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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Do Warfarin And Fluoxetine Interfere With Each Other?

Hello, I currently and have for one year take Warfarin and was just prescribed Fluoxetine. I see that it was noted that expected drug interaction with the two Rx s, can you elaborate about this issue as I am a little nervous about taking them both, please and thank you
Tue, 8 Mar 2016
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General & Family Physician,  's  Response
Hi & Welcome to HCM.
I can understand your concern for the possible interaction between the two prescribed medications. Yes, Fluoxetine can increase the risk of bleeding if given along with blood thinner Warfarin.
Selective serotonin reuptake inhibitors (SSRIs) like Fluoxetine which is commonly used to treat depression can increase the toxicity (high risk of bleeding) by interfering with platelet aggregation by depleting the levels of platelet serotonin, thus directly increasing the risk of bleeding, or they may also inhibit the metabolism of Warfarin (reduce the clearance from the body) hence increasing its plasma level thus causing bleeding.
You are therefore advised to consult your treating physician/neurologist for an alternate but a safer antidepressant like Venlafaxine or Desvenlafaxine which do not appear to have such harmful interaction with Warfarin.
Hope I could answer your query.
A feed back is appreciated.
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Do Warfarin And Fluoxetine Interfere With Each Other?

Hi & Welcome to HCM. I can understand your concern for the possible interaction between the two prescribed medications. Yes, Fluoxetine can increase the risk of bleeding if given along with blood thinner Warfarin. Selective serotonin reuptake inhibitors (SSRIs) like Fluoxetine which is commonly used to treat depression can increase the toxicity (high risk of bleeding) by interfering with platelet aggregation by depleting the levels of platelet serotonin, thus directly increasing the risk of bleeding, or they may also inhibit the metabolism of Warfarin (reduce the clearance from the body) hence increasing its plasma level thus causing bleeding. You are therefore advised to consult your treating physician/neurologist for an alternate but a safer antidepressant like Venlafaxine or Desvenlafaxine which do not appear to have such harmful interaction with Warfarin. Hope I could answer your query. A feed back is appreciated.