Drug interactions
Acetylsalicylic acid + Ticagrelor
Severity: Major
Acetylsalicylic acid and Ticagrelor: major interaction.
Last updated Sources: Health Canada product monograph
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Maintenance aspirin doses above 100 mg daily reduce the clinical benefit of ticagrelor, with worse cardiovascular outcomes seen. The combination is standard with low-dose aspirin, but bleeding risk is additive.
What this interaction means in plain words
Acetylsalicylic acid and Ticagrelor can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Acetylsalicylic acid belongs to Musculoskeletal; Ticagrelor belongs to Cardiovascular.
Why it happens
Additive platelet inhibition increases bleeding, and higher aspirin doses appear to diminish ticagrelor efficacy through a mechanism that is not fully understood.
What to do
Keep maintenance aspirin at 75-100 mg daily after any initial loading dose. Monitor for bleeding.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
Other interactions of Acetylsalicylic acid
- Acetylsalicylic acid + Ketorolac Contraindicated
- Acetylsalicylic acid + Ketorolac intranasal Contraindicated
- Abciximab + Acetylsalicylic acid Major
- Acemetacin + Acetylsalicylic acid Major
- Acetazolamide + Acetylsalicylic acid Major
- Acetylsalicylic acid + Alteplase Major
Other interactions of Ticagrelor
- Itraconazole + Ticagrelor Contraindicated
- Ketoconazole + Ticagrelor Contraindicated
- Levoketoconazole + Ticagrelor Contraindicated
- Abciximab + Ticagrelor Major
- Abrocitinib + Ticagrelor Major
- Acalabrutinib + Ticagrelor Major
Frequently asked questions
Can I take Acetylsalicylic acid with Ticagrelor?
MediHelp rates the interaction as major. Acetylsalicylic acid and Ticagrelor can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Maintenance aspirin doses above 100 mg daily reduce the clinical benefit of ticagrelor, with worse cardiovascular outcomes seen. The combination is standard with low-dose aspirin, but bleeding risk is additive.
How serious is the interaction between Acetylsalicylic acid and Ticagrelor?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Keep maintenance aspirin at 75-100 mg daily after any initial loading dose. Monitor for bleeding.
What other medicines interact with Acetylsalicylic acid?
MediHelp also lists interactions of Acetylsalicylic acid with, for example, Ketorolac, Ketorolac intranasal, Abciximab. The full list is on the Acetylsalicylic acid page.
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