{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T01:52:56Z","timestamp":1777859576236,"version":"3.51.4"},"reference-count":8,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2024,8,15]],"date-time":"2024-08-15T00:00:00Z","timestamp":1723680000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Pharmacy Practice"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:p>\n                    Ticagrelor is contraindicated in combination with cytochrome P450 3A4 and 3A5 enzyme (CYP3A4\/5) inducers due to increased clearance, causing diminished antiplatelet effects. The emergent nature of acute coronary syndromes (ACS) may preclude scrutinization of home medications before P2Y\n                    <jats:sub>12<\/jats:sub>\n                    inhibitor administration. The purpose of this case series is to establish the temporal impact of CYP3A4\/5 enzyme induction on ticagrelor\u2019s pharmacodynamic effect by utilizing VerifyNow platelet aggregation studies. This was a retrospective case series of three patients who were taking a CYP3A4\/5-inducing medication and loaded with ticagrelor for ACS. The duration of ticagrelor\u2019s antiplatelet effect was dramatically shortened in the presence of background CYP3A4\/5 induction. The offset of antiplatelet effect, defined by platelet reactivity units (PRU), was 10-24\u00a0hours in the presence of CYP3A4\/5 enzyme induction compared to the anticipated 36-48 hours. This was consistent across CYP3A4\/5-inducing medications including carbamazepine, phenobarbital, and phenytoin. This study demonstrates rapid return of platelet function after a ticagrelor loading dose in the presence of CYP3A4\/5-inducing medications. Monitoring of PRU every 6-12\u00a0hours with subsequent loading with clopidogrel or prasugrel should be considered. Larger scale studies are warranted to confirm these results.\n                  <\/jats:p>","DOI":"10.1177\/08971900241273095","type":"journal-article","created":{"date-parts":[[2024,8,15]],"date-time":"2024-08-15T22:07:56Z","timestamp":1723759676000},"page":"204-207","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Temporal Effect of CYP3A4\/5 Induction on Ticagrelor\u2019s Pharmacodynamic Effects: A Case Series"],"prefix":"10.1177","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8692-9675","authenticated-orcid":false,"given":"Thomas W.","family":"Szymanski","sequence":"first","affiliation":[{"name":"Department of Pharmacy, WVU Medicine, Morgantown, WV, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-7149-4695","authenticated-orcid":false,"given":"Matthew R.","family":"Rockhold","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, WVU Medicine, Morgantown, WV, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0804-584X","authenticated-orcid":false,"given":"Jordan L.","family":"Lacoste","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, WVU Medicine, Morgantown, WV, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2024,8,15]]},"reference":[{"key":"bibr1-08971900241273095","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0904327"},{"key":"bibr2-08971900241273095","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001038"},{"key":"bibr3-08971900241273095","unstructured":"Brilinta (ticagrelor) [prescribing information], Wilmington DE. AstraZeneca Pharmaceuticals LP. 2020. https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2020\/022433s029lbl.pdf"},{"key":"bibr4-08971900241273095","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.109.912550"},{"key":"bibr5-08971900241273095","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2019.03.034"},{"key":"bibr6-08971900241273095","volume-title":"Presented at: AHA","author":"So DYF","year":"2021"},{"key":"bibr7-08971900241273095","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.109.912550"},{"key":"bibr8-08971900241273095","doi-asserted-by":"publisher","DOI":"10.1007\/s11239-019-01971-1"}],"container-title":["Journal of Pharmacy Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/08971900241273095","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/08971900241273095","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/08971900241273095","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:33:35Z","timestamp":1777509215000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/08971900241273095"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,15]]},"references-count":8,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,2]]}},"alternative-id":["10.1177\/08971900241273095"],"URL":"https:\/\/doi.org\/10.1177\/08971900241273095","relation":{},"ISSN":["0897-1900","1531-1937"],"issn-type":[{"value":"0897-1900","type":"print"},{"value":"1531-1937","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,8,15]]}}}