Moderate
Established
説明
The combination of aspirin and sertraline increases upper GI bleeding risk through synergistic antiplatelet and platelet serotonin depletion effects.
機序
Aspirin impairs COX-1–mediated platelet activation; sertraline depletes platelet serotonin stores, reducing platelet aggregation response. Both impair primary hemostasis.
臨床的意義
The absolute increase in GI bleed risk is approximately 3.6 per 1000 patient-years when SSRIs are added to aspirin, based on large cohort data.
対処法
Add a PPI; use the lowest effective doses; monitor for GI symptoms and frank bleeding, particularly in patients over 65 years.