Описание
Sertraline can modestly increase warfarin anticoagulation through weak CYP2C9 inhibition combined with SSRI-mediated platelet serotonin depletion.
Механизм
Sertraline weakly inhibits CYP2C9, mildly increasing S-warfarin exposure; serotonin depletion in platelets reduces aggregation response, adding a pharmacodynamic component.
Клиническое значение
INR elevations are typically <20%; however, the platelet effect increases bleeding risk even within the therapeutic INR range.
Тактика ведения
Monitor INR when starting or stopping sertraline; educate patients about signs of bleeding. Use caution with other bleeding risk factors.
Медицинский отказ от ответственности
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.