Drug interactions
Efavirenz + Ticagrelor
Severity: Major
Efavirenz and Ticagrelor: major 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
Efavirenz is expected to reduce ticagrelor and its active metabolite exposure, which may weaken platelet inhibition and increase the risk of stent thrombosis or ischemic events. Ticagrelor labeling advises avoiding strong CYP3A inducers.
What this interaction means in plain words
Efavirenz 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.
Efavirenz belongs to Anti Virals; Ticagrelor belongs to Cardiovascular.
Why it happens
Efavirenz induces CYP3A4, accelerating ticagrelor metabolism.
What to do
Avoid the combination where possible; use a non-inducing antiretroviral or an alternative antiplatelet agent such as prasugrel, depending on indication.
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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Other interactions of Efavirenz
- Cobimetinib + Efavirenz Contraindicated
- Dienogest / estradiol valerate + Efavirenz Contraindicated
- Dihydroergotamine intranasal + Efavirenz Contraindicated
- Dihydroergotamine + Efavirenz Contraindicated
- Doravirine + Efavirenz Contraindicated
- Efavirenz + Elbasvir / grazoprevir Contraindicated
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 Efavirenz with Ticagrelor?
MediHelp rates the interaction as major. Efavirenz 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. Efavirenz is expected to reduce ticagrelor and its active metabolite exposure, which may weaken platelet inhibition and increase the risk of stent thrombosis or ischemic events. Ticagrelor labeling advises avoiding strong CYP3A inducers.
How serious is the interaction between Efavirenz 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: Avoid the combination where possible; use a non-inducing antiretroviral or an alternative antiplatelet agent such as prasugrel, depending on indication.
What other medicines interact with Efavirenz?
MediHelp also lists interactions of Efavirenz with, for example, Cobimetinib, Dienogest / estradiol valerate, Dihydroergotamine intranasal. The full list is on the Efavirenz page.
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