Ticagrelor
Anticoagulant/Antiplatelet · Antiplatelet
Indications
With aspirin for the prevention of atherothrombotic events in acute coronary syndromes, including patients managed medically, with PCI or with CABG.
Dosage
Adults: A loading dose of 180 mg, then 90 mg twice daily for up to 12 mth. Children: Not recommended.
Adverse Effects
Dyspnoea, epistaxis, GI haemorrhage, subcutaneous or dermal bleeding, bruising.
Risk Factor (Pregnancy/Lactation)
Pregnancy: Contraindicated in pregnancy. Lactation: Contraindicated or not recommended. Contraindications: Active bleeding, history of intracranial haemorrhage, moderate to severe hepatic impairment, dialysis, uric acid nephropathy. Ensure contraception in women. Precautions: Bleeding diathesis, surgery, sick sinus syndrome without a pacemaker, 2nd or 3rd degree AV block, bradycardia-related syncope, other risk factors for bradycardia events, history of asthma, COPD, hyperuricaemia, gouty arthritis. Monitor renal function.
Interactions
High-dose (more than 300 mg) aspirin. Ketoconazole, clarithromycin, nefazodone, ritonavir, atazanavir and other CYP3A4 inhibitors. Rifampicin, phenytoin, carbamazepine, phenobarbital and other CYP3A4 inducer. Ergot alkaloids, statins and other CYP3A4 substrates. NSAIDs, anticoagulants, fibrinolytics, antifibrinolytics and other agents that alter haemostasis. Verapamil, cyclosporin. Digoxin. SSRIs, agents that cause bradycardia.
Advice to Patient
Take with or without meals. Contact prescriber immediately if there is severe allergic reaction (rash; itching; hives; chest tightness; difficulty in breathing; swelling of the mouth, face, lips or tongue), bleeding in eye, chest pain, irregular, fast or slow heartbeat, confusion, difficulty in speaking, sudden numbness or weakness of arms/legs/face, blood in urine, coughing up blood, blood with vomit, black or dark coloured stools, bleeding from gums, unusual vaginal bleeding or bruising. Inform prescriber if you recently had surgery or a surgery is due. Medication needs to be stopped atleast 5 days before surgery.
Pharmacokinetics
Absorption: Quickly absorbed from the gut. Metabolism: Hepatic. Bioavailability: 36%. Half-life elimination: 7 hrs (ticagrelor). 9 hrs (active metabolite). Time to peak, plasma: 1.5 hrs (ticagrelor). 2.5 hrs (active metabolite). Excretion: Faeces (58%). Urine (26%). Active metabolite: Primarily by biliary excretion, urine (<1%).
Brands with this active ingredient
Compiled by Healify Pharmacy from published drug references. How we compile it →
Always consult a pharmacist or doctor.