Ticagrelor Disease Interactions

Ticagrelor is contraindicated in patients with active pathological bleeding, such as peptic ulcer or intracranial hemorrhage.

Ticagrelor is metabolized by the liver. The use of ticagrelor should be avoided in patients with severe hepatic impairment. Care should be taken in patients with moderate hepatic impairment and it is recommended to consider the risks and benefits of treatment due to the probable increase in exposure to ticagrelor. No dosage adjustment is needed in patients with mild hepatic impairment.

Ticagrelor can cause ventricular pauses. Bradyarrhythmias including AV block have been reported in the postmarketing setting. It is recommended to use care if prescribing this agent to patients with a history of sick sinus syndrome, 2nd or 3rd degree AV block or bradycardia-related syncope not protected by a pacemaker as they may be at increased risk of developing bradyarrhythmias.

Dyspnea has been reported with the use of ticagrelor. Care should be taken when prescribing this drug to patients that experienced dyspnea. If a patient develops new, prolonged, or worsened dyspnea that is determined to be related to the drug, no specific treatment is required; continue treatment and monitoring without interruption, if possible. In the case of intolerable dyspnea requiring discontinuation, consider prescribing another antiplatelet agent.

No dosage adjustment is needed in patients with renal impairment. Patients receiving dialysis have not been studied, close monitoring is recommended.