Drug interactions
Phenobarbital + Ticagrelor
Severity: Major
Phenobarbital 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
Phenobarbital is a potent CYP3A inducer that can considerably lower ticagrelor and active metabolite levels. This may reduce antiplatelet efficacy and increase the risk of thrombotic events.
What this interaction means in plain words
Phenobarbital 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.
Why it happens
Induction of CYP3A4 by phenobarbital accelerates ticagrelor clearance.
What to do
Avoid combining; labeling advises against potent CYP3A inducers. Use an alternative anticonvulsant or another P2Y12 inhibitor if feasible.
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
Frequently asked questions
Can I take Phenobarbital with Ticagrelor?
MediHelp rates the interaction as major. Phenobarbital 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. Phenobarbital is a potent CYP3A inducer that can considerably lower ticagrelor and active metabolite levels. This may reduce antiplatelet efficacy and increase the risk of thrombotic events.
How serious is the interaction between Phenobarbital 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 combining; labeling advises against potent CYP3A inducers. Use an alternative anticonvulsant or another P2Y12 inhibitor if feasible.
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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