Abametapir and Ticagrelor: Interaction Details
AI-assisted, pharmacist-reviewed · AI content regenerated Jul 11, 2026 · Source data updated Jun 30, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Abametapir
No brand names on recordTicagrelor
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
Abametapir is a lotion used to treat head lice. Even though it goes on your scalp, some can get into your body and briefly block a liver enzyme (called CYP3A4) that helps break down other medicines.
Ticagrelor (Brilinta) is a blood thinner that your liver clears using that same enzyme. If the enzyme is blocked, ticagrelor can build up in your body, which may raise your risk of bleeding or bruising. This is based on how the drugs work rather than reports of it actually happening, but it is taken seriously. The good news is your care team can manage this easily, often just by spacing out when you use each one. Please check with your pharmacist or doctor before using both.
Mechanism: Abametapir inhibits CYP3A4. Ticagrelor is a CYP3A4 substrate (and its active metabolite is also CYP3A4-mediated), so inhibition is expected to increase ticagrelor exposure (AUC/Cmax) and enhance antiplatelet effect and bleeding risk.
- Direction: increased ticagrelor exposure and effect
- Onset: rapid
- Evidence: theoretical
- Severity: major
Management: Avoid CYP3A4 substrates, including ticagrelor, within 2 weeks after a single abametapir application. If concurrent use is unavoidable, avoid abametapir. If both are used, monitor closely for signs of bleeding.
What happens
Increased exposure of CYP3A4 substrate
Interaction Deep Dive
For a period of 2 weeks following the application of abametapir, the use of CYP3A4 substrates should be avoided. Should avoiding these substrates not be possible, then abametapir itself should not be used 1.
Why it happens (mechanism)
Inhibition of CYP3A4-mediated metabolism by abametapir
How to manage this interaction
Do not stop or change either medicine on your own. Instead, talk with your pharmacist or prescriber before using both, because abametapir's enzyme-blocking effect can last for a while.
- Your care team will usually separate the two in time, avoiding ticagrelor for about 2 weeks after an abametapir lice treatment.
- If you cannot avoid ticagrelor, they may choose to hold off on the abametapir and use another lice treatment instead.
- Watch for and report unusual bruising, nosebleeds, bleeding gums, or blood in urine or stool.
With this planning and monitoring, your team can keep you safe on both.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Abametapir and Ticagrelor together?
Abametapir can raise ticagrelor levels and bleeding risk by blocking a liver enzyme, so avoid ticagrelor for about 2 weeks after using abametapir, or skip the abametapir. Let your pharmacist or doctor make that call. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Abametapir and Ticagrelor interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "rapid". Effects can appear quickly, often within about 24 hours of combining the drugs.
How is the Abametapir and Ticagrelor interaction managed?
Do not stop or change either medicine on your own. Instead, talk with your pharmacist or prescriber before using both, because abametapir's enzyme-blocking effect can last for a while. Your care team will usually separate the two in time, avoiding ticagrelor for about 2 weeks after an abametapir lice treatment. If you cannot avoid ticagrelor, they may choose to hold off on the abametapir and use a… Management is individual — always follow your own care team's guidance.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
Questions for your pharmacist
- Does my dose of Abametapir or Ticagrelor need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (1)
- Product Information: XEGLYZE(TM) topical lotion, abametapir topical lotion. Dr Reddy’s Laboratories Inc (per FDA), Princeton, NJ, 2020. DailyMed
Keep reading about Abametapir
Keep reading about Ticagrelor
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