How long should Brilinta be held/stopped before surgery?

Key Points

• If you are having surgery, your doctor may instruct you to stop taking Brilinta (generic name: ticagrelor) 5 days before your procedure. This will help to lower the chance of bleeding.
• Always follow your doctor’s directions about when to stop or start taking Brilinta again. If you stop taking Brilinta too soon, it may increase your risk of a heart attack, stroke or death.
• Brilinta is an oral antiplatelet prescription tablet that is usually taken twice a day, in the morning and the evening. It is classified as a P2Y12 inhibitor that works by making your platelets less sticky to help prevent blood clots from forming. Like blood thinners, it also has a risk of serious or possibly fatal bleeding.

Brilinta is approved by the FDA to:

• reduce the risk of cardiovascular death, a heart attack or stroke in patients with acute coronary syndrome (ACS) or a history of a heart attack. 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 (Plavix).
• lower the chance of a blood clot forming in a stent after it is placed in your artery for ACS. Further blockage of your stent could lead to a heart attack or even death.
• to 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)

Your doctor will also usually prescribe a daily dose of aspirin to reduce the chance of a blood clot forming. Using Brilinta and aspirin together is called “dual antiplatelet therapy”.

Related questions

• How long do I have to take Brilinta after a stent or heart attack?
• What foods should I eat or avoid when taking Brilinta?
• Can you drink alcohol while taking Brilinta?

Does Brilinta have a warning about bleeding?

Yes, Brilinta carries a Boxed Warning about bleeding risk in its package insert. It states:

• Brilinta, like other antiplatelet agents, can cause significant, sometimes fatal bleeding.
• Do not use Brilinta in patients with active pathological bleeding or a history of intracranial (within the skull) hemorrhage.
• Do not start Brilinta in patients undergoing urgent coronary artery bypass graft surgery (CABG).
• If possible, manage bleeding without discontinuing Brilinta. Stopping Brilinta increases the risk of subsequent cardiovascular events (like heart attack or stroke).

Bottom Line

If you are having surgery, your doctor may instruct you to stop taking Brilinta 5 days before your procedure. This will help to lower your chance for bleeding.

Always follow your doctor’s directions on when to stop and start taking Brilinta again. 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.

This is not all the information you need to know about Brilinta (generic name: ticagrelor) for safe and effective use. Review the full Brilinta information here, and discuss this information with your doctor or other health care provider.

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