藥物交互作用
Ketoconazole + Ticagrelor
嚴重程度: 禁忌併用
Ketoconazole and Ticagrelor: contraindicated interaction.
最後更新 來源: US FDA label
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摘要
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.
用白話說明這項交互作用的意義
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.
為什麼會發生
Ketoconazole is a strong CYP3A4 and P-glycoprotein inhibitor and blocks ticagrelor clearance, increasing levels of the parent drug.
處置方式
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.
可向藥師詢問的問題
- 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?
參考資料
- Brilinta (ticagrelor) Prescribing Information - Drug Interactions — FDA Label
- Brilique (ticagrelor) Summary of Product Characteristics — EMA SmPC
Ticagrelor 的其他交互作用
Ketoconazole 的其他交互作用
常見問題
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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