Inhibitors of the liver enzyme CYP3A4, such as ketoconazole and possibly grapefruit juice, increase blood plasma levels of<unk>  and consequently can lead to bleeding and other adverse effects.<unk>  is a weak CYP3A4 inhibitor and is known to increase the concentrations of CYP3A4 metabolised medications; however, this interaction is unlikely to be clinically significant for atorvastatin and simvastatin at recommended doses. CYP3A4 inducers, for example rifampicin and possibly St. John's wort, can reduce the effectiveness of<unk> . There is no evidence for interactions via CYP2C9. The drug also inhibits P-glycoprotein (P-gp), leading to increased plasma levels of digoxin, ciclosporin and other P-gp substrates. Levels of<unk>  and AR-C124910XX (the active metabolite of<unk>  formed by O-deethylation) are not significantly influenced by P-gp inhibitors. It is recommended to use low-dose aspirin (75–100 mg per day) with<unk>  as dual antiplatelet therapy (DAPT). The combination of<unk>  with aspirin doses greater than 100 mg per day may be less effective.
Ticagrelor
Clopidogrel
Ticlopidine
Prokarin
Rivaroxaban
Eptifibatide
Apixaban
Palladin