Drug Interaction Report

MONITOR CLOSELY: The concomitant use of ticagrelor with other platelet inhibitors, anticoagulants, thrombolytic agents, or nonsteroidal anti-inflammatory drugs may increase the risk of bleeding, including severe and sometimes fatal hemorrhage.

MANAGEMENT: Caution is advised when these drugs are used concomitantly with ticagrelor or within 24 hours of ticagrelor dosing. Close clinical and laboratory observation for hemorrhagic complications is recommended. Patients should be advised to promptly report any signs of bleeding to their doctor, including pain, swelling, headache, dizziness, weakness, prolonged bleeding from cuts, increased menstrual flow, vaginal bleeding, nosebleeds, bleeding of gums from brushing, unusual bleeding, or bruising, red or brown urine, or red or black stools.

ADJUST DOSE: In-vivo studies have demonstrated that the absorption of bromfenac is greatly reduced if the drug is taken within three and one-half hours following a high fat meal. The concomitant administration of a high fat meal has led to a 75% reduction in peak plasma concentrations and a 60% reduction in total area under the curve. The mechanism has not been described.

MANAGEMENT: An increased dosage of bromfenac (from 25 to 50 mg) may be needed if a high fat meal is consumed. The clinician may want to warn the patient about subtherapeutic analgesic effects if high fat meals are regularly consumed.