Ticlopidine and Abrocitinib: Interaction Details
AI-assisted, pharmacist-reviewed · AI content regenerated Jul 11, 2026 · Source data updated Jul 10, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Ticlopidine
Abrocitinib
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.
Taking these two together needs a close look from your care team. Ticlopidine (Ticlid) is a blood thinner that makes it harder for your platelets to form clots. Abrocitinib (Cibinqo) is used for eczema and can also raise bleeding risk. Put them together and the chance of bleeding, like easy bruising, nosebleeds, or bleeding that is slow to stop, goes up.
On top of that, ticlopidine slows down an enzyme (called CYP2C19) that your body uses to clear abrocitinib. That can let abrocitinib build up higher than intended. Please don't change anything on your own. Your doctor or pharmacist can sort this out safely, often by adjusting the plan or watching you more closely.
Direction: Ticlopidine increases bleeding risk and increases abrocitinib exposure.
- Mechanism: Additive antiplatelet effect on hemostasis, plus ticlopidine inhibition of CYP2C19, the main enzyme metabolizing abrocitinib, increasing parent and active metabolite AUC.
- Severity: Contraindicated during the first 3 months of abrocitinib therapy (antiplatelet agents other than low-dose aspirin =81 mg/day are contraindicated in this window).
- Evidence: Theoretical.
- Management: Avoid concurrent use in the first 3 months. If a strong CYP2C19 inhibitor is required, reduce abrocitinib to 50 mg once daily; may titrate to 100 mg once daily after 12 weeks if inadequate response, and discontinue if still inadequate. Monitor for bleeding.
What happens
Increased risk of bleeding, and increased abrocitinib and active metabolite exposure
Interaction Deep Dive
Using abrocitinib together with antiplatelet drugs is contraindicated within the initial 3 months of therapy because of an elevated bleeding risk; the only exception is low-dose aspirin (81 mg per day or less). Furthermore, when abrocitinib is given alongside strong CYP2C19 inhibitors, exposure to abrocitinib and its active metabolites rises. When such concurrent use cannot be avoided, lower the abrocitinib dose to 50 mg once daily. Should the patient fail to respond adequately following 12 weeks, the dosage may be raised to 100 mg orally once daily. Stop treatment if the response remains insufficient even after the dose has been increased to 100 mg once daily1.
Why it happens (mechanism)
Additive effects on hemostasis; inhibition of CYP2C19-mediated abrocitinib metabolism
How to manage this interaction
Keep taking both exactly as prescribed until your care team weighs in. This combination is flagged as one to avoid, especially in the first 3 months of abrocitinib.
- Your team may choose a different plan, or if the combination is truly needed, they can lower the abrocitinib dose (often to 50 mg once daily) and adjust it over time based on your response.
- They may also monitor you more closely for bleeding.
- Tell your pharmacist or prescriber about all blood thinners and antiplatelet drugs you take.
- Report unusual bruising, nosebleeds, blood in urine or stool, or bleeding that won't stop.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Ticlopidine and Abrocitinib together?
Combining ticlopidine with abrocitinib raises bleeding risk and lets abrocitinib build up, and it is contraindicated during the first 3 months of abrocitinib. Do not change anything yourself; let your doctor or pharmacist adjust the plan. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Ticlopidine and Abrocitinib interaction?
It is rated contraindicated. These should generally not be used together.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How is the Ticlopidine and Abrocitinib interaction managed?
Keep taking both exactly as prescribed until your care team weighs in. This combination is flagged as one to avoid, especially in the first 3 months of abrocitinib. Your team may choose a different plan, or if the combination is truly needed, they can lower the abrocitinib dose (often to 50 mg once daily) and adjust it over time based on your response. They may also monitor you more closely for bl… 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 Ticlopidine or Abrocitinib 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: CIBINQO(TM) oral tablets, abrocitinib oral tablets. Pfizer Labs (per FDA), New York, NY, 2022. DailyMed
Keep reading about Ticlopidine
Keep reading about Abrocitinib
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