Sertraline and Felbinac: Interaction Details
AI-assisted, pharmacist-reviewed · AI content regenerated Jul 11, 2026 · Source data updated Jul 2, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Sertraline
No brand names on recordFelbinac
No brand names on record
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
Taking sertraline with felbinac can raise your risk of bleeding. Sertraline is an antidepressant (an SSRI). One thing it does is make your platelets, the cells that help blood clot, a little less sticky. Felbinac is an anti-inflammatory pain medicine (an NSAID), and NSAIDs can irritate the stomach lining and also affect clotting. Put them together and the effect adds up.
Watch for things like easy bruising, nosebleeds, or black or bloody stools. This risk is higher if you are older or have had stomach ulcers. The good news: your care team can manage this by monitoring you and adjusting your plan. Don't stop either medicine on your own, just talk with your pharmacist or doctor.
Effect: Additive increased bleeding risk (GI bleeding, intracranial hemorrhage, epistaxis, ecchymosis, petechiae).
Mechanism: Sertraline (SSRI) depletes platelet serotonin, impairing serotonin-mediated platelet aggregation; felbinac (NSAID) inhibits platelet COX and causes GI mucosal injury. This is pharmacodynamic and additive, not a metabolic/prodrug interaction.
- Severity: Major; evidence: established; onset: unspecified.
- Management: Monitor for bleeding, especially in elderly patients and those with prior peptic ulcer disease. Consider acetaminophen for analgesia, an antidepressant with weaker serotonin reuptake inhibition, or gastroprotection (PPI/antiulcer prophylaxis) if the combination is continued.
What happens
An increased risk of bleeding
Interaction Deep Dive
Combining NSAIDs with antidepressants, SSRIs among them, warrants caution because it raises the likelihood of intracranial hemorrhage1 as well as gastrointestinal (GI) bleeding 6. Reported bleeding manifestations have encompassed epistaxis, ecchymosis, hematoma, petechiae, and hemorrhages that are life-threatening 5. In patients receiving both an SSRI and an NSAID at the same time, watch carefully for indications of adverse effects such as GI bleeds, with particular attention to the elderly and individuals who have previously had GI ulcers. Options to consider include alternative approaches to pain control (for example, acetaminophen), reassessing the selected antidepressant (that is, favoring agents with reduced serotonin reuptake inhibition), or providing prophylactic antiulcer medications 4.
Why it happens (mechanism)
Depletion of platelet serotonin by SSRI; additive effects on hemostasis
How to manage this interaction
Keep taking both as prescribed unless your prescriber tells you otherwise. This combination is manageable when your care team knows you are on both.
- Watch for bleeding: unusual bruising, nosebleeds, bleeding gums, or black/tarry or bloody stools. Report these promptly.
- Extra caution applies if you are older or have a history of stomach ulcers.
- Your team may monitor you more closely, and options they might discuss include a different pain reliever (such as acetaminophen), an antidepressant with less serotonin effect, or a stomach-protecting medicine.
Ask your pharmacist or doctor which approach fits you best before making any change.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
4 reports — tap to read
a) Taking NSAIDs together with antidepressants, including tricyclic antidepressants, SSRIs, serotonin-norepinephrine reuptake inhibitors, and MAOIs, produced a 60% higher risk of intracranial hemorrhage within 30 days of combined use when compared with using an antidepressant on its own. No significant variation was observed among the antidepressant drug classes with respect to this elevated risk; nevertheless, an increased risk was seen in male patients relative to female patients 1.
b) SSRIs raise the likelihood of upper gastrointestinal (GI) bleeding, and this effect is amplified when NSAIDs or low-dose aspirin are used at the same time. Admissions for upper GI bleeding were examined among 26,005 individuals taking antidepressant medications and compared with the number of admissions among patients who were not prescribed antidepressants. The number of upper GI bleeding events was 3.6 times greater than anticipated. Using an SSRI together with NSAIDs or low-dose aspirin raised the risk to 12.2 and 5.2 times, respectively. The results of this study show a heightened risk of upper GI bleeding while SSRIs are being used. Combining SSRIs with NSAIDs or low-dose aspirin increased the risk still more 5.
c) Two metaanalyses of upper GI bleed events attributed to SSRIs, NSAIDs, and their combination determined that SSRIs raised the risk by 1.73 6 to 2.36 times 7, NSAIDs by 2.55 times 6, and the combination of SSRIs and NSAIDs by 4.02 6 to 6.33 times 7.
d) The release of serotonin from platelets plays a key role in preserving hemostasis. Case-control and cohort studies have demonstrated that using SSRIs and NSAIDs together has been linked to a greater risk of bleeding 8.
Common questions
Can I take Sertraline and Felbinac together?
Sertraline and felbinac together add up to raise bleeding risk, especially in the stomach. Keep taking both as prescribed, watch for signs of bleeding, and talk with your pharmacist or doctor about the safest pain-relief plan. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Sertraline and Felbinac interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How is the Sertraline and Felbinac interaction managed?
Keep taking both as prescribed unless your prescriber tells you otherwise. This combination is manageable when your care team knows you are on both. Watch for bleeding: unusual bruising, nosebleeds, bleeding gums, or black/tarry or bloody stools. Report these promptly. Extra caution applies if you are older or have a history of stomach ulcers. Your team may monitor you more closely, and options th… Management is individual — always follow your own care team's guidance.
How strong is the evidence for this interaction?
The evidence is graded "established". Well documented — supported by controlled studies or strong clinical data.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Sertraline or Felbinac need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (8)
- Shin JY, Park MJ, Lee SH, et al: Risk of intracranial haemorrhage in antidepressant users with concurrent use of non-steroidal anti-inflammatory drugs: nationwide propensity score matched study. BMJ 2015; 351:h3517. PubMed
- Product Information: VIMOVO(TM) delayed release oral tablets, naproxen and esomeprazole magnesium delayed release oral tablets. AstraZeneca LPW, Wilmington, DE, 2010. DailyMed
- Product Information: SPRIX(TM) nasal spray, ketorolac tromethamine nasal spray. Roxro Pharma, Inc, Menlo Park, CA, 2009. DailyMed
- Mort JR, Aparasu RR, & Baer RK: Interaction between selective serotonin reuptake inhibitors and nonsteroidal antiinflammatory drugs: review of the literature. Pharmacotherapy 2006; 26(9):1307-1313. PubMed
- Dalton S, Johansen C, Mellemkjoer L, et al: Use of selective serotonin reuptake inhibitors and risk of upper gastrointestinal tract bleeding. Arch Intern Med 2003; 163:59-64. DOI
- Oka Y, Okamoto K, Kawashita N, et al: Meta-analysis of the risk of upper gastrointestinal hemorrhage with combination therapy of selective serotonin reuptake inhibitors and non-steroidal anti-inflammatory drugs. Biol Pharm Bull 2014; 37(6):947-953. PubMed
- Loke YK, Trivedi AN, & Singh S: Meta-analysis: gastrointestinal bleeding due to interaction between selective serotonin uptake inhibitors and non-steroidal anti-inflammatory drugs. Aliment Pharmacol Ther 2008; 27(1):31-40. PubMed
- Product Information: CELEXA(R) oral tablets, citalopram oral tablets. Allergan USA Inc (per FDA), Madison, NJ, 2023. DailyMed
Keep reading about Sertraline
Keep reading about Felbinac
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