Why the study?
Does the concomitant use of antidepressants alter the anticoagulant activity of warfarin in patients with cardiovascular problems and depression?
Does the concomitant use of antidepressants alter the anticoagulant activity of warfarin in patients with cardiovascular problems and depression?
Paroxetine, venlafaxine, fluoxetine, and duloxetine have relevant drug interactions with warfarin, which may alter anticoagulant activity and pose risks to patients.
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May warrant closer INR monitoring with these antidepressants in warfarin users; leaves open quantification of bleeding risk in prospective studies.
Oral anticoagulants are among the drugs with the greatest number of drug interactions. The concomitant use of several medications is a common practice in patients with cardiovascular problems, who often also present with depression; therefore, the probability of an interaction occurring between warfarin and the antidepressants is high, and may result in increased or decreased anticoagulant activity. Since the possible interactions between these two classes of drugs have been poorly explored in literature, with a risk to the patients who use them, we reviewed the pharmacology of warfarin and its possible interactions with antidepressants. Of the antidepressants analyzed, those that showed relevant effects on the interaction with warfarin were, in decreasing order: paroxetine, venlafaxine, fluoxetine, and duloxetine.
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Teles et al. (2012) studied this question.
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