Ticagrelor drug interactions: Difference between revisions
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==Indications and Usage== | ==Indications and Usage== | ||
===Drug Interactions=== | ====Drug Interactions==== | ||
Ticagrelor is predominantly metabolized by CYP3A4 and to a lesser extent by CYP3A5. Ticagrelor is also a p-glycoprotein (P-gp) substrate. | Ticagrelor is predominantly metabolized by [[CYP3A4]] and to a lesser extent by [[CYP3A5]]. Ticagrelor is also a p-glycoprotein (P-gp) substrate. | ||
===CYP3A inhibitors=== | ====CYP3A inhibitors==== | ||
Avoid use of strong inhibitors of CYP3A (e.g., ketoconazole, itraconazole, voriconazole, clarithromycin, nefazodone, ritonavir, saquinavir, nelfinavir, indinavir, atazanavir and telithromycin) [ | Avoid use of strong inhibitors of [[CYP3A]] (e.g., [[ketoconazole]], [[itraconazole]], [[voriconazole]], [[clarithromycin]], [[nefazodone]], [[ritonavir]], [[saquinavir]], [[nelfinavir]], [[indinavir]], [[atazanavir]] and [[telithromycin]]). See [[Ticagrelor warnings and precautions|Warnings and Precautions]] and [[Ticagrelor clinical pharmacology|Clinical pharmacology]]. | ||
===CYP3A inducers=== | ====CYP3A inducers==== | ||
Avoid use with potent inducers of CYP3A (e.g., rifampin, dexamethasone, phenytoin, carbamazepine and phenobarbital) [ | Avoid use with potent inducers of [[CYP3A]] (e.g., [[rifampin]], [[dexamethasone]], [[phenytoin]], [[carbamazepine]] and [[phenobarbital]]). See [[Ticagrelor warnings and precautions|Warnings and Precautions]] and [[Ticagrelor clinical pharmacology|Clinical pharmacology]]. | ||
===Aspirin=== | ====Aspirin==== | ||
Use of BRILINTA with aspirin maintenance doses above 100 mg reduced the effectiveness of BRILINTA[ | Use of BRILINTA with [[aspirin]] maintenance doses above 100 mg reduced the effectiveness of BRILINTA. [See [[Ticagrelor warnings and precautions|Warnings and Precautions]] and [[Ticagrelor clinical pharmacology|Clinical pharmacology]]]. | ||
====Effects of BRILINTA on other drugs==== | |||
Ticagrelor is an inhibitor of CYP3A4/5 and the [[P-glycoprotein]] transporter. | |||
'''* Simvastatin, lovastatin''' | |||
BRILINTA will result in higher serum concentrations of simvastatin and lovastatin because these drugs are metabolized by [[CYP3A4]]. Avoid [[simvastatin]] and [[lovastatin]] doses greater than 40 mg. See [[Ticagrelor clinical pharmacology|Clinical pharmacology]]. | |||
'''* Digoxin''' | |||
* Digoxin | |||
Digoxin: Because of inhibition of the P-glycoprotein transporter, monitor digoxin levels with initiation of or any change in BRILINTA therapy [see Clinical Pharmacology (12.3)]. | Digoxin: Because of inhibition of the P-glycoprotein transporter, monitor digoxin levels with initiation of or any change in BRILINTA therapy [see Clinical Pharmacology (12.3)]. | ||
* Other Concomitant Therapy | '''* Other Concomitant Therapy''' | ||
BRILINTA can be administered with unfractionated or low-molecular-weight heparin, GPIIb/IIIa inhibitors, proton pump inhibitors, beta-blockers, angiotensin converting enzyme inhibitors, and angiotensin receptor blockers.<ref>{{Cite web | last = | first = | title = BRILINTA (TICAGRELOR) TABLET [ASTRAZENECA LP] | url = http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=f7b3f443-e83d-4bf2-0e96-023448fed9a8 | publisher = | date = | accessdate = 12 March 2014 }}</ref> | |||
==References== | ==References== | ||
{{Reflist} | {{Reflist}} | ||
[[Category:ADP receptor inhibitors]] | [[Category:ADP receptor inhibitors]] | ||
[[Category:Cardiovascular Drugs]] | [[Category:Cardiovascular Drugs]] | ||
[[Category:Drugs]] | [[Category:Drugs]] | ||
Revision as of 20:24, 12 March 2014
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Jesus Rosario Hernandez, M.D. [2]
Indications and Usage
Drug Interactions
Ticagrelor is predominantly metabolized by CYP3A4 and to a lesser extent by CYP3A5. Ticagrelor is also a p-glycoprotein (P-gp) substrate.
CYP3A inhibitors
Avoid use of strong inhibitors of CYP3A (e.g., ketoconazole, itraconazole, voriconazole, clarithromycin, nefazodone, ritonavir, saquinavir, nelfinavir, indinavir, atazanavir and telithromycin). See Warnings and Precautions and Clinical pharmacology.
CYP3A inducers
Avoid use with potent inducers of CYP3A (e.g., rifampin, dexamethasone, phenytoin, carbamazepine and phenobarbital). See Warnings and Precautions and Clinical pharmacology.
Aspirin
Use of BRILINTA with aspirin maintenance doses above 100 mg reduced the effectiveness of BRILINTA. [See Warnings and Precautions and Clinical pharmacology].
Effects of BRILINTA on other drugs
Ticagrelor is an inhibitor of CYP3A4/5 and the P-glycoprotein transporter.
* Simvastatin, lovastatin
BRILINTA will result in higher serum concentrations of simvastatin and lovastatin because these drugs are metabolized by CYP3A4. Avoid simvastatin and lovastatin doses greater than 40 mg. See Clinical pharmacology.
* Digoxin
Digoxin: Because of inhibition of the P-glycoprotein transporter, monitor digoxin levels with initiation of or any change in BRILINTA therapy [see Clinical Pharmacology (12.3)].
* Other Concomitant Therapy
BRILINTA can be administered with unfractionated or low-molecular-weight heparin, GPIIb/IIIa inhibitors, proton pump inhibitors, beta-blockers, angiotensin converting enzyme inhibitors, and angiotensin receptor blockers.[1]
References
- ↑ "BRILINTA (TICAGRELOR) TABLET [ASTRAZENECA LP]". Retrieved 12 March 2014.