Drug Interactions between Tao and ticagrelor

GENERALLY AVOID: Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of ticagrelor, which is primarily metabolized by the isoenzyme. In healthy volunteers, administration of ticagrelor in combination with the potent CYP450 3A4 inhibitor ketoconazole resulted in increased ticagrelor peak plasma concentration (Cmax) and systemic exposure (AUC) by 2.4-fold and 7.3-fold, respectively, and reduced Cmax and AUC of the active metabolite by 89% and 56%, respectively.

MANAGEMENT: Avoid concomitant use of ticagrelor with potent CYP450 3A4 inhibitors. Some authorities consider concomitant use of ticagrelor with potent CYP450 3A4 inhibitors contraindicated. Labeling for itraconazole, a potent CYP450 3A4 inhibitor, contraindicates use with ticagrelor during and for 2 weeks after treatment with itraconazole.