Drug interactions
Escitalopram + Warfarin
Severity: Moderate
Escitalopram 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
Escitalopram combined with warfarin increases the risk of bleeding, especially gastrointestinal bleeding, even when the INR is stable. The risk is greater in older patients and those also taking antiplatelet drugs or NSAIDs.
What this interaction means in plain words
Escitalopram 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.
Escitalopram belongs to Central Nervous System; Warfarin belongs to Cardiovascular.
Why it happens
SSRIs deplete platelet serotonin and impair platelet aggregation, adding to warfarin's anticoagulant effect; there is minimal CYP2C9 inhibition by escitalopram.
What to do
Monitor for bleeding signs and check INR when starting or stopping escitalopram. Avoid additional NSAIDs or antiplatelets and 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 Escitalopram
- Cisapride + Escitalopram Contraindicated
- Citalopram + Escitalopram Contraindicated
- Escitalopram + Isocarboxazid Contraindicated
- Escitalopram + Methylene blue Contraindicated
- Escitalopram + Phenelzine Contraindicated
- Escitalopram + Pimozide Contraindicated
Frequently asked questions
Can I take Escitalopram with Warfarin?
MediHelp rates the interaction as moderate. Escitalopram 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. Escitalopram combined with warfarin increases the risk of bleeding, especially gastrointestinal bleeding, even when the INR is stable. The risk is greater in older patients and those also taking antiplatelet drugs or NSAIDs.
How serious is the interaction between Escitalopram 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 signs and check INR when starting or stopping escitalopram. Avoid additional NSAIDs or antiplatelets and 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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