Brilinta Interactions: Alcohol, Medications, and Others

Certain health conditions or other factors could raise your risk of harm if you take Brilinta. In such cases, your doctor may not prescribe Brilinta for you. These are known as contraindications. The list below includes contraindications of Brilinta.

If you have a history of intracranial hemorrhage. You should not take Brilinta if you’ve ever had an intracranial hemorrhage (bleeding inside your head). Taking Brilinta increases your risk of bleeding again. Your doctor can recommend other treatments that are safer for you to take instead.

If you’re currently bleeding. You should not take Brilinta if you’re currently bleeding, for example, from a peptic ulcer or colon polyp. Brilinta can cause you to bleed more. Your doctor will want to treat any active bleeding you have before you start taking Brilinta.

If you’ve had an allergic reaction. If you’ve had an allergic reaction to Brilinta or any of its ingredients, your doctor likely won’t prescribe Brilinta. This is because taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better options for you.

Before you start using Brilinta, talk with your doctor if any of the factors above apply to you. Your doctor can determine whether Brilinta is safe for you to take.

There’s no direct interaction between Brilinta and alcohol.

But your doctor may still suggest limiting or avoiding alcohol consumption while you’re taking Brilinta. This is because both Brilinta and alcohol decrease your blood’s ability to form clots and increases your risk of bleeding. Combining the two may further increase your risk of bleeding.

If you’re taking Brilinta, talk with your doctor before consuming alcohol. Your doctor can recommend what amount, if any, is safe for you to drink.

Before you start taking Brilinta, tell your doctor and pharmacist about any prescription, over-the-counter, or other drugs you take. Sharing this information with them may help prevent possible interactions. (To learn whether Brilinta interacts with supplements, herbs, and vitamins, see the “Are there other interactions with Brilinta?” section below.)

If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist.

The table below lists drugs that may interact with Brilinta. Keep in mind that this table does not include all drugs that may interact with Brilinta. For more information about some of these interactions, see the “Drug interactions explained” section below.

* To learn more, see the “Drug interactions explained” section just below.

Learn more about certain drug interactions that can occur with Brilinta.

Interaction with drugs that affect the CYP3A4 enzyme

Brilinta interacts with drugs that affect the CYP3A4 enzyme (a type of protein). This enzyme helps to break down drugs in your body, including Brilinta.

Some medications can slow down CYP3A4 enzyme activity. When this happens, Brilinta isn’t broken down as quickly. Examples of drugs that slow down the enzyme include:

• ketoconazole
• itraconazole (Tolsura, Sporanox)
• clarithromycin
• ritonavir (Norvir)
• darunavir (Prezista)

On the other hand, some medications can speed up the CYP3A4 enzyme. This causes Brilinta to be broken down more quickly. Examples of drugs that speed up the enzyme include:

• carbamazepine (Tegretol, others)
• phenytoin (Dilantin)
• rifampin (Rimactane)
• apalutamide (Erleada)
• primidone (Mysoline)

What could happen

Depending on whether the drug slows down or speeds up the CYP3A4 enzyme, it can affect Brilinta in one of two ways:

• The drug slows down the enzyme. When Brilinta isn’t broken down as quickly, it can build up in your body. This increases the risk of side effects, including the risk of bleeding.
• The drug speeds up the enzyme. When Brilinta is broken down more quickly, its level in your body decreases. When this happens, its effectiveness is decreased. It may allow a blood clot to form.

What you can do

Be sure to tell your doctor and pharmacist about all the medications you take before you begin treatment with Brilinta. Your doctor and pharmacist can check if any of your medications cause this interaction.

Doctors typically won’t prescribe Brilinta together with drugs that strongly affect the CYP3A4 enzyme. They can recommend a safer treatment for you instead. Or they may suggest stopping the other drug and exploring other treatment options that can be safely taken with Brilinta.

Interaction with nonsteroidal anti-inflammatory drugs (NSAIDs)

Brilinta interacts with a group of medications called nonsteroidal anti-inflammatory drugs (NSAIDs).

NSAIDs are available over the counter and as prescription drugs. They’re commonly used to treat mild to moderate pain. They may be used short-term or long-term depending on the condition you’re taking them for.

Examples of NSAIDs include:

• aspirin
• ibuprofen (Advil)
• naproxen (Aleve)
• celecoxib (Celebrex)
• meloxicam (Mobic)

What could happen

Both Brilinta and NSAIDs decrease your blood’s ability to form clots and increase your risk of bleeding. Combining the two may further increase your risk of bleeding.

What you can do

Talk with your doctor if you take NSAIDs on a regular basis or occasionally. They can advise you on whether it’s safe for you to take both drugs.

Interaction with certain statin drugs

Brilinta interacts with certain statin drugs.

Statins are medications used to treat high cholesterol. They’re also prescribed to lower cardiovascular (heart and blood vessel) risks, including the risk of heart attack. Brilinta is commonly prescribed together with a statin.

Brilinta slows down the activity of an enzyme that breaks down certain statins in the body, including:

• simvastatin (Zocor)
• lovastatin (Altoprev)

When Brilinta slow down the activity of this enzyme, certain statins that are typically broken down by this enzyme can build up in the body. Taking Brilinta with one of these statins can lead to higher levels of these drugs.

What could happen

Taking Brilinta with one of these statins can increase the level of that drug in your body. This increases your risk of side effects from that drug, such as the risk of statin-induced muscle pain.

What you can do

If you and your doctor decide you should take Brilinta with simvastatin or lovastatin, your doctor will likely lower the dose of the statin. And your doctor will also monitor you for side effects from the statin.

Brilinta may have other interactions. They could occur with supplements, foods, vaccines, or even lab tests. See below for details. Note that the information below does not include all other possible interactions with Brilinta.

Does Brilinta interact with supplements?

Before you start taking Brilinta, talk with your doctor and pharmacist about any supplements, herbs, and vitamins you take. Sharing this information with them may help you avoid possible interactions.

If you have questions about interactions that may affect you, talk with your doctor or pharmacist.

Brilinta interactions with herbs

The herbal supplement St. John’s wort interacts with Brilinta.

Some people take St. John’s wort to support their mood. But you should not take it with Brilinta.

St. John’s wort speeds up the activity of the enzyme that breaks down Brilinta. Taking St. John’s wort with Brilinta can cause you to have low levels of Brilinta in your body. This decreases Brilinta’s effectiveness.

If Brilinta isn’t able to work well, it may allow a blood clot to form. This increases your risk of having a heart attack or stroke.

Due to this interaction, your doctor will likely suggest that you not take St. John’s wort with Brilinta. Talk with your doctor about alternative treatments that are safe to take together.

Brilinta and vitamins

There are currently no reports of Brilinta interacting with vitamins. But this doesn’t mean that vitamin interactions won’t be recognized in the future.

For this reason, it’s still important to check with your doctor or pharmacist before taking any of these products while using Brilinta.

Does Brilinta interact with food?

While you’re taking Brilinta, your doctor may suggest that you avoid or limit consumption of grapefruit and grapefruit juice.

Grapefruit interferes with the enzyme that breaks down Brilinta. Consuming grapefruit while taking Brilinta may lead to Brilinta building up in your body. This increases the risk of side effects from Brilinta, including the risk of bleeding.

Talk with your doctor if you have questions about Brilinta and its interaction with grapefruit.

Does Brilinta interact with vaccines?

Brilinta isn’t known to interact with any vaccines.

Talk with your doctor or pharmacist if you have questions about receiving vaccines while you’re taking Brilinta.

Does Brilinta interact with lab tests?

Brilinta is an antiplatelet drug. It can interfere with lab tests that have to do with platelets. (Platelets are a type of blood cell that form clots.)

Remember to share your medication list with everyone on your healthcare team. And if you have questions about how Brilinta could affect your lab tests, talk with your doctor.

Does Brilinta interact with cannabis or CBD?

Cannabis (commonly called marijuana) and cannabis products, such as cannabidiol (CBD), have been specifically reported to interact with Brilinta. Cannabis and cannabis products weakly block the enzyme that breaks down Brilinta after you take a dose. This could lead to a buildup of Brilinta in your body and increase the primary effect and risk of side effects from Brilinta.

Before you start treatment with Brilinta, tell your doctor and pharmacist if you use cannabis. By sharing this information with them, you may help prevent possible interactions.

Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.

Certain medical conditions or other health factors may raise the risk of interactions with Brilinta. Before taking Brilinta, talk with your doctor about your health history. They’ll determine whether Brilinta is right for you.

Health conditions or other factors that might interact with Brilinta include:

Bleeding problem. Treatment with Brilinta increases your risk of bleeding. If you have an existing bleeding problem, such as hemophilia, this risk will likely be higher. Your doctor can help determine whether Brilinta is safe for you to take.

Severe liver problem. If you have a severe liver problem, such as cirrhosis, your doctor likely won’t prescribe Brilinta. It’s not known whether it’s safe to take the drug if you have a severe liver problem. Your doctor can recommend an alternative treatment for you instead.

Lung problem, such as asthma. In rare cases, treatment with Brilinta has caused shortness of breath as a side effect. If you have a lung problem, such as asthma, you may be at higher risk of this side effect if you take Brilinta.

Recent serious injury or surgery, or planned surgery. Taking Brilinta increases your risk of bleeding. It’s important to tell your doctor if you’ve recently had surgery or a serious injury. You should also let your doctor know if you have any procedures or surgeries scheduled for the future.

Pregnancy. It’s not known whether it’s safe to take Brilinta while pregnant. Talk with your doctor to learn more about the risks and benefits of treatments for your condition, including Brilinta, if used during pregnancy.

Breastfeeding. It’s recommended that you don’t breastfeed your child while taking Brilinta. Talk with your doctor if you have questions or concerns about feeding your child while taking Brilinta.

Allergic reaction. If you’ve had an allergic reaction to Brilinta or any of its ingredients, your doctor will likely not prescribe Brilinta. This is because taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better choices for you.

Taking certain steps can help you avoid interactions with Brilinta. Before starting treatment, talk with your doctor and pharmacist. Things to discuss with them include:

• Whether you drink alcohol or use cannabis.
• Other medications you take, as well as any vitamins, supplements, and herbs. Your doctor or pharmacist can help you fill out a medication list.
• What to do if you start taking a new drug during your Brilinta treatment.

It’s also important to understand Brilinta’s label and other paperwork that may come with the drug. Colored stickers that describe interactions may be on the label. And the paperwork (sometimes called the patient package insert or medication guide) may have other details about interactions. (If you did not get paperwork with Brilinta, ask your pharmacist to print a copy for you.)

If you have trouble reading or understanding this information, your doctor or pharmacist can help.

Taking Brilinta exactly as prescribed can also help prevent interactions.

If you still have questions about Brilinta and its possible interactions, talk with your doctor.

Questions you may want to ask your doctor include:

• Could my diet increase my risk of side effects from Brilinta?
• Should I tell you if I take any over-the-counter medications while taking Brilinta?
• Do other drugs that prevent blood clots have similar interactions?
• If Brilinta interacts with a health condition I have, is the drug still safe for me to take?

To learn more about Brilinta, see these articles:

• All About Brilinta
• Side Effects of Brilinta: What You Need to Know
• Dosage Details for Brilinta
• Brilinta and Cost: What You Need to Know

To get information on different conditions and tips for improving your health, subscribe to any of Healthline’s newsletters. You may also want to check out the online communities at Bezzy. It’s a place where people with certain conditions can find support and connect with others.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.