duloxetine + warfarin

Duloxetine + warfarin is a combination of two pharmaceutical drugs. Duloxetine is a serotonin-norepinephrine reuptake inhibitor (SNRI) antidepressant, primarily inhibiting the reuptake of serotonin and norepinephrine, thereby increasing their availability in the synaptic cleft and improving mood and pain symptoms. Warfarin is a vitamin K antagonist anticoagulant that inhibits vitamin K-dependent synthesis of biologically active forms of clotting factors II, VII, IX, and X, reducing blood coagulation and risk of thrombosis. The combination is not marketed as a fixed-dose product, but these drugs are sometimes co-prescribed, for example, in patients requiring anticoagulation (e.g., for atrial fibrillation or venous thromboembolism) who also have depression or neuropathic pain. Coadministration can increase bleeding risk, likely due to duloxetine’s impairment of platelet function as well as pharmacodynamic interactions, but pharmacokinetic interaction is minimal. Careful monitoring of bleeding and INR is recommended during concomitant administration[1][2][4][5][6].

Brand names

Cymbalta + Coumadin

Other names

duloxetine hydrochloride + warfarin