Drug interactions
Hydromorphone + Ticagrelor
Severity: Moderate
Hydromorphone 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
Opioids slow gastric emptying and have been shown to delay and reduce absorption of oral ticagrelor and its active metabolite, which may reduce early antiplatelet effect in acute coronary syndrome. The clinical consequences, such as stent thrombosis, are uncertain but plausible.
What this interaction means in plain words
Hydromorphone 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.
Hydromorphone belongs to Musculoskeletal; Ticagrelor belongs to Cardiovascular.
Why it happens
Opioid-induced delayed gastric emptying reduces and delays oral ticagrelor absorption.
What to do
In acute coronary syndrome requiring opioids, consider a parenteral antiplatelet agent such as cangrelor or use non-opioid analgesia where possible. Use the lowest effective opioid dose.
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 Hydromorphone
- Alvimopan + Hydromorphone Contraindicated
- Bupropion-naltrexone + Hydromorphone Contraindicated
- Hydromorphone + Isocarboxazid Contraindicated
- Hydromorphone + Olanzapine / samidorphan Contraindicated
- Hydromorphone + Phenelzine Contraindicated
- Hydromorphone + Tranylcypromine 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 Hydromorphone with Ticagrelor?
MediHelp rates the interaction as moderate. Hydromorphone 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. Opioids slow gastric emptying and have been shown to delay and reduce absorption of oral ticagrelor and its active metabolite, which may reduce early antiplatelet effect in acute coronary syndrome. The clinical consequences, such as stent thrombosis, are uncertain but plausible.
How serious is the interaction between Hydromorphone 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: In acute coronary syndrome requiring opioids, consider a parenteral antiplatelet agent such as cangrelor or use non-opioid analgesia where possible. Use the lowest effective opioid dose.
What other medicines interact with Hydromorphone?
MediHelp also lists interactions of Hydromorphone with, for example, Alvimopan, Bupropion-naltrexone, Isocarboxazid. The full list is on the Hydromorphone page.
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