Drug & supplement interaction

Guggul + Ticagrelor

Ticagrelor brand name: Brilinta.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Ticagrelor falls into 2 drug categories that Guggul can interact with; the most serious is rated moderate. Theoretically, guggul might reduce the effects of CYP3A4 substrates.

Read the full interaction report
SeverityModerate
LikelihoodProbable
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Guggul and Ticagrelor

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Guggul interacts with whole categories of medication. Ticagrelor falls into 2 of those categories, so it can interact with Guggul in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

1 of 2

Why this applies to Ticagrelor

Ticagrelor falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES — the group Guggul interacts with.

Theoretically, guggul might reduce the effects of CYP3A4 substrates.
In vitro research shows that guggul constituents known as guggulsterones can induce CYP3A4.
Severity Moderate Likelihood Probable Evidence D

Interaction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the gist for Brilinta (ticagrelor): your liver uses an enzyme called CYP3A4 to handle this medicine. Lab research hints that guggul may speed that enzyme up. If it does, your body could clear ticagrelor a little faster, which in theory might soften its clot-preventing punch. Since you're taking ticagrelor specifically to stop a heart attack or stroke, you don't want anything quietly weakening it.

I want to be honest about the evidence, though: this is only test-tube and animal data, not real cases in people, so it's far from proven. Cooking-style amounts wouldn't be the worry, concentrated supplement doses would be. Before adding guggul, please run it by your pharmacist or cardiologist first.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Brobst DE, Ding X, Creech KL, et al. Guggulsterone activates multiple nuclear receptors and induces CYP3A gene expression through the pregnane X receptor. J Pharmacol Exp Ther 2004;310:528-35. PubMed
Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

2 of 2

Ticagrelor also falls under ANTICOAGULANT/ANTIPLATELET DRUGS.

Theoretically, guggul might increase the risk of bleeding when taken with anticoagulant/antiplatelet drugs.
In vitro research and preliminary clinical studies suggest that guggul might have antiplatelet and anticoagulant effects.
Severity Moderate Likelihood Possible Evidence B

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Brilinta (ticagrelor) is already a strong blood thinner that keeps your platelets from clumping together, which is exactly what protects you after a heart attack, stent, or stroke. The concern here is that guggul may have mild blood-thinning, antiplatelet effects of its own. Stack that on top of ticagrelor and you could, in theory, nudge your bleeding risk a little higher.

In real life that might look like easier bruising, nosebleeds, bleeding gums, or cuts that take longer to stop. I want to be honest though: this is mostly based on lab work and small, lower-quality studies, so it is more of a caution than a proven problem. Since ticagrelor is so important for your heart, please don't add guggul without first checking with your pharmacist or doctor.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Singh RB, Niaz MA, Ghosh S. Hypolipidemic and antioxidant effects of Commiphora mukul as an adjunct to dietary therapy in patients with hypercholesterolemia. Cardiovasc Drugs Ther 1994;8:659-64. PubMed
  2. Mester L, Mester M, Nityanand S. Inhibition of platelet aggregation by "guggulu" steroids. Planta Med 1979;37:367-9. PubMed
  3. Gaur SP, Garg RK, Kar AM, et al. Gugulipid, a new hypolipidaemic agent, in patients of acute ischaemic stroke: effect on clinical outcome, platelet function and serum lipids. Asia Pacif J Pharm 1997;12:65-69.
  4. Baldwa VS, Sharma RC, Ranka PC, et al. Effect of Commiphora mukul (guggul) on fibrinolytic activity and platelet aggregation in coronary artery disease. Rajas Med J 1980;19:84-86.

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Guggul Also Interacts With Other Medications

Guggul has 756 moderate known drug interactions in our database — the Ticagrelor one above is among them. If you take anything else, check it against the full list below.

Moderate 756 No known interaction 2,074 (incl. Ticagrelor)
Taking anything else?

Check Another of Your Medications Against Guggul

Covers the 2,830 medications we’ve checked against Guggul. Pick one to open its full report.

From our Q&A

Questions About Guggul or Ticagrelor

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Guggul or Ticagrelor, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Ticagrelor

This page covers Guggul only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Ticagrelor page lists 286 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Danshen (major), Grapefruit (major), Piracetam (major) and St. John's Wort (major).

By severity: 5 major · 241 moderate · 40 minor.

From our pharmacist’s overview on the Ticagrelor page

“Grapefruit sits at the top of this list for good reason. Ticagrelor (Brilinta) is cleared by the CYP3A4 enzyme, and grapefruit blocks that enzyme, so drug levels can climb and bleeding becomes more likely.”

Reviewed by 2 · Jul 18, 2026

Open the Ticagrelor interaction page

One more smart check

Taking Guggul as Part of a Dietary Supplement Product? Check It for Interactions

We hold 955 real supplement products containing Guggul, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Guggul. Your product may carry other ingredients that interact with Ticagrelor too, on top of Guggul — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Guggul and Ticagrelor Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Guggul
Top 25%

#215 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Ticagrelor
Steady interest

#1,561 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Guggul

What is Guggul?

Guggul
  • High cholesterol
  • Joint pain and arthritis
  • Weight management
  • Acne
  • Skin conditions

Guggul is a gum resin from the Commiphora wightii tree, long used in Ayurvedic medicine for cholesterol, joint, and skin problems. Modern studies are mixed and often low-quality, and it can cause stomach upset and skin rashes. Talk to your pharmacist or doctor before using it, and avoid it during pregnancy and breastfeeding.

Read the full Guggul monograph & all interactions
Medication

About Ticagrelor

What Is Ticagrelor Used For?

Brand name: Brilinta

Ticagrelor tablets are used to lower the risk of cardiovascular death, heart attack, and stroke in adults who have had an acute coronary syndrome (ACS — a sudden reduction of blood flow to the heart) or a previous heart attack. They also reduce the risk of stent thrombosis (a blood clot forming in a coronary stent) in people stented during ACS treatment.

Ticagrelor tablets are also used to reduce the risk of a first heart attack or stroke in people with coronary artery disease (CAD) who are at high risk — including those with type 2 diabetes. Brilinta is additionally indicated to reduce the risk of stroke in adults with a mild acute ischemic stroke or a high-risk transient ischemic attack (TIA, sometimes called a "mini-stroke").

See full Ticagrelor drug information
Keep checking

Other Drugs & Guggul

Browse every other medication we’ve checked against Guggul — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
756Moderate
0Minor
2,073No known interaction
756 Moderate 2,073 No interaction
Moderate

756 interactions

Showing 60 of 756 moderate interactions — see all 756 on the Guggul page.

No interaction 2,073 drugs checked — show the list

We also checked Guggul against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,073 medications checked with no known interaction — see the full Guggul list.

See the full Guggul interactions page
See every supplement checked against Ticagrelor, ranked by severity
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Keep exploring
Guggul monograph › Uses, safety, and every drug interaction in one place Ticagrelor supplement interactions › Every supplement checked against Ticagrelor, ranked by severity Ticagrelor drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Guggul and Ticagrelor Together: Common Questions

Can you take Guggul with Ticagrelor?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 2 interactions listed for Guggul and Ticagrelor?
Ticagrelor belongs to more than one drug category, and Guggul interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Guggul and Ticagrelor interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Ticagrelor and Guggul?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.