Sertraline and Lornoxicam: 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 recordLornoxicam
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.
You've been prescribed sertraline (an antidepressant) and lornoxicam (an anti-inflammatory pain reliever, similar to ibuprofen). Taken together, these two can raise your risk of bleeding. Here's why: sertraline lowers the amount of serotonin in your platelets, which are the cells that help your blood clot. Lornoxicam can also irritate the stomach lining. Put together, that means a higher chance of things like nosebleeds, easy bruising, or bleeding in the stomach.
This is manageable. Watch for warning signs like black or bloody stools, vomit that looks like coffee grounds, or unusual bruising, and let your pharmacist or doctor know you take both so they can keep an eye on you.
Effect: Additive bleeding risk (GI and intracranial hemorrhage) with concurrent SSRI and NSAID use.
Mechanism: Sertraline depletes platelet serotonin, impairing platelet aggregation; lornoxicam adds antiplatelet/COX-mediated GI mucosal injury. Pharmacodynamic, additive; neither is a relevant prodrug here.
Evidence: Established. Severity: Major. Onset unspecified.
Management:
- Monitor for GI bleeding, epistaxis, ecchymosis, petechiae; heightened vigilance in elderly and those with prior GI ulcers.
- Consider acetaminophen as an alternative analgesic.
- Consider an antidepressant with less serotonergic reuptake inhibition.
- Consider gastroprotection (eg, PPI/antiulcer prophylaxis).
What happens
An increased risk of bleeding
Interaction Deep Dive
Exercise caution when NSAIDs and antidepressants, SSRIs among them, are used together, given the heightened likelihood of intracranial hemorrhage1 and gastrointestinal (GI) bleeding 6. Reported bleeding manifestations have ranged from epistaxis, ecchymosis, hematoma, and petechiae to hemorrhages that are life-threatening 5. If an SSRI is administered alongside an NSAID, monitor the patient carefully for indications of adverse events such as GI bleeds, with particular attention to elderly patients and those with prior GI ulcers. Options to consider include alternative pain management approaches (for example, acetaminophen), reassessment of the selected antidepressant (that is, favoring agents with weaker serotonin reuptake inhibition), or prophylactic use of 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 care team tells you otherwise. This combination is commonly managed with a few practical steps.
- Your team may monitor you more closely for signs of bleeding, especially if you are older or have had stomach ulcers.
- They may consider a different pain option (such as acetaminophen), review your antidepressant choice, or add a stomach-protecting medicine.
- Watch for and report black/tarry stools, blood in vomit or stool, frequent nosebleeds, or unusual bruising.
Bring this up with your pharmacist or prescriber so they can tailor the plan to you.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
4 reports — tap to read
a) Taking NSAIDs together with antidepressants, such as tricyclic antidepressants, SSRIs, serotonin-norepinephrine reuptake inhibitors, and MAOIs, produced a 60% higher risk of intracranial hemorrhage during the first 30 days of combined use when compared with using an antidepressant by itself. No meaningful difference in the elevated risk was seen across the antidepressant drug classes; nevertheless, male patients showed an increased risk 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 to hospital for upper GI bleeding were examined among 26,005 people taking antidepressant drugs and set against 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. Concurrent use of SSRIs with NSAIDs or low-dose aspirin raised the risk still further 5.
c) Two metaanalyses examining upper GI bleed events attributable to SSRIs, NSAIDs, and their combination found 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) Serotonin released by platelets plays an important 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 Lornoxicam together?
Combining sertraline and lornoxicam raises the risk of bleeding, especially in the stomach. Keep taking both as prescribed, watch for bleeding signs, and ask your pharmacist or doctor about the best plan for you. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Sertraline and Lornoxicam 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 Lornoxicam interaction managed?
Keep taking both as prescribed unless your care team tells you otherwise. This combination is commonly managed with a few practical steps. Your team may monitor you more closely for signs of bleeding, especially if you are older or have had stomach ulcers. They may consider a different pain option (such as acetaminophen), review your antidepressant choice, or add a stomach-protecting medicine. Wat… 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 Lornoxicam 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 Lornoxicam
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
Check another combination
Our instant two-drug interaction checker is almost here.
Still have questions about this combination?
Every question gets a real answer from a licensed pharmacist — free, and usually within a day.
Ask the pharmacist