Ticalor Drug Interactions

Strong CYP3A Inhibitors: Strong CYP3A inhibitors substantially increase ticagrelor exposure and so increase the risk of dyspnea, bleeding, and other adverse events. Avoid use of strong inhibitors of CYP3A (e.g., ketoconazole, itraconazole, voriconazole, clarithromycin, nefazodone, ritonavir, saquinavir, nelfinavir, indinavir, atazanavir, and telithromycin) (see Pharmacology: Pharmacokinetics under Actions).
Strong CYP3A Inducer: Strong CYP3A inducers substantially reduce ticagrelor exposure and so decrease the efficacy of ticagrelor. Avoid use with strong inducers of CYP3A (e.g., rifampin, phenytoin, carbamazepine and phenobarbital) (see Pharmacology: Pharmacokinetics under Actions).
Aspirin: Use of Ticalor with aspirin maintenance doses above 100 mg reduced the effectiveness of Ticalor (see Warnings and Precautions).
Opioids: As with other oral P2Y12 inhibitors, co-administration of opioid agonists delay and reduce the absorption of ticagrelor and its active metabolite presumably because of slowed gastric emptying. Consider the use of a parenteral anti-platelet agent in acute coronary syndrome patients requiring co-administration of morphine or other opioid agonists.
Digoxin: Ticalor inhibits the P-glycoprotein transporter; monitor digoxin levels with initiation of or change in ticagrelor therapy (see Pharmacology: Pharmacokinetics under Actions).