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What Are The Repercussions Of Using Warfarin And Sertraline?
Question: If I am monitoring my pt's INR very closely, is it safe to continue the pt's sertraline? He is in his 80's and has an indwelling Foley. I am a locum and picked this pt up with warfarin and sertraline already prescribed. He has a history of depression. INR is being monitored weekly at this time.
XXXXXXX M. XXXXXXX RN, BSN, MSN, FNP-C
The pt is a male in his 80's.
The pt profile just has my name and age, as the section was not applicable.
XXXXXXX M. XXXXXXX RN, BSN, MSN, FNP-C
The pt is a male in his 80's.
The pt profile just has my name and age, as the section was not applicable.
Brief Answer:
I would recommend as follows:
Detailed Answer:
Hello!
Welcome and thank you for asking on HCM!
Regarding your concern, I would explain that sertraline increases levels of warfarin by decreasing metabolism.
So, it increases the risk of bleeding.
In fact all the drugs of this class (SSRI), like escitalopram, citalopram, paroxetine, etc. interact with warfarin by increasing its plasma levels and thus the INR.
So, it is up to you to make a choice, knowing this possible interaction. But, I would not recommend switching to another drug of this class, because of the same interactions.
You may stop it, but it may affect the patients emotional state (sertraline is a very helpful drug against anxiety or depression).
You should discuss with the patient or his prescribing doctor on the above issues.
Anyway, if your decide to stop sertraline, I would recommend doing this gradually (half the dose for a week and than a quarter for another week until stopping). This is made in order to avoid possible aggravation of his symptoms.
Hope you will find this answer helpful!
Wishing all the best,
Dr. Iliri
I would recommend as follows:
Detailed Answer:
Hello!
Welcome and thank you for asking on HCM!
Regarding your concern, I would explain that sertraline increases levels of warfarin by decreasing metabolism.
So, it increases the risk of bleeding.
In fact all the drugs of this class (SSRI), like escitalopram, citalopram, paroxetine, etc. interact with warfarin by increasing its plasma levels and thus the INR.
So, it is up to you to make a choice, knowing this possible interaction. But, I would not recommend switching to another drug of this class, because of the same interactions.
You may stop it, but it may affect the patients emotional state (sertraline is a very helpful drug against anxiety or depression).
You should discuss with the patient or his prescribing doctor on the above issues.
Anyway, if your decide to stop sertraline, I would recommend doing this gradually (half the dose for a week and than a quarter for another week until stopping). This is made in order to avoid possible aggravation of his symptoms.
Hope you will find this answer helpful!
Wishing all the best,
Dr. Iliri
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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