Drugs That Interfere With Ticagrelor

More Information on Ticagrelor Drug Interactions

The following sections explain in detail the potentially negative interactions that can occur when ticagrelor is combined with any of the drugs listed above.
 
Certain Statins
Ticagrelor can slow the breakdown of certain statin medications, increasing the risk of serious side effects. For lovastatin or simvastatin, the maximum recommended dosage (when combined with ticagrelor) is 40 mg once daily. No similar recommendation is available for atorvastatin.
 
CYP 3A4 Inducers
The liver breaks down ticagrelor using an enzyme known as CYP 3A4. Medications known as CYP 3A4 inducers increase the activity of this enzyme, thereby speeding up the breakdown of ticagrelor. This could make ticagrelor less effective.
 
CYP 3A4 inducers cause this problem to varying degrees. For "extensive" CYP 3A4 inducers, this is a major interaction. For minor CYP 3A4 inducers, this interaction may not cause problems. Check with your healthcare provider before combining these drugs.
 
CYP 3A4 Inhibitors
The liver breaks down ticagrelor using an enzyme known as CYP 3A4. Medications known as CYP 3A4 inhibitors decrease the activity of this enzyme, thereby slowing down the breakdown of ticagrelor. This could increase the risk of serious ticagrelor side effects.
 
CYP 3A4 inhibitors cause this problem to varying degrees. For "extensive" CYP 3A4 inhibitors, this is a major interaction. For minor CYP 3A4 inhibitors, this interaction may not cause problems. Check with your healthcare provider before combining these drugs.
 
Digoxin
P-glycoprotein (Pgp) is a protein found in the body. One of its roles is to help remove substances, such as medications, out of the tissues so they can be excreted through the urine or feces. Pgp helps remove digoxin from the body. Ticagrelor is a Pgp inhibitor, meaning it decreases the activity of Pgp.
 
Taking digoxin and ticagrelor together causes digoxin to be removed from the body more slowly, potentially increasing the amount of digoxin in your body and increasing your risk for serious side effects. Your healthcare provider may choose to monitor your digoxin levels if you take it with ticagrelor.
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Ticagrelor Drug Information

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