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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.

Livello di evidenza: High

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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Riferimenti

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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