Drug interactions
Bivalirudin + Ticagrelor
Severity: Moderate
Bivalirudin and Ticagrelor: moderate interaction.
Last updated
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
Ticagrelor inhibits platelet aggregation while bivalirudin is a direct thrombin inhibitor, so together they raise the risk of bleeding. The combination is often used deliberately during percutaneous coronary intervention, but bleeding events remain more likely than with either drug alone.
What this interaction means in plain words
Bivalirudin and Ticagrelor can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Why it happens
Additive pharmacodynamic effect from P2Y12 receptor blockade combined with direct thrombin inhibition.
What to do
Monitor for bleeding and track hemoglobin and access-site status, and stop bivalirudin at the intended end of the procedure. Reassess the need for continued antithrombotic therapy if bleeding occurs.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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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 Bivalirudin with Ticagrelor?
MediHelp rates the interaction as moderate. Bivalirudin and Ticagrelor can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Ticagrelor inhibits platelet aggregation while bivalirudin is a direct thrombin inhibitor, so together they raise the risk of bleeding. The combination is often used deliberately during percutaneous coronary intervention, but bleeding events remain more likely than with either drug alone.
How serious is the interaction between Bivalirudin and Ticagrelor?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for bleeding and track hemoglobin and access-site status, and stop bivalirudin at the intended end of the procedure. Reassess the need for continued antithrombotic therapy if bleeding occurs.
What other medicines interact with Ticagrelor?
MediHelp also lists interactions of Ticagrelor with, for example, Itraconazole, Ketoconazole, Levoketoconazole. The full list is on the Ticagrelor page.
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