Drug interactions
Paroxetine + Warfarin
Severity: Moderate
Paroxetine 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
SSRIs impair platelet function and increase bleeding risk, especially gastrointestinal bleeding, when combined with warfarin. The risk exists even when the INR is stable.
What this interaction means in plain words
Paroxetine 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.
Paroxetine belongs to Central Nervous System; Warfarin belongs to Cardiovascular.
Why it happens
SSRI-mediated depletion of platelet serotonin impairs hemostasis, adding to warfarin anticoagulation; mild CYP2C9 effects may also contribute.
What to do
Monitor INR after initiation or dose changes and counsel on bleeding signs. 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 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 Paroxetine with Warfarin?
MediHelp rates the interaction as moderate. Paroxetine 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. SSRIs impair platelet function and increase bleeding risk, especially gastrointestinal bleeding, when combined with warfarin. The risk exists even when the INR is stable.
How serious is the interaction between Paroxetine 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 INR after initiation or dose changes and counsel on bleeding signs. 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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