., 2023. Pharmacognostic and phytochemical studies as an invaluable approach for correct identification of medicinal plants: The case of Artemisia vulgaris L. substituted for Artemisia annua L. in Western Uganda. TMR Integr Med, 7, p.e23004.

  https://doi.org/10.53388/TMRIM202307004 

▪ Nalimu, F., Oloro, J., Kahwa, I. and Ogwang, P.E., 2021. Review on the phytochemistry and toxicological profiles of Aloe vera and Aloe ferox. Future Journal of Pharmaceutical Sciences, 7, pp.1-21.

https://doi.org/10.1186/s43094-021-00296-2 

▪ Elamin, O.H.S., Ali, M.A., Elgezuli, I.A.A., Bashir, M.A. and Kahwa, I., 2021. Diagnosis of pre-and post-treatment of echinococcus granulosus with counter current immune electrophoresis and bacterial co-agglutination. Journal of Microbiology and Infectious Diseases, 11(02), pp.88-94.

https://doi.org/10.5799/jmid.951600 

Published book Chapter

▪ Kahwa, I., Ayesiga, I., Nakalema, S., Alinaiswe, R., Mbabazi, R. and Iqbal, S., 2023. Natural products in the management of onchocerciasis. In Natural Products in Vector-Borne Disease Management (pp. 63-80). Academic Press. Book Chapter.

 https://doi.org/10.1016/B978-0-323-91942-5.00012-4 

Submitted manuscripts Under Review:

▪ Comparison of the Wound Healing Activity of the Leaf and Leaf Ash Extracts of Vernonia amygdalina in Rats. Journal name: Clinical Phytoscience

▪ Ethnobotanical Survey of Medicinal plants used in the management of cancer in Uganda. Journal name: Journal of Herbal Medicine

▪ Ethnobotanical survey and phytochemical screening of medicinal plants used in treatment of epilepsy by PROMETRA-Uganda Traditional Health Practitioners in Mpigi District, Uganda. Journal name: Journal of Ethnopharmacology

Submitted book chapters under review

1.Book title: Algae as a Natural Solution for Water-Food-Energy Nexus, Section 4:  Microalgae and cyanobacteria for food applications, Chapter 4.6:  Safety, toxicological and allergenic aspects of using algae for food. Authors: Christine Kyarimpa, Tom Omute, Caroline K. Nakiguli, Alice V. Khanakwa4, Christopher Angiro, Ivan Kahwa, Fortunate Ahumuza, Timothy Omara*. Publisher:  Springer Nature Singapore Pte Ltd. 152 Beach Road, #21-01/04 Gateway East, Singapore 189721, Singapore.

2.Book title: Nutraceuticals Inspiring the Contemporary Therapy for Lifestyle Diseases. Chapter: Nutraceutical applications of Seaweeds and their Phytocompounds in Nutrition and Treatment of Diseases. Authors:  Ivan Kahwa, Timothy Omara , Innocent Ayesiga , Gael Noel Neh Neba Ambe , Zehbanaz Javidbhai Panwala  , Rachel Mbabazi  , Shabnoor Iqbal  , Christine Kyarimpa , Christine Betty Nagawa , Kamal Shah ,Nagendra Singh Chauhan* Publisher: CRC Press

 

You can view my works on the following professional sites:

 

Research Gate: https://www.researchgate.net/profile/Ivan-Kahwa

 

Google Scholar: https://scholar.google.com/citations?user=tOwrvqoAAAAJ&hl=en

ORCID: https://orcid.org/0000-0002-6440-3437

Linkedin: https://de.linkedin.com/in/ivan-kahwa-865450159 

 

 

 

 


Ivan Kahwa
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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.

Was this helpful?

Thanks for your feedback!

References

1.-

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:https://medlineplus.gov/druginfo/meds/a604030.html

2.-

Dhaliwal JS, Spurling BC, Molla M. Duloxetine. [Updated 2023 May 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK549806/

3.-

Li N, Wallén NH, Ladjevardi M, Hjemdahl P. Effects of serotonin on platelet activation in whole blood. Blood Coagul Fibrinolysis. 1997 Nov;8(8):517-23. doi: 10.1097/00001721-199711000-00006. PMID: 9491270. https://pubmed.ncbi.nlm.nih.gov/9491270/

4.-

HIGHLIGHTS OF PRESCRIBING INFORMATION of  Cymbalta (duloxetine hydrochloride), by The U.S. Food and Drug Administration, https://www.accessdata.fda.gov/drugsatfda_docs/label/2010/022516lbl.pdf

5.-

Cymbalta, Department of Health and Human Services, Public Health Service, Food and Drug Administration, Center for Drug Evaluation and Research, https://www.fda.gov/media/74142/download

6.-

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. https://pubmed.ncbi.nlm.nih.gov/29437014/

7.-

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. https://doi.org/10.1016/j.jsha.2014.09.002

8.-

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. https://pubmed.ncbi.nlm.nih.gov/9716869/

9.-

Tabassom A, Dahlstrom JJ. Epistaxis. [Updated 2022 Sep 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK435997/

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