Sertraline and Lumiracoxib: 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 recordLumiracoxib
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 lumiracoxib can raise your risk of bleeding. Sertraline is an antidepressant that lowers the amount of serotonin your platelets use to help form clots. Lumiracoxib is an anti-inflammatory pain reliever (an NSAID) that can irritate the stomach lining. Put together, they make bleeding a bit more likely, especially in the stomach or gut.
Watch for warning signs like black or tarry stools, throwing up blood, easy bruising, or nosebleeds that won't stop. Don't stop either medicine on your own. Your pharmacist or doctor can manage this well by watching you more closely, adjusting things, or suggesting a gentler pain option.
Effect: Additive increased bleeding risk (GI and, rarely, intracranial hemorrhage).
Mechanism: Sertraline (SSRI) depletes platelet serotonin, impairing platelet aggregation; lumiracoxib (COX-2 selective NSAID) contributes additive effects on hemostasis and GI mucosal injury. Neither is a prodrug in a way that alters this PD interaction.
Evidence: Established. Onset: unspecified.
- Monitor for GI bleed, bruising, epistaxis, especially in elderly or those with prior peptic ulcer disease.
- Consider acetaminophen for pain, an antidepressant with less serotonin reuptake inhibition, or gastroprotection (PPI/antiulcer prophylaxis).
What happens
An increased risk of bleeding
Interaction Deep Dive
Exercise caution when NSAIDs and antidepressants, SSRIs among them, are taken together, since this combination raises the likelihood of intracranial hemorrhage1 as well as gastrointestinal (GI) bleeding 6. Reported bleeding manifestations have ranged from epistaxis, ecchymosis, hematoma, and petechiae to hemorrhages that are life-threatening 5. If a patient receives both an SSRI and an NSAID at the same time, watch carefully for indications of adverse events such as GI bleeds, particularly among elderly individuals and those who have previously had GI ulcers. Options to consider include alternative approaches to pain control (for example, acetaminophen), reassessing the selected antidepressant (that is, opting for agents with weaker 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 medicines as prescribed unless your care team tells you otherwise. This combination is manageable with the right precautions.
Your care team may:
- Monitor you more closely for bleeding, especially if you are older or have had stomach ulcers.
- Consider a gentler pain option such as acetaminophen.
- Review whether a different antidepressant with less serotonin effect could work.
- Add a stomach-protecting medicine (antiulcer prophylaxis).
Tell your pharmacist or doctor right away if you notice black or bloody stools, vomit that looks like coffee grounds, unusual bruising, or nosebleeds that won't stop.
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 within 30 days of combined use when compared with the use of an antidepressant by itself. No meaningful difference in this elevated risk was observed among the various antidepressant drug classes; however, male patients carried a higher risk than female patients 1.
b) SSRIs raise the risk of upper gastrointestinal (GI) bleeding, and this effect is amplified when NSAIDs or low-dose aspirin are used at the same time. Hospitalizations for upper GI bleeding were examined among 26,005 users of antidepressant medications and compared with the number of hospitalizations in patients who were not prescribed antidepressants. The number of upper GI bleeding episodes 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 an elevated risk of upper GI bleeding during SSRI use. Combining SSRIs with NSAIDs or low-dose aspirin raised the risk still further 5.
c) Two metaanalyses examining occurrences of upper GI bleed related 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 maintaining hemostasis. Case-control and cohort studies have demonstrated that using SSRIs together with NSAIDs has been linked to a higher risk of bleeding 8.
Common questions
Can I take Sertraline and Lumiracoxib together?
Combining sertraline and lumiracoxib raises your bleeding risk, especially in the stomach and gut, so watch for bleeding signs and let your care team monitor you or adjust your pain or antidepressant plan. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Sertraline and Lumiracoxib 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 Lumiracoxib interaction managed?
Keep taking both medicines as prescribed unless your care team tells you otherwise. This combination is manageable with the right precautions. Your care team may: Monitor you more closely for bleeding, especially if you are older or have had stomach ulcers. Consider a gentler pain option such as acetaminophen. Review whether a different antidepressant with less serotonin effect could work. Add a s… 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 Lumiracoxib 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
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