Description

Aspirin combined with fluoxetine increases GI hemorrhage risk through synergistic platelet impairment and CYP2C9-mediated interactions.

Mechanism

Fluoxetine depletes platelet serotonin and inhibits COX-2 at higher concentrations; aspirin inhibits COX-1. Both reduce platelet aggregation through different but additive mechanisms.

Clinical Significance

Epidemiological studies document a 3- to 5-fold increase in upper GI bleed risk with combined antiplatelet + SSRI.

Management

Co-prescribe a PPI; counsel patients on GI bleeding signs; use the lowest effective dose of each agent.

Medical Disclaimer

This content is for educational and informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider before making medication decisions.

Data sources: ChEMBL, PubChem, DailyMed.