Drug interactions
Mefenamic acid + Ticagrelor
Severity: Major
Mefenamic acid 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
Using an NSAID with ticagrelor increases the risk of bleeding, especially from the gastrointestinal tract. This adds to the bleeding tendency already present with dual antiplatelet therapy.
What this interaction means in plain words
Mefenamic 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.
Mefenamic acid belongs to Musculoskeletal; Ticagrelor belongs to Cardiovascular.
Why it happens
Additive platelet inhibition (P2Y12 blockade plus NSAID-induced COX-1 inhibition) together with NSAID gastric mucosal injury.
What to do
Avoid regular NSAID use and use paracetamol for pain where possible. If an NSAID is unavoidable, add gastroprotection and 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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Other interactions of Mefenamic acid
- Ketorolac intranasal + Mefenamic acid Contraindicated
- Ketorolac + Mefenamic acid Contraindicated
- Aceclofenac + Mefenamic acid Major
- Acemetacin + Mefenamic acid Major
- Acetylsalicylic acid + Mefenamic acid Major
- Alteplase + Mefenamic acid 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 Mefenamic acid with Ticagrelor?
MediHelp rates the interaction as major. Mefenamic 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. Using an NSAID with ticagrelor increases the risk of bleeding, especially from the gastrointestinal tract. This adds to the bleeding tendency already present with dual antiplatelet therapy.
How serious is the interaction between Mefenamic 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: Avoid regular NSAID use and use paracetamol for pain where possible. If an NSAID is unavoidable, add gastroprotection and monitor for bleeding.
What other medicines interact with Mefenamic acid?
MediHelp also lists interactions of Mefenamic acid with, for example, Ketorolac intranasal, Ketorolac, Aceclofenac. The full list is on the Mefenamic acid page.
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