Drug Interaction Report
1 potential interaction and/or warning found for the following 2 drugs:
- Brilinta (ticagrelor)
- evening primrose
Interactions between your drugs
evening primrose ticagrelor
Applies to: evening primrose, Brilinta (ticagrelor)
Theoretically, use of borage or evening primrose oil with anticoagulants or antiplatelet aggregation drugs may increase the risk of bleeding in some patients. In one study, 12 hyperlipidemic males took gamma linolenic acid 240 mg and linolenic acid 2200 mg (both main components of borage and evening primrose oil) daily for 4 months. After 4 months on this supplementation and compared to baseline, platelet aggregation decreased by 50% when platelets were aggregated with adenosine diphosphate (ADP), and by 60% with adrenaline. Also, in the same study platelet thromboxane B2 levels were reduced by 54% as compared to placebo. However, another study suggests platelet aggregation in healthy patients may not be affected by borage oil supplementation. Until further information is available, clinical and laboratory observation for hematologic complications is recommended. Patients should be advised to promptly report any signs of bleeding to their physician, including prolonged bleeding from cuts, increased menstrual flow, vaginal bleeding, nosebleeds, bleeding of gums from brushing, unusual bruising, red or brown urine, or red or black stools.
References (5)
- Kathy Wedig, Jeffrey Whitsett (2008) "Down the Primrose Path: Petechiae in a Neonate Exposed to Herbal Remedy for Parturition." J Pediatr, 10, p. 2
- Guivernau M, Meza N, Barja P, Roman O (1994) "Clinical and experimental study on the long-term effect of dietary gamma-linolenic acid on plasma lipids, platelet aggregation, thromboxane formation, and prostacyclin production." Prostaglandins Leukot Essent Fatty Acids, 51, p. 311-6
- N. A. Michael Eskin (2008) "Borage and evening primrose oil." European Journal of Lipid Science and Technology, 110, p. 1
- Bard JM, Luc G, Jude B, et al. (1997) "A therapeutic dosage (3 g/day) of borage oil supplementation has no effect on platelet aggregation in healthy volunteers." Fundam Clin Pharmacol, 11, p. 143-4
- Asadi-Samani M, Bahmani M, Rafieian-Kopaei M (2014) "The chemical composition, botanical characteristic and biological activities of Borago officinalis: a review." Asian Pac J Trop Med, 7S1, S22-8
Drug and food/lifestyle interactions
No alcohol/food interactions were found with the drugs in your list. However, this does not necessarily mean no food interactions exist. Always consult your healthcare provider.
Therapeutic duplication warnings
No duplication warnings were found for your selected drugs.
Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.
Drug Interaction Classification
Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. | |
No interaction information available. |
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Further information
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