Drug interactions
Citalopram + Warfarin
Severity: Moderate
Citalopram and Warfarin: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Citalopram impairs platelet function and may raise bleeding risk when combined with warfarin, even without a clear change in INR. Gastrointestinal bleeding is the main concern.
What this interaction means in plain words
Citalopram and Warfarin can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Citalopram belongs to Central Nervous System; Warfarin belongs to Cardiovascular.
Why it happens
Pharmacodynamic: SSRI-related platelet serotonin depletion adds to vitamin K antagonism.
What to do
Monitor for bleeding and check INR after starting or stopping citalopram. Consider gastroprotection in high-risk patients.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Warfarin
- Defibrotide + Warfarin Contraindicated
- Ketorolac + Warfarin Contraindicated
- Abciximab + Warfarin Major
- Acetylsalicylic acid + Warfarin Major
- Adagrasib + Warfarin Major
- Amiodarone + Warfarin Major
Other interactions of Citalopram
- Cisapride + Citalopram Contraindicated
- Citalopram + Dronedarone Contraindicated
- Citalopram + Escitalopram Contraindicated
- Citalopram + Isocarboxazid Contraindicated
- Citalopram + Methylene blue Contraindicated
- Citalopram + Phenelzine Contraindicated
Frequently asked questions
Can I take Citalopram with Warfarin?
MediHelp rates the interaction as moderate. Citalopram and Warfarin can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Citalopram impairs platelet function and may raise bleeding risk when combined with warfarin, even without a clear change in INR. Gastrointestinal bleeding is the main concern.
How serious is the interaction between Citalopram and Warfarin?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for bleeding and check INR after starting or stopping citalopram. Consider gastroprotection in high-risk patients.
What other medicines interact with Warfarin?
MediHelp also lists interactions of Warfarin with, for example, Defibrotide, Ketorolac, Abciximab. The full list is on the Warfarin page.
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