Moderate
Acetylsalicylic acid × citalopram
Antiplatelet agents (low dose) / NSAIDs (analgesic dose)×SSRI (selective serotonin reuptake inhibitor)
Mechanism
Similar to ASA + fluvoxamine. SSRI-induced platelet dysfunction plus aspirin's antiplatelet effect – bleeding risk.
Symptoms
Gum bleeding, epistaxis, bruising without trauma. Severe cases: GI bleeding.
Management
The combination is acceptable at low aspirin doses (75–100 mg). PPI cover with pantoprazole is mandatory. Alternative antidepressants: mirtazapine or agomelatine.
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.