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Similar reactions may occur if Cymbalta duloxetine is combined with antipsychotics, tricyclic antidepressants or other drugs that affect serotonin in the brain. Examples include tryptophan, sumatriptan Imitrex lithium, linezolid Zyvox tramadol Ultram and St. John s Wort.No dosage adjustment is necessary for patients with mild or moderate renal dysfunction creatinine clearance 30 to 80 ml/min Cymbalta must not be how to get free samples of cymbalta in patients with severe renal impairment creatinine clearance 30 ml/min; see section 4.

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