Does Sertraline Interact With Xarelto? (3+ Safety Measures)

By Ivan Kahwa

Page last updated: 02/01/2024 | Next review date: 02/01/2026

Author bio

Mr Ivan Kahwa is a chemist and phytopharmaceutical scientist with expertise in chemistry, pharmacology, phytochemistry, and Nanobiotechnology. He writes and reviews content on these topics.

Mr Ivan Kahwa’s Highlights:

Guest Researcher at the University of Leipzig, Senior Research Fellow/Scientist, and Lecturer at the Department of Pharmacy, Faculty of Medicine, Mbarara University of Science and Technology.

Professional Experience:

Mr Ivan joined PHARMBIOTRAC as a research fellow/scientist during his master of science tenure. He contributed to the development of most of the phytopharmaceutical products in the project. Furthermore, he participated in carrying out the pharmacological activities of the developed products in laboratory animals such as mice and rats in order to develop proper doses hence leading to pre-clinical studies.

With the above relevant research experience, Ivan started to work with the University of Leipzig on collaborative projects with Mbarara University to develop the chemistry of Ugandan Medicinal plants and their pharmacological activities. This was coupled with several consultative positions by different German NGOs. Mr. Kahwa is also a supporting in the teaching and learning at the Departments of Pharmacy and Pharmaceutical Sciences, Faculty of Medicine, Mbarara University of Science and Technology.

With the increase in antimicrobial resistance globally, Ivan retooled his thinking towards developing new naturally derived antibiotic regimens from Ugandan propolis with the assistance of nanotechnology to improve their delivery to microbial cells. Kahwa has also published over 28 articles in peer-reviewed journals and he is currently reviewing for many journals.

Education:

2023-2027: PhD in Pharmaceutical Sciences (ongoing) with a focus on Pharmaceutical Microbiology and Nanobiology at Mbarara University of Science and Technology.

2022: 2Msc. in Pharmacognosy and Natural Medicine Science at Mbarara University of Science and Technology.

2018: Bachelor of Science (Chemistry) at Mbarara University of Science and Technology.

Publications:

▪ Iqbal, S., Jabeen, F., Kahwa, I., & Omara, T. 2023. Suberosin Alleviates Thiazolidinedione-Induced Cardiomyopathy in Diabetic Rats by Inhibiting Ferroptosis via Modulation of ACSL4-LPCAT3 and PI3K-AKT Signaling Pathways. Cardiovascular Toxicology. https://doi.org/10.1007/s12012-023-09804-7

▪ Gupta, A. K., Yadav, R., Sharma, S., Sawale, J., & Kahwa, I. 2023. Anti-ageing Activity and Antioxidant Activity of Methanol Extracts of Leaves and Flowers of Salvia officinalis and Rosmarinus officinalis. Journal of Young Pharmacists, 15(3), 448–455. https://doi.org/10.5530/jyp.2023.15.60

▪ Tolo, C.U., Kahwa, I., Nuwagira, U., Weisheit, A. and Ikiriza, H., 2023. Medicinal plants used in treatment of various diseases in the Rwenzori Region, Western Uganda. Ethnobotany Research and Applications, 25, pp.1-16.

https://ethnobotanyjournal.org/index.php/era/article/view/4683

▪ Kahwa, I., Ajayi, C.O., Yadav, R., Chauhan, N.S., Shah, K., Abdelgadir, A.A., Shegena, E.A., Daniel, S., Omara, T., Asiimwe, J.B. and Ikiriza, H., 2023. Pharmacognostic and phytochemical studies as an invaluable approach for correct identification of medicinal plants: The case of Artemisia vulgaris L. substituted for Artemisia annua L. in Western Uganda. TMR Integr Med, 7, p.e23004.

https://doi.org/10.53388/TMRIM202307004

▪ Nalimu, F., Oloro, J., Kahwa, I. and Ogwang, P.E., 2021. Review on the phytochemistry and toxicological profiles of Aloe vera and Aloe ferox. Future Journal of Pharmaceutical Sciences, 7, pp.1-21.

https://doi.org/10.1186/s43094-021-00296-2

▪ Elamin, O.H.S., Ali, M.A., Elgezuli, I.A.A., Bashir, M.A. and Kahwa, I., 2021. Diagnosis of pre-and post-treatment of echinococcus granulosus with counter current immune electrophoresis and bacterial co-agglutination. Journal of Microbiology and Infectious Diseases, 11(02), pp.88-94.

https://doi.org/10.5799/jmid.951600

Published book Chapter

▪ Kahwa, I., Ayesiga, I., Nakalema, S., Alinaiswe, R., Mbabazi, R. and Iqbal, S., 2023. Natural products in the management of onchocerciasis. In Natural Products in Vector-Borne Disease Management (pp. 63-80). Academic Press. Book Chapter.

https://doi.org/10.1016/B978-0-323-91942-5.00012-4

Submitted manuscripts Under Review:

▪ Comparison of the Wound Healing Activity of the Leaf and Leaf Ash Extracts of Vernonia amygdalina in Rats. Journal name: Clinical Phytoscience

▪ Ethnobotanical Survey of Medicinal plants used in the management of cancer in Uganda. Journal name: Journal of Herbal Medicine

▪ Ethnobotanical survey and phytochemical screening of medicinal plants used in treatment of epilepsy by PROMETRA-Uganda Traditional Health Practitioners in Mpigi District, Uganda. Journal name: Journal of Ethnopharmacology

Submitted book chapters under review

1.Book title: Algae as a Natural Solution for Water-Food-Energy Nexus, Section 4: Microalgae and cyanobacteria for food applications, Chapter 4.6: Safety, toxicological and allergenic aspects of using algae for food. Authors: Christine Kyarimpa, Tom Omute, Caroline K. Nakiguli, Alice V. Khanakwa4, Christopher Angiro, Ivan Kahwa, Fortunate Ahumuza, Timothy Omara*. Publisher: Springer Nature Singapore Pte Ltd. 152 Beach Road, #21-01/04 Gateway East, Singapore 189721, Singapore.

2.Book title: Nutraceuticals Inspiring the Contemporary Therapy for Lifestyle Diseases. Chapter: Nutraceutical applications of Seaweeds and their Phytocompounds in Nutrition and Treatment of Diseases. Authors: Ivan Kahwa, Timothy Omara , Innocent Ayesiga , Gael Noel Neh Neba Ambe , Zehbanaz Javidbhai Panwala , Rachel Mbabazi , Shabnoor Iqbal , Christine Kyarimpa , Christine Betty Nagawa , Kamal Shah ,Nagendra Singh Chauhan* Publisher: CRC Press

You can view my works on the following professional sites:

Research Gate: https://www.researchgate.net/profile/Ivan-Kahwa

Google Scholar: https://scholar.google.com/citations?user=tOwrvqoAAAAJ&hl=en

ORCID: https://orcid.org/0000-0002-6440-3437

Linkedin: https://de.linkedin.com/in/ivan-kahwa-865450159

Ivan Kahwa

View More north_east

In this article, we will discuss the interaction between Sertraline and Xarelto, along with the risks associated with concurrently taking these medications. This article will also include some of the safety measures that can be observed to prevent possible complications.

Does Sertraline interact with Xarelto?

Yes, Sertraline (Zoloft) can interact with Xarelto (Rivaroxaban). Although indicated for treating different health conditions, the interaction of these medications may cause certain risks and potential complications.

What is the interaction between Sertraline and Xarelto?

The interaction between Sertraline and Xarelto is the increased risk of bleeding. When used individually, both medications can be well tolerated. However, using these two together can cause some severe side effects (1).

Xarelto is a blood thinner which works by inhibiting the blood’s ability to clot easily, thereby preventing the formation of blood clots (2). Sertraline, on the other hand, is an antidepressant used to treat various mental health conditions, such as depression and anxiety, by increasing serotonin in the brain which can help improve mood and reduce symptoms of the said conditions (3).

Despite being used as an antidepressant, Sertraline can cause thinning of blood by inhibiting the clumping of the platelets (4), which is a vital process for blood clotting.

Due to this, the use of Sertraline, along with other antidepressants including Fluoxetine, Paroxetine, and Fluvoxamine, is generally avoided when taking Xarelto.

In some cases, your healthcare provider will prescribe and recommend the use of these medications together only if it is beneficial for your condition despite the risk that it imposes.

What to do if you’re bleeding while on Sertraline and Xarelto?

If you experience unusual bleeding, such as nosebleeds, vomiting of blood, and heavy menstrual flow (6), you should get in touch with your doctor immediately.

The degree of severity may differ for each person, your doctor will assess you and will observe safety measures that can be applied to manage your condition.

What to do if you have taken Sertraline and Xarelto together?

If you have taken Sertraline and Xarelto together, you should immediately contact your healthcare provider. Upon consultation, the following precautions and safety measures may be observed and recommended by your physician:

Dosage Adjustment. Your physician may need to adjust the dose of either of these medications to prevent or minimize the risk of bleeding while ensuring that both conditions being treated are appropriately managed.

Adjustment of Dosing Schedule. To reduce the risk of bleeding, your healthcare provider may recommend that you take these medications at a different time of day.

Regular Monitoring. Close monitoring of your symptoms through regular check-ups and laboratory tests may be performed by your physician to assess the safety and effectiveness of the medication treatment.

Adherence to Medication Regimen. Make sure to take your medications as prescribed by your healthcare provider – do not skip doses or make any adjustments to your regimen without consulting them.

What are the alternatives to Sertraline when taking Xarelto?

To avoid the risk of the interaction between Sertraline and Xarelto, your healthcare provider may consider the use of other antidepressants such as Citalopram, Venlafaxine, and Mirtazapine that have less interaction and are deemed safer (5).

However, make sure you do not make any changes to your prescription without talking to your doctor first.

Conclusion

This article discussed the drug interaction between Sertraline and Xarelto – how taking these two medications concomitantly can impose an increased risk of bleeding.

Precautions and safety measures that can be employed to ensure the safety of the medication therapy were also stated, as well as the alternative antidepressants that can be considered to lessen the risk of bleeding.

It is important to assess both the benefits and risks of taking these medications simultaneously – always consult your healthcare provider regarding the medications that you are taking to prevent further health complications.

Was this helpful?

Thanks for your feedback!

References

1.-

Bruni-Montero MÁ, Caro-Teller JM, Hernández-Ramos JA, Rosas-Espinoza C, Canales-Siguero D, Ferrari-Piquero JM. Rivaroxaban and selective serotonin reuptake inhibitors: Bleeding risk resulting from their concomitant use. Farm Hosp [Internet]. 2021 December 1 [cited 2023 October 4]; 46 (1): 10-14. Available from: https://pubmed.ncbi.nlm.nih.gov/35379086/

2.-

Medline Plus. Rivaroxaban: MedlinePlus drug information [Internet]. Bethesda (MD): National Library of Medicine (US); [updated 2023 April 15; cited 2023 October 4]. Available from: https://medlineplus.gov/druginfo/meds/a611049.html

3.-

Medline Plus. Sertraline: MedlinePlus drug information [Internet]. Bethesda (MD): National Library of Medicine (US); [updated 2022 January 15; cited 2023 October 4]. Available from: https://medlineplus.gov/druginfo/meds/a697048.html

4.-

Eslami Shahrbabki M, Eslami Shahrbabaki A. Sertraline-Related Bleeding Tendency: Could It Be Dose-Dependent? Iran J Psychiatry Behav Sci [Internet]. 2014 [cited 2023 October 4]; 8 (3):81-3. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4359729/

5.-

Aguilar C. Treatment of Depression in Patients on Anticoagulation Therapy: Antidepressant-Rivaroxaban Drug Interactions. Drug Metab Toxicol [Internet]. 2016 October 15 [cited 2023 October 4]; 7: 215. Available from: https://doi.org/10.4172/2157-7609.1000215

6.-

1. Halperin D, Reber G. Influence of antidepressants on hemostasis. Dialogues Clin Neurosci [Internet]. 2007 March [cited 2023 October 4]; 9 (1): 47-59. Available from: https://doi.org/10.31887/DCNS.2007.9.1/dhalperin

Pharmaceuticals and Medications

Diseases & Conditions

Does Sertraline interact with Xarelto? (3+ safety measures)