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SSRI choice with clopidogrel — GPhC CRA MCQ

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HardCNS TherapeuticsSSRI choice with clopidogrelGPhC CRA

A 58-year-old woman taking clopidogrel 75mg daily after stroke is prescribed fluoxetine 20mg daily for depression. She previously had a GI bleed and is not taking gastroprotection. The GP asks the pharmacy to check suitability. What is the most appropriate alternative?

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Correct answer: A — Consider an antidepressant with lower interaction concern and assess gastroprotection need

Fluoxetine can inhibit CYP2C19 and may reduce clopidogrel activation, and SSRIs can also increase bleeding risk. Previous GI bleeding increases the need for careful selection and gastroprotection review. The pharmacist should contact the prescriber about a safer antidepressant choice.

Reference: BNF; NICE CKS