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Ticagrelor

Generic Name: ticagrelor (tye KA grel or)
Brand Name: Brilinta (ticagrelor), Brilinta

Medically reviewed on May 8, 2018

What is ticagrelor?

Ticagrelor prevents platelets in your blood from sticking together to form an unwanted blood clot that could block an artery.

Ticagrelor is used together with aspirin to lower your risk of having a stroke or serious heart problems after you've had a heart attack or severe chest pain (angina).

Ticagrelor may also be used for purposes not listed in this medication guide.

Important Information

You should not use ticagrelor if you have any active bleeding or a history of bleeding in the brain. Do not use ticagrelor just before heart bypass surgery.

Ticagrelor may cause you to bleed more easily, which can be severe or life-threatening. Call your doctor or seek emergency medical attention if you have bleeding that will not stop, black or bloody stools, red or pink urine, or if you cough up blood or vomit that looks like coffee grounds.

Tell your doctor about all your current medicines and any you start or stop using. Many drugs can interact with ticagrelor.

Do not stop taking ticagrelor without first talking to your doctor, even if you have signs of bleeding. Stopping ticagrelor may increase your risk of a heart attack or stroke.

Before taking this medicine

You should not use ticagrelor if you are allergic to it, or if you have:

  • any active bleeding; or

  • a history of bleeding in the brain (such as from a head injury).

Tell your doctor if you have ever had:

  • a stroke;

  • heart problems;

  • a surgery or bleeding injury;

  • bleeding problems;

  • a stomach ulcer or colon polyps;

  • liver disease; or

  • asthma, COPD (chronic obstructive pulmonary disorder) or other breathing problem.

It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

You should not breast-feed while using ticagrelor.

How should I take ticagrelor?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Ticagrelor is taken together with aspirin. Use these medicines exactly as directed.

Do not take more aspirin than your doctor has prescribed. Taking too much aspirin can make ticagrelor less effective.

Take ticagrelor at the same time each day, with or without food.

If you cannot swallow a tablet whole, crush the pill and mix it with water. Stir and drink this mixture right away. Add more water to the glass, stir, and drink right away.

Ticagrelor keeps your blood from coagulating (clotting) and can make it easier for you to bleed, even from a minor injury. Contact your doctor or seek emergency medical attention if you have any bleeding that will not stop.

To prevent excessive bleeding, you may need to stop using ticagrelor for a short time before a surgery, medical procedure, or dental work. Any healthcare provider who treats you should know that you are taking ticagrelor.

Do not stop taking ticagrelor without first talking to your doctor, even if you have signs of bleeding. Stopping the medicine could increase your risk of a heart attack or stroke.

Store at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Overdose can cause excessive bleeding.

What should I avoid while taking ticagrelor?

Drinking alcohol while taking aspirin can increase your risk of stomach bleeding.

Avoid activities that may increase your risk of bleeding or injury. Use extra care to prevent bleeding while shaving or brushing your teeth.

While taking ticagrelor with aspirin, avoid using medicines for pain, fever, swelling, or cold/flu symptoms. They may contain ingredients similar to aspirin (such as salicylates, ibuprofen, ketoprofen, or naproxen). Taking certain products together can cause you to get too much aspirin which can increase your risk of bleeding.

Ticagrelor side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • slow heartbeats;

  • nosebleeds, or any bleeding that will not stop;

  • shortness of breath even with mild exertion or while lying down;

  • easy bruising, unusual bleeding, purple or red spots under your skin;

  • red, pink, or brown urine;

  • black, bloody, or tarry stools; or

  • coughing up blood or vomit that looks like coffee grounds.

Common side effects may include:

  • bleeding; or

  • shortness of breath.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Ticagrelor dosing 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.

What other drugs will affect ticagrelor?

Sometimes it is not safe to use certain medications at the same time. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective.

Tell your doctor about all your current medicines. Many drugs can affect ticagrelor, especially:

  • antifungal medicine;

  • antiviral medicine to treat HIV or AIDS;

  • a blood thinner;

  • cholesterol medication;

  • heart or blood pressure medication;

  • opioid medication;

  • seizure medicine; or

  • tuberculosis medicine.

This list is not complete and many other drugs may affect ticagrelor. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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