Drug & supplement interaction

Propolis + Ticagrelor

Ticagrelor brand name: Brilinta.

Moderate Interaction
The bottom line Moderate

Ticagrelor falls into 2 drug categories that Propolis can interact with; the most serious is rated moderate. Theoretically, high doses of propolis might increase blood levels of drugs metabolized by CYP3A4.

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

Propolis and Ticagrelor

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

Why Are There 2 Interactions?

Propolis interacts with whole categories of medication. Ticagrelor falls into 2 of those categories, so it can interact with Propolis 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 Propolis interacts with.

Theoretically, high doses of propolis might increase blood levels of drugs metabolized by CYP3A4.
Some in vitro research shows that propolis extract can inhibit CYP3A4; however, other in vitro research shows that propolis has no effect on CYP3A4 activity. Furthermore, animal research shows that propolis extract does not significantly affect CYP3A4 activity when administered to rats at doses up to 250 mg/kg. It is postulated that the constituents of propolis that might in inhibit CYP3A4 in vitro do not have significant effects in vivo due to low bioavailability and hepatic first-pass effect. This effect has not been reported in humans.
Severity Moderate Likelihood Possible Evidence D

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

Here's the short version: your body relies on a liver enzyme called CYP3A4 to clear ticagrelor (Brilinta). In some test-tube studies, propolis appeared to slow that enzyme down. If that actually happened in people, ticagrelor could build up a bit, and since this is a blood thinner, that could mean a higher chance of bruising or bleeding, like nosebleeds, bleeding gums, or blood that's slower to stop.

The reassuring part is that this is only a theoretical concern. Other lab work showed no effect, and animal studies didn't find a real change. It has never been reported in actual people, and the small amounts in everyday products are unlikely to matter. Still, because ticagrelor protects your heart, I'd mention any propolis supplement to your pharmacist or doctor first.

References
  1. Naramoto K, Kato M, Ichihara K. Effects of an ethanol extract of Brazilian green propolis on human cytochrome P450 enzyme activities in vitro. J Agric Food Chem 2014;62(46):11296-302. PubMed
  2. Ryu CS, Oh SJ, Oh JM, et al. Inhibition of cytochrome P450 by propolis in human liver microsomes. Toxicol Res 2016;32(3):207-13. PubMed
Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

2 of 2

Ticagrelor also falls under ANTICOAGULANT/ANTIPLATELET DRUGS.

Theoretically, propolis might increase the risk of bleeding when taken with antiplatelet or anticoagulant drugs.
In vitro research shows that propolis water extract and the propolis constituent, caffeic acid phenethyl ester, can inhibit platelet aggregation. Additionally, evidence from an animal model shows that taking propolis in addition to warfarin decreases INR, suggesting that propolis can decrease the effectiveness of warfarin.
Severity Moderate Likelihood Possible Evidence D

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

Here's the thing to keep in mind with this pairing. Ticagrelor (Brilinta) is already a blood thinner, well, more precisely an antiplatelet, so its whole job is to keep your platelets from clumping together and forming clots. In lab studies, propolis seems to slow platelet clumping too. So if both nudge in the same direction, the theoretical worry is a little extra bleeding risk on top of what Brilinta already gives you.

I want to be honest about how shaky this is. The evidence here comes only from test tube and animal work, not real people, so we don't truly know if it matters in everyday life. Still, watch for things like easy bruising, nosebleeds, gums that bleed when you brush, or bleeding that's slow to stop. Please don't stop either one on your own. Just give your pharmacist or doctor a quick heads-up before adding propolis.

References
  1. Chen, T. G., Lee, J. J., Lin, K. H., Shen, C. H., Chou, D. S., and Sheu, J. R. Antiplatelet activity of caffeic acid phenethyl ester is mediated through a cyclic GMP-dependent pathway in human platelets. Chin J Physiol 6-30-2007;50(3):121-126.
  2. Akbay E, Özenirler Ç, Çelemli ÖG, Durukan AB, Onur MA, Sorkun K. Effects of propolis on warfarin efficacy. Kardiochir Torakochirurgia Pol. 2017;14(1):43-46. PubMed
  3. Zhang YX, Yang TT, Xia L, Zhang WF, Wang JF, Wu YP. Inhibitory Effect of Propolis on Platelet Aggregation In Vitro. J Healthc Eng. 2017;2017:3050895. PubMed

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

Propolis Also Interacts With Other Medications

Propolis has 920 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.

Taking anything else?

Check Another of Your Medications Against Propolis

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

From our Q&A

Questions About Propolis 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 Propolis 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 Propolis 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 Propolis as Part of a Dietary Supplement Product? Check It for Interactions

We hold 723 real supplement products containing Propolis, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Propolis. Your product may carry other ingredients that interact with Ticagrelor too, on top of Propolis — 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 Propolis 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 Propolis
Top 25%

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

29 days ago today
Medication Ticagrelor
Steady interest

#1,437 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 Propolis

What is Propolis?

Propolis
  • Cold sores and herpes lesions (topical)
  • Sore throat and mouth sores
  • Wound and skin healing
  • Immune support
  • Oral and gum health

Propolis is a natural, resin-like substance made by bees that has antimicrobial and anti-inflammatory properties in lab studies. Early research suggests it may help with cold sores, mouth sores, and minor wounds, but high-quality evidence is limited for most uses. It is generally well tolerated, but allergic reactions can occur, especially in people allergic to bee products.

Read the full Propolis 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 & Propolis

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

0Major
920Moderate
0Minor
1,909No known interaction
Moderate

920 interactions

Showing 60 of 920 moderate interactions — see all 920 on the Propolis page.

No interaction 1,909 drugs checked — show the list
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

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Pharmacist Counseling Corner

Taking Propolis and Ticagrelor Together: Common Questions

Can you take Propolis 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 Propolis and Ticagrelor?
Ticagrelor belongs to more than one drug category, and Propolis 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 Propolis 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 Propolis?

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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.