How long do I have to take Brilinta after a stent or heart attack?
Medically reviewed by Leigh Ann Anderson, PharmD. Last updated on Nov 12, 2020.
Brilinta is typically used for 6 to 12 months, or longer, after a stent or heart attack. It is given with low-dose aspirin to help prevent blood clots. Based on your use, you may receive Brilinta for different amounts of time. Follow your doctor’s orders when taking Brilinta. If you stop taking Brilinta too soon, it can increase your risk of a heart attack, stroke or death.
Brilinta is used to:
- reduce the chance of a heart attack, stroke or death if you have acute coronary syndrome (ACS). ACS can result in severe chest pain (angina) or a heart attack (myocardial infarction). This could happen because your heart is not getting enough oxygen. For at least the first 12 months following ACS, it is superior to clopidogrel.
- to reduce the risk of a clot formation in stents of patients who have been stented for treatment of ACS. Further blockage of the stent could lead to heart attack or even death.
- reduce the risk of a first heart attack or stroke in patients with coronary artery disease (CAD) at high risk for such events.
- to reduce the risk of stroke in patients with acute ischemic stroke (NIH Stroke Scale score ≤5) or high-risk transient ischemic attack (TIA)
You will usually be prescribed aspirin with Brilinta to reduce the chance of a blood clot forming. Using Brilinta and aspirin together is called “dual antiplatelet therapy”. Do not stop either of these medications without speaking to your doctor first, as that can increase your risk of a heart attack, stroke or death.
Brilinta after a stent
- Brilinta plus aspirin is usually given for 6 to 12 months and sometimes longer to reduce clot formation in the stent.
- A blockage in your stent could happen quickly (within hours or days) or even as late as one year after you get your stent.
- Your doctor may decide to stop the aspirin earlier based on your bleeding risk. The exact duration is usually based on your age, bleeding risk, and risk for cardiac events or other medical conditions.
Brilinta after a heart attack
- Brilinta plus aspirin is typically continued for one year after an acute coronary syndrome (ACS) event, like a heart attack, and your doctor may decide it should be continued for longer than one year.
- For at least one year after ACS, Brilinta has been found in studies to be better than the use of another antiplatelet drug known as clopidogrel (brand name: Plavix).
Brilinta to prevent a heart attack
In June 2020, Brilinta was approved to reduce the risk of a first heart attack or stroke in patients with coronary artery disease (CAD) at high risk for such events.
- While use is not limited to this setting, the effectiveness of Brilinta was shown in Phase 3 studies in patients with type 2 diabetes.
- In studies of high-risk patients with coronary artery disease (CAD) and type-2 diabetes, at 36 months, the combined use of aspirin plus Brilinta 60 mg was significantly more effective at preventing a major event such as heart attack or stroke when compared to taking aspirin alone.
Brilinta to reduce the risk of stroke of high-risk TIA
- In studies, Brilinta or placebo was given to patients with an acute ischemic stroke or TIA within 24 hours of onset. Treatment was continued for a median of 30 days.
- Brilinta was found to be superior to placebo in reducing the rate of a composite of stroke and death (the primary endpoint).
- The manufacturer suggests treatment be continued for up to 30 days. The treatment effect accrued early in the course of therapy
Brilinta and surgery
If you are having surgery, your doctor may instruct you to stop taking Brilinta 5 days before your procedure. This will help to lower the chance of bleeding. Follow your doctor’s directions on when to start taking Brilinta again.
- Brilinta is often used for 6 to 12 months, or longer, after a stent or heart attack. It is very important to follow your doctor’s orders when taking Brilinta. It is given with low-dose aspirin to help prevent blood clots.
- If you stop taking Brilinta too soon, it can increase your risk of a heart attack, stroke or death. However, Brilinta can also increase the risk of severe bleeding that might lead to death. Ask your doctor how long you’ll need to take these drugs and do not stop taking them without talking to your cardiologist first.
- Brilinta (ticagrelor) is manufactured by AstraZeneca and was first approved by the FDA in July 2011.
This is not all the information you need to know about Brilinta for safe and effective use. Review the full Brilinta information here, and discuss this information and any questions with your doctor or other health care provider.
- Brilinta (ticagrelor) [package insert]. Wilmington, DE: AstraZeneca Pharmaceuticals LP; Revised 11/2020. Accessed Nov. 12, 2020 at https://www.azpicentral.com/brilinta/brilinta.pdf
- Cutlip D, et al. Long-term antiplatelet therapy after coronary artery stenting in stable patients. Up to Date. Accessed April 5, 2020 at https://www.uptodate.com/contents/long-term-antiplatelet-therapy-after-coronary-artery-stenting-in-stable-patients#H3906465077
- Patient education: Stenting for the heart (Beyond the Basics). Up to Date. Accessed April 5, 2020 at https://www.uptodate.com/contents/stenting-for-the-heart-beyond-the-basics
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