Moderate
Acetylsalicylic acid × venlafaxine
Antiplatelet agents (low dose) / NSAIDs (analgesic dose)×SNRI (serotonin-norepinephrine reuptake inhibitor)
Mechanism
Venlafaxine (SNRI) depletes the platelet serotonin pool, impairing primary haemostasis. With aspirin: additive GI bleeding risk.
Symptoms
Gum bleeding, epistaxis, bruising without trauma, black or tarry stools. Severe cases: GI bleeding.
Management
The combination is acceptable at low aspirin doses (75–100 mg). PPI cover with pantoprazole is mandatory. Alternative antidepressants with minimal platelet effect: 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.