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. December, 2012.
2.Lexapro (escitalopram oxalate) US prescribing information. Forest Pharmaceuticals Inc. December, 2012.
3.Prozac (fluoxetine hydrochloride) US prescribing information. Eli Lilly and Company January, 2013.
4.Paxil (paroxetine hydrochloride) US prescribing information. GlaxoSmithKline December, 2012.
5.Pexeva (paroxetine mesylate) US prescribing information. Noven Therapeutics, LLC December, 2012.
6.Zoloft (sertraline) US prescribing information. Pfizer Inc. December, 2012.
7.Pristiq (desvenlafaxine succinate) US prescribing information. Wyeth Pharmaceuticals, Inc. December, 2013.
8.Effexor (venlafaxine hydrochloride) US prescribing information. Wyeth Pharmaceuticals December, 2012.
9.Cymbalta (duloxetine hydrochloride) US prescribing information. Eli Lilly and Company June, 2015.
10.Dalton SO, Johansen C, Mellemkjaer L, Norgard B, Sorensen HT, Olsen JH. Use of selective serotonin reuptake inhibitors and risk of upper gastrointestinal tract bleeding: a population-based cohort study. Arch Intern Med 2003 Jan 13;163(1):59-64.
11.de Abajo FJ, Rodriguez LA, Montero D. Association between selective serotonin reuptake inhibitors and upper gastrointestinal bleeding: population based case-control study. BMJ 1999 Oct 23;319(7217):1106-9.
12.Schalekamp T, Klungel OH, Souverein PC, de Boer A. Increased bleeding risk with concurrent use of selective serotonin reuptake inhibitors and coumarins. Arch Intern Med 2008 Jan 28;168(2):180-5.
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.