This site is intended for healthcare professionals only

Antiplatelet drug ticagrelor interacts with grapefruit

Written by: | Published:

Nurses should warn patients taking the antiplatelet drug ticagrelor (which treats acute coronary syndromes, such as unstable angina and myocardial infarction) to avoid grapefruit juice, according to research published in the British Journal of Clinical Pharmacology.

An enzyme, called cytochrome p450 3A (CYP3A), expressed in the liver and intestine metabolises ticagrelor.Grapefruit juice strongly inhibits intestinal CYP3A4. So, ten healthy volunteers drank 200 ml of grapefruit juice or water three times daily for four days. On the third day, volunteers took 90mg ticagrelor. After a two-week washout, those who drank grapefruit juice switched to water and vice versa.

Grapefruit juice increased the peak concentration of ticagrelor in the blood (Cmax) by 165 per cent compared to water. Grapefruit juice also increased the area under the concentration-time curve (AUC) - which indicates total exposure to the drug - by 221 per cent and elimination half-life (the time for blood concentrations to halve) from 6.7 to 7.2 hours.

Grapefruit juice enhanced ticagrelor's antiplatelet effect and delayed recovery of platelet reactivity, potentially increasing the risk of adverse events, complicating preparations for surgery and making management of bleeding side effects more difficult. The authors commented that 'the concomitant use of ticagrelor and grapefruit juice is best to be avoided'.

  • British Journal of Clinical Pharmacology (2012) doi: 10.1111/bcp.12026

What do you think? Leave a comment below or tweet your views to @IndyNurseMag

This material is protected by MA Healthcare Ltd copyright.
See Terms and Conditions.

Comments

Name
 
Email
 
Comments
 

Please view our Terms and Conditions before leaving a comment.

Change the CAPTCHA codeSpeak the CAPTCHA code
 

Read a free issue from Practice Nursing

Register to read a free issue from our sister publication, Practice Nursing.

Including articles on asthma, diabetes and more. Read your copy.

Newsletter

Sign up to the newsletter

About

Independent Nurse is the professional resource for primary care and community nurses, providing clinical articles for practice nurses and prescribers.

Newsletter

Subscribe to our newsletter and stay up to date with the latest nursing news.

Stay Connected

Stay social with Independent Nurse by following us on Twitter, liking us on Facebook or connecting on LinkedIn.

Archive

Need access to some of our older articles? You can view our archive, or alternatively contact us.

Contact Us

MA Healthcare Ltd.
St Jude's Church, Dulwich Road
London, SE24 0PB

Tel: +44 (0)20 7738 5454
Registered in England and Wales No. 01878373

Meet the team

Authors

Find out how to contribute to Independent Nurse here.