CYP3A4与替格瑞洛预案.ppt

Ticagrelor is a moderate inhibitor of CYP3A4, CYP2C9, CYP3A5 and CYP2D6.[6] Ticagrelor and its major metabolite are weak p-glycoprotein substrates and inhibitors. Digoxin levels need to be monitored when given along with ticagrelor, the latter being a p-glycoprotein inhibitor.[6,14] Antiplatelet drugs and statins are commonly administered together in patients with cardiovascular diseases. Ticagrelor when given with simvastatin and lovastatin increases their serum concentration as they are metabolized by CYP3A4. So, simvastatin and lovastatin in doses 40 mg should be avoided with ticagrelor.[14,15] Ticagrelor should be avoided in patients on CYP3A4 inhibitors (ketoconazole, clarithromycin, nefazodone, ritonavir and atazanavir) and CYP3A4 inducers (rifampicin, dexamethasone, phenytoin, carbamazepine and phenobarbital).[14] CYP3A4 与替格瑞洛