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.

GENERALLY AVOID: Grapefruit juice may increase the plasma concentrations of ruxolitinib. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruits.

MANAGEMENT: Patients treated with ruxolitinib should avoid consumption of grapefruit, grapefruit juice, and any supplement containing grapefruit extract. Ruxolitinib may be administered with or without food.