https://interactions.guidetherapeutiquevih.com/en/interaction-details?id=10345

Lopinavir / ritonavir

Ticagrelor

Contraindicated.

No pharmaceutical opinion available for this interaction.

Mechanism

Lopinavir / ritonavir can inhibit the CYP 3A4 and P-gp and increase the plasma concentration of Ticagrelor.

Lopinavir / ritonavir can inhibit the metabolism (CYP 3A4) and decrease the active metabolite formation of Ticagrelor.

Lopinavir / ritonavir

Pharmacodynamic effects

–

Recommendations

–

Alternative solution(s)

–

Ticagrelor

Pharmacodynamic effects

Possible decrease of clinical efficacy.

Possible increase of adverse effects.

Recommendations

Contraindicated. Use alternative.

Alternative solution(s)

Prasugrel (Efficient)

Monitor

Adverse effects of ticagrelor: Bleeding (epistaxis, gastrointestinal/cutaneous hemorrhage), bruising, dyspnea, headache, dizziness, gastrointestinal effects (nausea, vomiting, dyspepsia, diarrhea or constipation), bradycardia.

Tests

–

Pharmacokinetic parameters

–

Comment

Ref #3164 : An in vitro study with healthy volunteers showed that ketoconazole, a potent inhibitor of CYP3A4, increased ticagrelor AUC by more than 7.3-fold and Cmax by 2.4-fold and decreased the active metabolite AUC and Cmax by 56% and 89%, respectively.

Comment
Reference
  • 2647
    Ticagrelor (Brilinta), AstraZeneca, Ontario, Canada, 14 novembre 2023.
  • 2971
    Egan G, Hughes CA, Ackman ML. Drug interactions between antiplatelet or novel anticoagulant medications and antiretroviral medications. Ann Pharmacother. 2014 Jun; 48 (6): 734-40.
  • 2992
    Zhou D, Anderson TB, Grimm SW. In vitro evaluation of potential drug-drug interactions with ticagrelor: cytochrome P450 reaction phenotyping, inhibition, induction and differential kinetics. Drug Metabolism and Disposition 2011 39: 703-710.
  • 3164
    Teng R, Butler K. Effect of the CYP3A inhibitors, diltiazem and ketoconazole, on ticagrelor pharmacokinetics in healthy volunteers. Journal of Drug Assessment 2013; 2: 30-9.