Does Cymbalta Cross The Placenta? (3+ Facts)

By Ivan Kahwa

Page last updated: 02/02/2024 | Next review date: 02/02/2026

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

View More north_east

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.

Was this helpful?

Thanks for your feedback!

References

1.-

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/

2.-

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: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3590601/

3.-

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: https://pubmed.ncbi.nlm.nih.gov/19809008/#:~:text=Discussion%3A%20Duloxetine%20crosses%20the%20placenta,first%2032%20days%20after%20birth.

4.-

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: https://www.bmj.com/content/368/bmj.m237

5.-

Mother To Baby | Fact Sheets [Internet]. Brentwood (TN): Organization of Teratology Information Specialists (OTIS); 1994-. Duloxetine (Cymbalta®) 2022 Feb. Available from: https://www.ncbi.nlm.nih.gov/books/NBK582683/

Pharmaceuticals and Medications

Diseases & Conditions

Does Cymbalta cross the placenta? (3+ facts)