Drug interactions
Escitalopram + Tolfenamic acid
Severity: Moderate
Escitalopram and Tolfenamic acid: 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
SSRIs impair platelet serotonin uptake and NSAIDs inhibit platelet function and damage gastric mucosa, so together they raise the risk of gastrointestinal bleeding. The risk is greater in older patients and those with a history of ulcers or on anticoagulants.
What this interaction means in plain words
Escitalopram and Tolfenamic acid 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.
Escitalopram belongs to Central Nervous System; Tolfenamic acid belongs to Musculoskeletal.
Why it happens
Additive impairment of platelet aggregation combined with NSAID-induced mucosal injury.
What to do
Avoid the combination where possible, or use the shortest NSAID course and consider gastroprotection with a proton pump inhibitor. Counsel patients to report black stools or abdominal pain.
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 Escitalopram
- Cisapride + Escitalopram Contraindicated
- Citalopram + Escitalopram Contraindicated
- Escitalopram + Isocarboxazid Contraindicated
- Escitalopram + Methylene blue Contraindicated
- Escitalopram + Phenelzine Contraindicated
- Escitalopram + Pimozide Contraindicated
Other interactions of Tolfenamic acid
Frequently asked questions
Can I take Escitalopram with Tolfenamic acid?
MediHelp rates the interaction as moderate. Escitalopram and Tolfenamic acid 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. SSRIs impair platelet serotonin uptake and NSAIDs inhibit platelet function and damage gastric mucosa, so together they raise the risk of gastrointestinal bleeding. The risk is greater in older patients and those with a history of ulcers or on anticoagulants.
How serious is the interaction between Escitalopram and Tolfenamic acid?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination where possible, or use the shortest NSAID course and consider gastroprotection with a proton pump inhibitor. Counsel patients to report black stools or abdominal pain.
What other medicines interact with Escitalopram?
MediHelp also lists interactions of Escitalopram with, for example, Cisapride, Citalopram, Isocarboxazid. The full list is on the Escitalopram page.
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