Moderate
Established
説明
Naproxen combined with sertraline increases the risk of upper GI bleeding through complementary impairment of platelet function and gastric mucosal defense.
機序
Sertraline depletes platelet serotonin stores, reducing aggregation; naproxen inhibits COX-1 and damages gastric mucosa. The combination amplifies GI hemorrhagic risk.
臨床的意義
Epidemiological studies show a 12–15-fold increase in upper GI bleed risk with NSAID + SSRI combined.
対処法
Co-prescribe a PPI; prefer acetaminophen over NSAIDs in patients on SSRIs; educate patient about GI bleeding warning signs.