Drug-induced Bleeding

Johnathan W. Hamrick, PharmD; Diane Nykamp, PharmD


US Pharmacist. 2015;40(12):17-21. 

In This Article

Drugs That Increase Bleeding Risk

Certain drug classes are known to increase the risk of bleeding (Table 1).[1–3] Of interest are drugs used in the treatment of depression. Selective serotonin reuptake inhibitors and selective norepinephrine reuptake inhibitors are reported to inhibit the reuptake of serotonin into platelets, resulting in an increased risk of bleeding.[4] These agents may have additive effects when taken concomitantly with other drugs known to cause bleeding. Fluoxetine and fluvoxamine pose additional risks since they inhibit warfarin metabolism by CYP450 enzymes.[4] Bupropion, mirtazapine, and trazodone may be less likely to cause bleeding because they have weak affinity for the serotonin transporter.[5]