Does Cymbalta cross the placenta? (3+ facts)

This article will answer the question, “Does Cymbalta cross the placenta?” We will discuss the effects of Cymbalta on pregnancy and the research findings related to it. Additionally, we will discuss if it is safe to take Cymbalta during pregnancy, along with some safety measures. 

Does Cymbalta cross the placenta? 

Yes, Cymbalta does cross the placenta. The FDA has classified Cymbalta under pregnancy category C. Drugs classified as category C can have an impact on the developing fetus. Animal experiments have demonstrated adverse effects on the fetus, but there are not enough studies to know the effect of drugs on the human fetus. It is recommended to use Cymbalta only if the benefits outweigh the risks. (1)

If you are planning to conceive or if you are pregnant, make sure you consult your physician to make the necessary changes in your regimen. Do not stop taking the drug suddenly or make any changes to your regimen, as it can cause withdrawal symptoms and worsen your condition.

Your physician will help you taper the drug gradually and stop the medication, which will help avoid withdrawal symptoms. Cymbalta is also found in the breast milk. If you are breastfeeding an infant and notice any changes in behaviour, feeding, growth, or sleep patterns, consult your physician. (1)

What does the research suggest?  

Cymbalta (duloxetine) is an antidepressant which belongs to the group of serotonin-norepinephrine reuptake inhibitors (SNRI), which increases the level of neurotransmitters such as serotonin, norepinephrine and dopamine. An increase in these neurotransmitters helps treat depression, anxiety disorders, fibromyalgia, peripheral neuropathy, and chronic pain. (1)

A safety surveillance study conducted by Sharon L. Hoog et al. found 400 cases of pregnancy associated with the use of duloxetine. From which 41 reported cases of spontaneous abortions, 25 cases of post/perinatal conditions, and 19 cases of premature births. (2)

A case study by Briggs et al. reported that a 29-year-old female was treated with duloxetine for her depression in her second half-trimester. She continued her treatment with duloxetine after the birth. No defects or developmental toxicity were seen in the infant. However, the breast milk samples which were tested positive for duloxetine. (3)

A cohort study by Krista et al. evaluated the risk of adverse events/reactions when duloxetine was administered to pregnant women. The age of participants was between 18 and 55 years. This study found congenital malformation, cardiovascular malformations, preterm birth, pre-eclampsia and postpartum haemorrhage in the participants. The result concluded that the relative risk for these adverse events was 1.11, 1.29, 1.01, 1.12, and 1.53, respectively. (4)

What are the effects of Cymbalta on pregnancy and fetus? 

Studies have shown that duloxetine can lead to a few adverse effects when taken during pregnancy, such as congenital malformation, miscarriage, pre-eclampsia and postpartum haemorrhage. (4)

Cymbalta, when used during pregnancy, can increase the risk of hypertension, heavy bleeding after birth, premature birth of the baby, and a 3-5 % chance of birth defects. Cymbalta is also found in breast milk; around 2.3% of Cymbalta gets transferred to the infant during breastfeeding via breast milk. Hence, it is advised to monitor for any behavioural changes in the infant. (1,5)

When Cymbalta is taken during pregnancy, temporary withdrawal symptoms are observed in the newborns. This withdrawal symptom is seen rarely in newborns, and not all babies are affected by Cymbalta. The withdrawal symptoms include breathing problems, jitters, tremors, irritability, and issues related to sleeping and feeding, which usually subside within a few days/weeks. (5)

What are the safety measures for taking Cymbalta during pregnancy? 

It is safe to use Cymbalta during pregnancy if the benefits outweigh the risks with proper monitoring. There are no guaranteed safety measures for taking Cymbalta during pregnancy. However, here are some general measures that may help minimise the risks.

Discuss other treatment options with your healthcare provider if you plan to conceive. Your doctor can help you weigh the potential risks and benefits of using Cymbalta during pregnancy and make the necessary adjustments in your treatment. 

Take the lowest effective dose of Cymbalta, which is necessary to manage your symptoms. Closely monitor for any side effects, such as increased blood pressure or spotting. Do not miss the regular prenatal checkups.

Be aware of the potential side effects of Cymbalta, such as nausea, vomiting, diarrhoea, constipation, dry mouth, dizziness, insomnia, etc. If you are breastfeeding, look out for changes in your infant’s behaviour, feeding, growth, or sleep patterns.

You can consider other non-pharmacological therapies to cope with your depression, anxiety or pain-related disorders, such as:

  • Cognitive behavioural therapy
  • Relaxation techniques (deep breathing, meditation)
  • Physical therapy for pain
  • Acupuncture
  • Massage therapy 
  • Yoga
  • Social skills training
  • Exposure therapy
  • Sleep hygiene

In my opinion, Cymbalta can cross the placenta, and studies have shown few side effects when Cymbalta is used during pregnancy. Even though the occurrence may be low, it is crucial to monitor the treatment properly, as it can cause problems if left unchecked. I suggest consulting your physician before altering your current treatment plan. 




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Dhaliwal JS, Spurling BC, Molla M. Duloxetine. [Updated 2023 May 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: 


Hoog SL, Cheng Y, Elpers J, Dowsett SA. Duloxetine and pregnancy outcomes: safety surveillance findings. International journal of medical sciences. 2013;10(4):413. Available from: 


Briggs GG, Ambrose PJ, llett KF, Hackett LP, Nageotte MP, Padilla G. Use of duloxetine in pregnancy and lactation. Annals of Pharmacotherapy. 2009 Nov;43(11):1898-902. Available from:,first%2032%20days%20after%20birth. 


Huybrechts KF, Bateman BT, Pawar A, Bessette LG, Mogun H, Levin R, Li H, Motsko S, Fernandes MF, Upadhyaya HP, Hernandez-Diaz S. Maternal and fetal outcomes following exposure to duloxetine in pregnancy: cohort study. bmj. 2020 Feb 19;368. Available from: 


Mother To Baby | Fact Sheets [Internet]. Brentwood (TN): Organization of Teratology Information Specialists (OTIS); 1994-. Duloxetine (Cymbalta®) 2022 Feb. Available from: 

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