SSRIs;SNRIs/Slt Anticoagulants;Antiplatelets;Thrombolytics Interactions
This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.
Medical warning:
Moderate. These medicines may cause some risk when taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.
How the interaction occurs:
Selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, anticoagulants, antiplatelets, and thrombolytics all affect how your body stops bleeding.
What might happen:
If you take these medicines together, you may have a higher risk of bleeding.
What you should do about this interaction:
Let your healthcare professionals (e.g. doctor or pharmacist) know that you are taking these medicines together. Let your doctor know right away if you have any signs of bleeding such as bleeding from your gums, nosebleeds, unusual bruising, or dark stools.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.
- 1.Celexa (citalopram hydrobromide) US prescribing information. Forest Laboratories Inc. August, 2023.
- 2.Lexapro (escitalopram oxalate) US prescribing information. Forest Pharmaceuticals Inc. September, 2021.
- 3.Prozac (fluoxetine hydrochloride) US prescribing information. Eli Lilly and Company August, 2023.
- 4.Paxil (paroxetine hydrochloride) US prescribing information. Apotex Technologies January, 2017.
- 5.Pexeva (paroxetine mesylate) US prescribing information. Noven Therapeutics, LLC September, 2021.
- 6.Zoloft (sertraline) US prescribing information. Pfizer Inc. August, 2023.
- 7.Pristiq (desvenlafaxine succinate) US prescribing information. Wyeth Pharmaceuticals, Inc. August, 2023.
- 8.Effexor XR (venlafaxine hydrochloride) US prescribing information. Viatris August, 2023.
- 9.Cymbalta (duloxetine hydrochloride) US prescribing information. Eli Lilly and Company September, 2021.
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- 13.Labos C, Dasgupta K, Nedjar H, Turecki G, Rahme E. Risk of bleeding associated with combined use of selective serotonin reuptake inhibitors and antiplatelet therapy following acute myocardial infarction. CMAJ 2011 Nov 8;183(16):1835-43.
- 14.Teichert M, Visser LE, Uitterlinden AG, Hofman A, Buhre PJ, Straus S, De Smet PA, Stricker BH. Selective serotonin reuptake inhibiting antidepressants and the risk of overanticoagulation during acenocoumarol maintenance treatment. Br J Clin Pharmacol 2011 May 4.
- 15.Iwagami M, Tomlinson LA, Mansfield KE, Douglas IJ, Smeeth L, Nitsch D. Gastrointestinal bleeding risk of selective serotonin reuptake inhibitors by level of kidney function: A population-based cohort study. Br J Clin Pharmacol 2018 Sep;84(9):2142-2151.
- 16.Zhou M, Leonard CE, Brensinger CM, Bilker WB, Kimmel SE, Hecht TEH, Hennessy S. Pharmacoepidemiologic Screening of Potential Oral Anticoagulant Drug Interactions Leading to Thromboembolic Events. Clin Pharmacol Ther 2020 Aug;108(2):377-386.
- 17.Jiang HY, Chen HZ, Hu XJ, Yu ZH, Yang W, Deng M, Zhang YH, Ruan B. Use of selective serotonin reuptake inhibitors and risk of upper gastrointestinal bleeding: a systematic review and meta-analysis. Clin Gastroenterol Hepatol 2015 Jan;13(1):42-50.e3.
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CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.