Drug interactions
Clopidogrel + Fluoxetine
Severity: Moderate
Clopidogrel and Fluoxetine: 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
Fluoxetine and its metabolite inhibit CYP2C19, which may reduce clopidogrel activation and weaken platelet inhibition. SSRIs also impair platelet function, so bleeding risk is increased, creating competing concerns.
What this interaction means in plain words
Clopidogrel and Fluoxetine 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.
Clopidogrel belongs to Cardiovascular; Fluoxetine belongs to Central Nervous System.
Why it happens
CYP2C19 inhibition reduces active clopidogrel metabolite formation, with additive serotonergic platelet effects raising bleeding risk.
What to do
Consider an antidepressant with less CYP2C19 inhibition, such as sertraline or escitalopram, when clopidogrel is needed. Monitor for bleeding and for ischemic events.
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 Clopidogrel
Other interactions of Fluoxetine
- Fluoxetine + Isocarboxazid Contraindicated
- Fluoxetine + Mavacamten Contraindicated
- Fluoxetine + Methylene blue Contraindicated
- Fluoxetine + Phenelzine Contraindicated
- Fluoxetine + Pimozide Contraindicated
- Fluoxetine + Rasagiline Contraindicated
Frequently asked questions
Can I take Clopidogrel with Fluoxetine?
MediHelp rates the interaction as moderate. Clopidogrel and Fluoxetine 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. Fluoxetine and its metabolite inhibit CYP2C19, which may reduce clopidogrel activation and weaken platelet inhibition. SSRIs also impair platelet function, so bleeding risk is increased, creating competing concerns.
How serious is the interaction between Clopidogrel and Fluoxetine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Consider an antidepressant with less CYP2C19 inhibition, such as sertraline or escitalopram, when clopidogrel is needed. Monitor for bleeding and for ischemic events.
What other medicines interact with Clopidogrel?
MediHelp also lists interactions of Clopidogrel with, for example, Ombitasvir / paritaprevir / ritonavir and dasabuvir, Abrocitinib, Acetylsalicylic acid. The full list is on the Clopidogrel page.
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