2 Sep 2010
Interactions between your selected drugs
diclofenac ↔ citalopram
Applies to: Zipsor (diclofenac), Celexa (citalopram)
MONITOR: Serotonin reuptake inhibitors (SRIs) may potentiate the risk of bleeding in patients treated with ulcerogenic agents and agents that affect hemostasis such as anticoagulants, platelet inhibitors, thrombin inhibitors, thrombolytic agents, or agents that commonly cause thrombocytopenia. The tricyclic antidepressant, clomipramine, is also a strong SRI and may interact similarly. Serotonin release by platelets plays an important role in hemostasis, thus SRIs may alter platelet function and induce bleeding. Published case reports have documented the occurrence of bleeding episodes in patients treated with psychotropic agents that interfere with serotonin reuptake. Additional epidemiological studies have confirmed the association between use of these agents and the occurrence of upper gastrointestinal bleeding, and concurrent use of NSAIDs or aspirin was found to potentiate the risk. Preliminary data also suggest that there may be a pharmacodynamic interaction between SSRIs and oral anticoagulants that can cause an increased bleeding diathesis. Concomitant administration of paroxetine and warfarin, specifically, has been associated with an increased frequency of bleeding without apparent changes in the disposition of either drug or changes in the prothrombin time. Bleeding has also been reported with fluoxetine and warfarin, while citalopram and sertraline have been reported to prolong the prothrombin time of patients taking warfarin by about 5% to 8%.
MANAGEMENT: Caution is advised if SRIs or clomipramine are used in combination with other drugs that affect hemostasis. Close clinical and laboratory observation for hematologic complications is recommended. Patients should be advised to promptly report any signs of bleeding to their physician, including pain, swelling, headache, dizziness, weakness, prolonged bleeding from cuts, increased menstrual flow, vaginal bleeding, nosebleeds, bleeding of gums from brushing, unusual bleeding or bruising, red or brown urine, or red or black stools.
Other drugs that your selected drugs interact with
Celexa (citalopram) interacts with more than 300 other drugs.
Zipsor (diclofenac) interacts with more than 200 other drugs.
Interactions between your selected drugs and food
No results found - however, this does not necessarily mean no interactions exist. ALWAYS consult with your doctor or pharmacist.
- Zipsor Information for Consumers
- Zipsor Information for Healthcare Professionals (includes dosage details)
- Side Effects of Zipsor (detailed)
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1 answer • 18 Feb 2010
I have bronchitis which I am almost over, but not I have doubke ear infections, and a throbbing head. Doc gave me 250mg Keflex and 25mg Zipsor. Are ...
1 answer • 6 Mar 2010
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1 answer • 29 Jun 2013
I am undergoing hip replacement surgery in one week and would like to know if it is ok to continue to take both Rxs right up to the day of surgery?
1 answer • 19 Aug 2013
1 answer • 20 Sep 2013