Management of Sertraline and Warfarin Combination Therapy

Monitoring and Safety Precautions

• The American Academy of Family Physicians recommends monitoring INR at least weekly during the first 6 weeks when initiating or discontinuing sertraline in warfarin-treated patients, as peak interaction effects may take several weeks to manifest 1, 2
• Continue regular INR monitoring beyond 6 weeks, though frequency can be reduced if stable, and assess for signs of bleeding at every clinical encounter, according to the American Heart Association, as published in Circulation 3, 4
• Patients taking this combination should immediately report unusual bruising or bleeding, blood in urine or stool, prolonged bleeding from cuts, as advised by the American Academy of Family Physicians 3