Drug interactions
Ticagrelor + Tolmetin
Severity: Major
Ticagrelor and Tolmetin: 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
Tolmetin adds antiplatelet effect and gastric mucosal injury to ticagrelor, increasing the risk of bleeding, especially in the gastrointestinal tract. The risk rises with prolonged NSAID use.
What this interaction means in plain words
Ticagrelor and Tolmetin 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.
Ticagrelor belongs to Cardiovascular; Tolmetin belongs to Musculoskeletal.
Why it happens
Additive pharmacodynamic effect on platelet function (P2Y12 blockade plus COX inhibition) and NSAID-related mucosal damage.
What to do
Avoid chronic NSAID use with ticagrelor and prefer paracetamol. If 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 Tolmetin
- Ketorolac intranasal + Tolmetin Contraindicated
- Ketorolac + Tolmetin Contraindicated
- Aceclofenac + Tolmetin Major
- Acemetacin + Tolmetin Major
- Alteplase + Tolmetin Major
- Amlodipine-hydrochlorothiazide-valsartan + Tolmetin 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 Ticagrelor with Tolmetin?
MediHelp rates the interaction as major. Ticagrelor and Tolmetin 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. Tolmetin adds antiplatelet effect and gastric mucosal injury to ticagrelor, increasing the risk of bleeding, especially in the gastrointestinal tract. The risk rises with prolonged NSAID use.
How serious is the interaction between Ticagrelor and Tolmetin?
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 chronic NSAID use with ticagrelor and prefer paracetamol. If unavoidable, add gastroprotection and monitor for bleeding.
What other medicines interact with Tolmetin?
MediHelp also lists interactions of Tolmetin with, for example, Ketorolac intranasal, Ketorolac, Aceclofenac. The full list is on the Tolmetin page.
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