Inter have rested Diego Milito despite the injury crisis, returning to a 4-2-3-1 system in Lecce with Coutinho in the Wesley Sneijder role.
The Nerazzurri are missing a host of players for this match at the Stadio Via del Mare, including Sneijder, Esteban Cambiasso, Douglas Maicon, Julio Cesar, Sulley Muntari, MacDonald Mariga, Walter Samuel and David Suazo.
Dejan Stankovic is back in the squad, but only fit for the bench, where he is joined by Milito.
Rafa Benitez has opted to go back to the 4-2-3-1 system with Samuel Eto'o as lone striker, but Coutinho moves into a more central role to replace Sneijder, who has been diagnosed with anaemia.
It gives Joel Obi a rare start in midfield with Javier Zanetti, while Davide Santon and Ivan Cordoba fill the defensive gaps.
Lecce are going for David Di Michele and Jeda with Ruben Olivera returning from suspension to start in a wider position.
Lecce: Rosati; Rispoli, Gustavo, Giuliatto, Brivio; Olivera, Vives, Giacomazzi, Mesbah; Jeda, Di Michele
Inter: Castellazzi; Santon, Lucio, Cordoba, Chivu; Zanetti, Obi; Biabiany, Coutinho, Pandev; Eto'o