Interazioni tra farmaci
Ketoconazole + Ticagrelor
Gravità: Controindicata
Ketoconazole and Ticagrelor: contraindicated interaction.
Ultimo aggiornamento Fonti: US FDA label
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Sintesi
Ketoconazole substantially increases ticagrelor exposure, raising the risk of bleeding. Ticagrelor labeling lists strong CYP3A4 inhibitors as contraindicated or to be avoided. The risk is greatest in patients also on aspirin or anticoagulants.
Cosa significa questa interazione in parole semplici
Ketoconazole and Ticagrelor are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Ketoconazole belongs to Anti Fungals; Ticagrelor belongs to Cardiovascular.
Perché avviene
Ketoconazole is a strong CYP3A4 and P-glycoprotein inhibitor and blocks ticagrelor clearance, increasing levels of the parent drug.
Cosa fare
Avoid the combination; use an alternative antifungal with less CYP3A4 inhibition, or another P2Y12 inhibitor such as prasugrel or clopidogrel where appropriate. If antifungal therapy cannot be changed, review the antiplatelet choice with cardiology.
Cosa chiedere al farmacista
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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Riferimenti
- Brilinta (ticagrelor) Prescribing Information - Drug Interactions — FDA Label
- Brilique (ticagrelor) Summary of Product Characteristics — EMA SmPC
Altre interazioni di Ticagrelor
- Itraconazole + Ticagrelor Controindicata
- Levoketoconazole + Ticagrelor Controindicata
- Abciximab + Ticagrelor Maggiore
- Abrocitinib + Ticagrelor Maggiore
- Acalabrutinib + Ticagrelor Maggiore
- Acetylsalicylic acid + Ticagrelor Maggiore
Altre interazioni di Ketoconazole
- Alfuzosin + Ketoconazole Controindicata
- Alprazolam + Ketoconazole Controindicata
- Avanafil + Ketoconazole Controindicata
- Conivaptan + Ketoconazole Controindicata
- Dihydroergotamine intranasal + Ketoconazole Controindicata
- Dihydroergotamine + Ketoconazole Controindicata
Domande frequenti
Can I take Ketoconazole with Ticagrelor?
MediHelp rates the interaction as contraindicated. Ketoconazole and Ticagrelor are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Ketoconazole substantially increases ticagrelor exposure, raising the risk of bleeding. Ticagrelor labeling lists strong CYP3A4 inhibitors as contraindicated or to be avoided. The risk is greatest in patients also on aspirin or anticoagulants.
How serious is the interaction between Ketoconazole and Ticagrelor?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination; use an alternative antifungal with less CYP3A4 inhibition, or another P2Y12 inhibitor such as prasugrel or clopidogrel where appropriate. If antifungal therapy cannot be changed, review the antiplatelet choice with cardiology.
What other medicines interact with Ticagrelor?
MediHelp also lists interactions of Ticagrelor with, for example, Itraconazole, Levoketoconazole, Abciximab. The full list is on the Ticagrelor page.
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