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Dr. Andrew Rynne
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What are the repercussions of using Warfarin and Sertraline?

Answered by
Dr. Ilir Sharka


Practicing since :2001

Answered : 6905 Questions

Posted on Mon, 16 Jan 2017 in Hypertension and Heart Disease
Question: If I am monitoring my pt's INR very closely, is it safe to continue the pt's sertraline? He is in his 80's and has an indwelling Foley. I am a locum and picked this pt up with warfarin and sertraline already prescribed. He has a history of depression. INR is being monitored weekly at this time.

The pt is a male in his 80's.

The pt profile just has my name and age, as the section was not applicable.
Answered by Dr. Ilir Sharka 27 minutes later
Brief Answer:
I would recommend as follows:

Detailed Answer:

Welcome and thank you for asking on HCM!

Regarding your concern, I would explain that sertraline increases levels of warfarin by decreasing metabolism.

So, it increases the risk of bleeding.

In fact all the drugs of this class (SSRI), like escitalopram, citalopram, paroxetine, etc. interact with warfarin by increasing its plasma levels and thus the INR.

So, it is up to you to make a choice, knowing this possible interaction. But, I would not recommend switching to another drug of this class, because of the same interactions.

You may stop it, but it may affect the patients emotional state (sertraline is a very helpful drug against anxiety or depression).

You should discuss with the patient or his prescribing doctor on the above issues.

Anyway, if your decide to stop sertraline, I would recommend doing this gradually (half the dose for a week and than a quarter for another week until stopping). This is made in order to avoid possible aggravation of his symptoms.

Hope you will find this answer helpful!

Wishing all the best,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

The User accepted the expert's answer

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