Drug interactions
Prasugrel + Ticagrelor
Severity: Major
Prasugrel and Ticagrelor: major interaction.
Last updated Sources: EMA SmPC
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
Both are potent P2Y12 platelet inhibitors, and combining them gives no added benefit while greatly increasing bleeding risk. They are not intended to be used together.
What this interaction means in plain words
Prasugrel 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.
Prasugrel belongs to Cardiovascular; Ticagrelor belongs to Cardiovascular.
Why it happens
Additive pharmacodynamic inhibition of the platelet P2Y12 receptor.
What to do
Avoid concurrent use; give only one P2Y12 inhibitor at a time. When switching, follow guideline-recommended transition and loading practices.
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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References
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 Prasugrel
Frequently asked questions
Can I take Prasugrel with Ticagrelor?
MediHelp rates the interaction as major. Prasugrel 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. Both are potent P2Y12 platelet inhibitors, and combining them gives no added benefit while greatly increasing bleeding risk. They are not intended to be used together.
How serious is the interaction between Prasugrel 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 concurrent use; give only one P2Y12 inhibitor at a time. When switching, follow guideline-recommended transition and loading practices.
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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