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Malonyl CoA is an important substance required in fatty acid metabolism, and cytoplasmic malonyl CoA can regulate the balance of fatty acid synthesis and oxidation by inhibiting carnitine palmitoyltransferase I (CPT1)

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The concomitant use of acid-suppressive agents reduces the risk of UGIB.[] A case series analysis that included data from 7 population-based health care databases and data of 114,835 patients with UGIB with information of 930,888 person-years of follow-up reported that the relative risk of UGIB was 2.06 (95% CI: 1.942.18) with SSRI monotherapy, 4.60 (95% CI: 4.095.17) with a combination of SSRIs and low-dose aspirin, and 6.95 (95% CI: 5.97-8.08) with a combination of SSRIs and NSAIDs.[] Increased risk of UGIB with concomitant use of warfarin has also been reported.[] In terms of number needed to harm (NNH), some of the authors have estimated that for one patient to develop UGIB with SSRIs, 791 patients need to be exposed to SSRIs

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