Drug interactions
Clopidogrel + Paroxetine
Severity: Moderate
Clopidogrel and Paroxetine: 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
Paroxetine reduces platelet serotonin uptake and impairs platelet aggregation, which adds to the antiplatelet effect of clopidogrel. This increases the risk of bleeding, particularly gastrointestinal bleeding.
What this interaction means in plain words
Clopidogrel and Paroxetine 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; Paroxetine belongs to Central Nervous System.
Why it happens
Additive pharmacodynamic effect on platelet function from SSRI-induced platelet serotonin depletion plus P2Y12 blockade.
What to do
Monitor for bleeding and consider gastroprotection in older patients or those with prior GI bleeding. Reassess the need for combined therapy if bleeding occurs.
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 Paroxetine
- Isocarboxazid + Paroxetine Contraindicated
- Methylene blue + Paroxetine Contraindicated
- Paroxetine + Phenelzine Contraindicated
- Paroxetine + Pimozide Contraindicated
- Paroxetine + Procarbazine Contraindicated
- Paroxetine + Selegiline Contraindicated
Frequently asked questions
Can I take Clopidogrel with Paroxetine?
MediHelp rates the interaction as moderate. Clopidogrel and Paroxetine 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. Paroxetine reduces platelet serotonin uptake and impairs platelet aggregation, which adds to the antiplatelet effect of clopidogrel. This increases the risk of bleeding, particularly gastrointestinal bleeding.
How serious is the interaction between Clopidogrel and Paroxetine?
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 consider gastroprotection in older patients or those with prior GI bleeding. Reassess the need for combined therapy if bleeding occurs.
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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