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Ticagrelor Dosage

Applies to the following strength(s): 60 mg ; 90 mg

The information at Drugs.com is not a substitute for medical advice. Always consult your doctor or pharmacist.

Usual Adult Dose for:

Additional dosage information:

Usual Adult Dose for Acute Coronary Syndrome

Following an acute coronary syndrome (ACS) event:

Loading dose: 180 mg orally once
Maintenance dose: 90 mg orally twice a day for 1 year
Maintenance dose after 1 year: 60 mg orally twice a day

Comments:
-This drug should be taken in conjunction with a daily maintenance dose of aspirin 75 to 100 mg orally once a day.
-For at least the first 12 months following ACS, this drug is superior to clopidogrel.

Uses:
-To reduce the rate of cardiovascular death, myocardial infarction, and stroke in patients with acute coronary syndrome (ACS) or a history of myocardial infarction.
-To reduce the rate of stent thrombosis in patients who have been stented for treatment of ACS.

Usual Adult Dose for Prevention of Atherothrombotic Events

Following an acute coronary syndrome (ACS) event:

Loading dose: 180 mg orally once
Maintenance dose: 90 mg orally twice a day for 1 year
Maintenance dose after 1 year: 60 mg orally twice a day

Comments:
-This drug should be taken in conjunction with a daily maintenance dose of aspirin 75 to 100 mg orally once a day.
-For at least the first 12 months following ACS, this drug is superior to clopidogrel.

Uses:
-To reduce the rate of cardiovascular death, myocardial infarction, and stroke in patients with acute coronary syndrome (ACS) or a history of myocardial infarction.
-To reduce the rate of stent thrombosis in patients who have been stented for treatment of ACS.

Renal Dose Adjustments

No adjustment recommended

Liver Dose Adjustments

Mild liver dysfunction: No adjustment recommended

Moderate liver dysfunction: Limited clinical evidence; consider risks versus benefits of treatment

Severe liver dysfunction: Avoid use

Dose Adjustments

-Switching to ticagrelor from clopidogrel: Give the first ticagrelor 90 mg oral dose 24 hours after the last dose of clopidogrel

-Switching from prasugrel to ticagrelor has not been studied.

Precautions

US BOXED WARNINGS: BLEEDING RISK and ASPIRIN DOSE AND TICAGRELOR EFFECTIVENESS
-Bleeding risk: This drug, like other antiplatelet agents, can cause significant and sometimes fatal bleeding. Do not use this drug in patients with active pathological bleeding or a history of intracranial hemorrhage. Do not start in patients undergoing urgent coronary artery bypass graft surgery (CABG). If possible, manage bleeding without discontinuing this drug; stopping it increases the risk of subsequent cardiovascular events.
-Aspirin Dose and Ticagrelor Effectiveness: Maintenance doses of aspirin above 100 mg reduce the effectiveness of this drug and should be avoided.

Safety and efficacy have not been established in patients younger than 18 years.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration advice:
-Administer with or without food

For patients who are unable to swallow tablets whole:
-The oral tablet can be crushed, mixed with water, and swallowed immediately; refill the glass with water, stir, and drink again.
-May administer via nasogastric tube (CH8 or greater).

Missed dose: If a dose is missed, take 1 dose at next scheduled time

General:
-This drug should be administered concurrently with aspirin unless specifically contraindicated.
-This drug is superior to clopidogrel for at least the first 12 months following acute coronary syndrome.
-Do not administer with another oral P2Y12 platelet inhibitor.

Monitoring:
-Hematologic: Signs and symptoms of bleeding

Patient advice:
-Instruct the patient that this drug will cause them to bleed and bruise more easily and to report any unexpected, excessive, or prolonged bleeding, blood in the stool/urine, or coughing up blood.
-Instruct patient to contact their health care professional if they experience shortness of breath, especially if severe.
-Instruct patients to check with health care professional when choosing over the counter products as this drug should not be taken with any other products that contain aspirin.
-Instruct patient to inform all physicians and dentists that they are taking this drug.

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