Critical
Ketoconazole × Ticagrelor
Systemic antimycotics. Imidazole derivatives×Reversible P2Y12 receptor inhibitor
Mechanism
Ketoconazole inhibits CYP3A4. Ticagrelor rises 7-fold – severe bleeding risk. FDA Brilinta Section 4.3 strict contraindication.
Symptoms
Spontaneous bleeding, including intracranial.
Management
Combination contraindicated.
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.