Ticagrelor and Butorphanol Injection: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Ticagrelor
Butorphanol Injection
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.
What happens
Reduced absorption of ticagrelor
Interaction Deep Dive
Coadministration of ticagrelor with opioid agonists delays and reduces the absorption of clopidogrel, presumably because of slowed gastric emptying, resulting in reduced exposure to clopidogrel metabolites. In a clinical study, Coadministration of 5 mg intravenous morphine with 180 mg loading dose of ticagrelor decreased observed mean ticagrelor exposure by up to 25% in healthy adults and up to 36% in ACS patients undergoing PCI. Tmax was delayed by 1-2 hours. Exposure of the active metabolite decreased to a similar extent. Coadministration of intravenous fentaNYL with 180 mg loading dose of ticagrelor in ACS patients undergoing PCI resulted in similar effects on ticagrelor exposure and platelet inhibition. Consider the use of a parenteral antiplatelet agent in acute coronary syndrome patients requiring coadministration of morphine or other opioid agonists1.
Why it happens (mechanism)
Slowed gastric emptying
Literature reports
2 reports — tap to read
a) In a clinical study, coadministration of 5 mg intravenous morphine with 180 mg loading dose of ticagrelor decreased observed mean ticagrelor exposure by up to 25% in healthy adults and up to 36% in ACS patients undergoing PCI. Tmax was delayed by 1-2 hours. Exposure of the active metabolite decreased to a similar extent 1.
b) In a clinical study, coadministration of intravenous fentaNYL with 180 mg loading dose of ticagrelor in ACS patients undergoing PCI resulted in decreased observed mean ticagrelor exposure and Tmax was delayed 1.
Common questions
Can I take Ticagrelor and Butorphanol Injection together?
Reduced absorption of ticagrelor Always confirm with your pharmacist or prescriber before making any change.
How serious is the Ticagrelor and Butorphanol Injection interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How strong is the evidence for this interaction?
The evidence is graded "probable". Good supporting evidence, though not definitively proven.
Questions for your pharmacist
- Does my dose of Ticagrelor or Butorphanol Injection 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: BRILINTA(R) oral tablets, ticagrelor oral tablets. AstraZeneca Pharmaceuticals LP (per FDA), Wilmington, DE, 2024.
Keep reading about Ticagrelor
Keep reading about Butorphanol Injection
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Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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