Drug General Information (ID: DDIOZJ4G09)
Drug Name			Sibutramine		Drug Info		Danaparoid		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Appetite Depressants				Anticoagulants

Mechanism of Sibutramine-Danaparoid Interaction (Severity Level: Moderate)
Increased risk of bleeding Click to Show/Hide Mechanism Graph
Drug Name		Sibutramine				Danaparoid
Mechanism		Risk of bleeding Antiplatelet effects				Risk of bleeding Anticoagulant
Key Mechanism Factor 1
		Factor Name		Bleeding
		Factor Description		Patients may be at risk for bleeding when the outcome of a disease or disease treatment confounds the standard mechanisms for maintaining hemostasis. Signs or symptoms of abnormal bleeding include: bleeding that takes a long time to stop (including nosebleeds, bleeding gums, bleeding from cuts and abrasions, and menstrual bleeding); severe unexplained bruising, or bruising that becomes larger; blood in the urine or stool, etc.
Mechanism Description		Increased risk of bleeding by the combination of Sibutramine and Danaparoid

Recommended Action
Management		Caution is recommended if a serotonin reuptake inhibitor is administered with heparin therapy, especially in the elderly and patients with renal impairment. Patients should be advised to promptly report any signs of bleeding to their physician, including pain, swelling, headache, dizziness, weakness, prolonged bleeding from cuts, increased menstrual flow, vaginal bleeding, nosebleeds, bleeding of gums from brushing, unusual bleeding or bruising, red or brown urine, or red or black stools.

References
1	Pai VB, Kelly MW "Bruising associated with the use of fluoxetine." Ann Pharmacother 30 (1996): 786-8. [PMID: 8826562]
2	Product Information. Paxil (paroxetine). GlaxoSmithKline, Research Triangle Park, NC.
3	Product Information. Prozac (fluoxetine). Dista Products Company, Indianapolis, IN.