Drug interactions
Ivosidenib + Ticagrelor
Severity: Major
Ivosidenib 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
Ivosidenib induces CYP3A4 and may lower ticagrelor exposure, reducing platelet inhibition. This could raise the risk of stent thrombosis or ischemic events.
What this interaction means in plain words
Ivosidenib 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.
Ivosidenib belongs to Oncology; Ticagrelor belongs to Cardiovascular.
Why it happens
Ivosidenib induces CYP3A4, increasing ticagrelor metabolism.
What to do
Avoid coadministration and use an alternative antiplatelet not dependent on CYP3A4 such as prasugrel. If unavoidable, monitor for loss of antiplatelet efficacy.
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 Ticagrelor
- Itraconazole + Ticagrelor Contraindicated
- Ketoconazole + Ticagrelor Contraindicated
- Levoketoconazole + Ticagrelor Contraindicated
- Abciximab + Ticagrelor Major
- Abrocitinib + Ticagrelor Major
- Acalabrutinib + Ticagrelor Major
Other interactions of Ivosidenib
- Alfuzosin + Ivosidenib Major
- Amiodarone + Ivosidenib Major
- Amisulpride + Ivosidenib Major
- Amitriptyline + Ivosidenib Major
- Amobarbital + Ivosidenib Major
- Anagrelide + Ivosidenib Major
Frequently asked questions
Can I take Ivosidenib with Ticagrelor?
MediHelp rates the interaction as major. Ivosidenib 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. Ivosidenib induces CYP3A4 and may lower ticagrelor exposure, reducing platelet inhibition. This could raise the risk of stent thrombosis or ischemic events.
How serious is the interaction between Ivosidenib 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 coadministration and use an alternative antiplatelet not dependent on CYP3A4 such as prasugrel. If unavoidable, monitor for loss of antiplatelet efficacy.
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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