Supplements and Ticagrelor.
Ticagrelor, sold under the brand names Brilique, Brilinta, is an antiplatelet agent: it reduces platelet aggregation.
Ticagrelor is an antiplatelet agent. UK prescribing is mostly for secondary cardiovascular prevention. Aspirin acetylates COX-1 in platelets for the platelet lifespan, which runs seven to ten days. Clopidogrel and the newer P2Y12 inhibitors block ADP receptors on platelets instead. The supplement surface is additive antiplatelet. Ginkgo biloba, garlic in concentrated extract form, fish oil at higher doses, curcumin, bromelain, andrographis, nattokinase, and vitamin E at higher doses all carry measurable platelet or fibrinolytic effects in human studies. None individually changes bleeding risk much at OTC doses. But the stack matters, and the six week washout window before surgery applies. CYP2C19 metabolism matters specifically for clopidogrel. Omeprazole and certain supplements at high doses can reduce its antiplatelet effect by blocking conversion to the active metabolite. The BNF flags this.
Below are the 6 documented pairs we have explicitly assessed against Ticagrelor in the Distil database: 6 amber. The pairs cluster around 1 mechanism: Additive antiplatelet effect. Every call is cited to either a clinical reference (PMID) or the British National Formulary. Anything not on this list is either still to be assessed or beyond our database scope. The checker beneath surfaces assessments by supplement, and the missing-item form at the bottom of the page routes any uncatalogued supplement into our next curation pass.
Documented interactions
Last reviewed 14 June 2026. Each interaction below lists the evidence its assessment drew on: some rest on studies of the exact pair, others on mechanism evidence, where a citation may support one part of the reasoning rather than the exact combination. The evidence line on each entry says which.
Additive antiplatelet effect
Amber Does Bromelain interact with ?
Bromelain has mild blood-thinning activity that can add to ticagrelor's. Tell your GP if you take bromelain alongside ticagrelor, and stop high-dose bromelain about two weeks before any planned surgery.
Evidence: Limited human data, based on case reports and a known mechanism.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does Fisetin interact with ?
Fisetin may mildly reduce platelet clumping, which could add a little to ticagrelor's blood-thinning effect. This is most relevant during a high-dose fisetin course. If you take ticagrelor and run a fisetin course, mention it to your GP and watch for bruising or bleeding.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does Omega-3 EPA interact with ?
Standard supplement doses of fish oil (under 1 gram of EPA+DHA per day) add only marginally to the antiplatelet effect of ticagrelor. At higher cardiology doses (3 grams per day and above), the combination more meaningfully increases bleeding risk. The combination is worth flagging before any planned surgery or dental procedure.
Evidence: Limited human data, based on case reports and a known mechanism.
Amber Does Pine Bark Extract interact with ?
Pine bark extract (pycnogenol) has a mild blood-thinning effect of its own, most clearly shown in smokers, that can add to ticagrelor's. The combined effect can mean more bruising or bleeding. Stop high-dose pine bark extract at least a week before any planned surgery and tell your GP if you take both together, especially if ticagrelor is combined with aspirin.
Evidence: Limited human data, based on case reports and a known mechanism.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does Resveratrol interact with ?
Resveratrol can mildly reduce platelet clumping, which adds to ticagrelor's blood-thinning effect and may slightly raise bleeding risk. Concentrated supplements are the concern. If you take ticagrelor and use resveratrol, mention it to your GP and watch for bruising or bleeding.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does Vitamin E interact with ?
Vitamin E at high doses (above 400 IU per day) can raise bleeding risk in its own right, which may add to ticagrelor's blood-thinning effect. At low supplement doses (100 to 200 IU) the effect is minimal. Keep vitamin E to modest mixed-tocopherol doses, tell your GP if you take high-dose vitamin E, and stop it six weeks before any planned surgery.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
What this list does not say. Pairs not flagged here are not implicitly safe. They are either not yet in our database, or fall outside our inclusion scope (food-supplement interactions only; for drug-drug interactions, the BNF is authoritative). Use the checker below to surface any supplement, and submit a missing item if you take something we have not catalogued.
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How we grade severity, choose what's in scope, and what we exclude.
Every call on this page is reasoned. We publish the full rubric for severity tiers, the medication inclusion logic, the evidence grades we accept, and what we deliberately leave out. About three thousand words. Worth reading once if you use this tool more than occasionally.
Read the full methodologyA full supplement review, built around you, not a generic stack.
The free checker answers one interaction question at a time. A Distil report reviews the bigger picture: your goals, diet, medications, current supplements and any blood results you provide, then shows what appears worth keeping, changing, adding or leaving out.
- what your diet already covers, so you are not adding a capsule for something food is already handling
- which evidence-graded compounds are worth considering for your goals, and which were considered but left out
- what to keep, change or stop from what you already take, plus the order to introduce anything new
- how your medications and complete supplement stack fit together, with daily timing and a clear point for reassessment
The interaction check is one section of the full report. You also get the reasoning behind each recommendation and the evidence references used.
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