Ticagrelor (Oral)

By preventing cells in the blood from grouping together, Ticagrelor cuts the risk of blood clots, heart attacks and strokes in patients who are particularly at risk.

Overview

Ticagrelor is an anti-platelet designed to be used either by itself or alongside aspirin to cut down on the chances of patients experiencing a heart attack or stroke. It works by stopping some of the cells naturally present in the blood from grouping together, which in turn reduce the risk of a blood clot taking place. Blood clots are one possible cause of strokes and heart attacks, so by taking ticagrelor, the chances are lowered. Ticagrelor is often prescribed to people who have already experienced either issues with their blood circulation or have had heart attacks or strokes before now.

This medication is only available as a tablet, and can only be procured following a prescription from a physician. Ticagrelor has the brand name Brilinta, so you may see it referred to as this in stores and pharmacies.

Conditions treated

  • Blood circulation issues
  • Risk of heart attack
  • Risk of stroke

Type of medicine

  • Anti-platelet

Side effects

All medicines are designed to alleviate symptoms and improve your condition, but often there are unpleasant extra problems which can arise as a result of taking the medication - and ticagrelor is no exception.

These can vary from patient to patient, and there is no guarantee that you will or will not experience any particular group of side effects. For that reason, it's a good idea to familiarise yourself with the full list of side effects so that you can prepare for any eventuality.

If you're unsure about any of the side effects or are nervous about the risk they pose to you, it's a good idea to speak to your physician or other healthcare professional before you start taking this medication. That way, you can put your mind at rest and pick up some techniques for managing the effects that taking ticagrelor can bring.

The side effects of ticagrelor can broadly be split into two categories. The first category of ticagrelor side effects is the urgent category: in the event that you experience any of these side effects, you should seek medical attention right away by visiting your physician. If they are not available, you or someone who is accompanying you should tell the staff on duty there that you are taking ticagrelor.

The most serious of these side effects is the risk of major bleeding. This can happen because the medication works by stopping blood cells clotting together, which is usually the body's way of preventing bleeding. Prolonged bleeding can manifest itself in many different ways, so it is wise to be alert. If you start bleeding from the skin and it persists or is unexplained, it should be considered a serious side effect. Furthermore, if you notice blood in your urine (or it takes on a pink or brown color), stools (a red, tarry or black color) or vomit then this should also be considered a serious side effect.

In addition to serious bleeding, there is a wide range of other possible serious ticagrelor side effects which you should be aware of before beginning your course of this medicine. These include chest-related problems, such as pain, difficulty catching your breath or an unusually fast, slow or irregular heartbeat. In addition, if you find that you develop spots under the skin in a red or purple hue or you begin to bruise easily, you should seek medical attention. This is not an exhaustive list, so you should familiarise yourself with the other possible serious side effects before beginning your course of ticagrelor.

The next category of ticagrelor side effects are those which are common and less serious. In the event that you develop any of these side effects, you should consult your doctor if they persist or become particularly severe, painful or uncomfortable. However, they do not usually require emergency medical attention. This category includes conditions such as a bad headache, a mild feeling of dizziness, digestive problems like diarrhea or nausea, or tiredness and fatigue.

The full list of possible side effects will usually be printed on the information booklet which comes inside your ticagrelor package, so it is a good idea to keep this booklet and read it through before beginning the course. If this is not available or is unclear, speak to your physician or healthcare professional.

Dosage

Although average dosage information is available, this won't necessarily match the dosage you are given by your physician as your dose is designed specifically for you. Depending on your own personal medical situation, your dosage can vary. For that reason, you should always follow the instructions given to you by your healthcare professional or the information printed on the packaging.

Your dosage is built around you and your medical needs, so don't alter it unless your physician says so. Furthermore, it is not just the dosage itself which can vary from patient to patient. Also affected are the number of doses, the time in between doses and more.

Adults usually begin on a dosage of 180 milligrams (mg) of ticagrelor. This works out as two tablets of 90 mg, taken together. Following this initial dose, adults usually take 90 mg twice per day. In addition, your physician may prescribe aspirin to take alongside ticagrelor. The standard "loading dose" - a higher than usual first dose to kick off the treatment - of aspirin when taken with ticagrelor is 325 mg, and this often gets reduced to a figure between 75 mg and 100 mg to be taken alongside your ticagrelor.

No average dosage information is available for children, as this is usually set by your child's physician.

Interactions

When a drug enters your body, it can sometimes interact with other substances which are also present. This is because each drug has powerful ingredients which not only help you to get better but can also cause problems.

These substances include other medication, certain foodstuffs and drinks, and also other illnesses which your body has to deal with simultaneously. Ticagrelor is no exception.

For that reason, you should always ensure you keep an up to date and accurate record of all the drugs you currently take and ensure that this list is placed in your medical notes and shared with your doctor.

Firstly, ticagrelor can interact with other medications you are currently taking. If you are taking antibiotics, for example, you should be aware that ticagrelor can interact with some of them. They include PrevPac (composed of clarithromycin, lansoprazole and amoxicillin) as well as Ketek (whose technical name is telithromycin).

Medications which are designed to treat high blood pressure can also interact with ticagrelor, while if you are taking certain medications to treat human immunodeficiency virus (HIV) then you also need to be careful. HIV medications which can interact with ticagrelor include Viracept (nelfinavir), Reyataz (atazanavir) and Invirase (saquinavir).

In addition, some medications designed to slash the level of cholesterol in your body - such as Vfend (voriconazole) or Nizoral (ketoconazole) - can also interact with ticagrelor.

Secondly, there are some food and drink items which are known to interact with ticagrelor. For example, you should avoid consuming alcohol while taking ticagrelor as it boosts the risk of bleeding in your stomach or intestines.

These lists are not exhaustive, so again, you should ensure your physician has all the knowledge they need to make a safe judgment about your usage of ticagrelor.

Warnings

As with many drugs, ticagrelor comes with a list of warnings designed to prevent complications when taking the medication. While it's unlikely that all of the warnings associated with ticagrelor will apply to you, it's a good idea to check the full list so that you are fully prepared.

The first set of ticagrelor warnings relate to the anti-blood clotting function the drug possesses. Ticagrelor comes with what is known as a "black box warning", and this warning is carried on all medications which can cause life-threatening or particularly serious bleeding in those who take it. For that reason, you should always make sure your physician is aware if you have ever suffered from a medical condition which means you bleed easily, or if you have recently experienced an injury (perhaps from sport or exercise), developed a stomach ulcer, undergone surgery or experienced bleeding in your organs.

Furthermore, you should make sure your physician knows if you have ever suffered from polyps or other conditions in the intestines, medicinal allergies, lung or liver disease, or strokes. While these conditions may not appear to have a direct link to bleeding, they can in some circumstances raise the risk.

Because of the raised risk of bleeding when taking ticagrelor, it's wise to avoid any strenuous activities which can cause cuts and consequent bleeding. For example, certain types of exercise may be best suspended for the course of the medication, while using knives in the kitchen may be worth avoiding. In addition, normal hygiene activities which can lead to cuts - such as teeth brushing or shaving - should be carried out with extra care and attention.

While not directly related to bleeding, you should also bear in mind that ticagrelor can affect how alert you feel, and it can also cause dizziness. For that reason, it is recommended that you steer clear of tasks such as driving until you are fully certain how taking ticagrelor is affecting your reaction times and other key skills.

In terms of pregnancy, it is not known whether or not taking ticagrelor can cause harm to an unborn baby. In the event that you fall pregnant or may become pregnant at some point in the duration of your ticagrelor course, you should ensure your physician is made aware straight away. However, you should not breastfeed while you are taking ticagrelor, as it is not known what the consequences on breast milk of taking this drug might be.

It's very important that all healthcare professionals with whom you come into contact are aware that you are taking ticagrelor. This includes physicians, but it also involves those who work in pharmacies and other locations such as dental practices. If you are about to have dental work or another procedure carried out, you may need to stop taking your ticagrelor and wait around five days before you can undergo it in order to ensure your body has time to begin clotting blood again. Do not do this without talking to your physician.

In addition to this, you should never stop taking this medication without speaking to your physician for any reason. This is because stopping without appropriate medical supervision can lead to a higher risk of experiencing blood clots, heart attacks or other problems.

Your ticagrelor will most likely come with an information booklet inside its packaging. You should keep this booklet for the duration of your course of ticagrelor, as you may need to refer back to it at some point in the future.

Storage

When it comes to keeping medication securely stored away, it's vital that you take appropriate care and attention to stop it falling into the wrong hands.

Firstly, keep your ticagrelor stored high up and safely out of the reach of children. This can help prevent accidental consumption. Even if you do not have children living with you, you should make sure you keep it stored away just in case any children come to visit your home and you forget to move it.

Secondly, you should always store your medication in a location which is far away from any adverse environmental conditions. These include sources of heat and moisture, but also sources of direct light. Never freeze your ticagrelor, as this can seriously damage it. Ensure you keep your ticagrelor in a closed box.

In the event that you stop taking ticagrelor early (with your physician's permission) or you have a surplus of tablets, you should dispose of them in an appropriate fashion. If you are unsure how to go about doing this, you should speak to a healthcare professional about the best way of doing it.

Summary

Ticagrelor is a useful drug for those who are at risk of health outcomes like heart attacks, strokes and blood circulation problems. Available only via prescription and known in the USA as Brilinta, it treats a number of conditions and it is often given to those who have suffered from these health problems before. This anti-platelet works by preventing certain cells in the blood from grouping together and causing blood clots.

As with many medications, using ticagrelor brings with it a number of possible side effects - and these can vary from person to person. Major side effects of using ticagrelor include problems like excessive bleeding, as ticagrelor carries a black box warning for risk of serious bleeding. This can manifest itself not just as blood seeping from the skin, but also blood in urine, stools, vomit and more.

Other serious side effects include chest pain, difficulty catching your breath or a heartbeat with an unusual rhythm. In the event that you experience any of these, you should see a physician or medical professional right away. Less serious side effects include dizziness and fatigue.

Dosages vary from person to person, but the standard adult dosage is 180 mg per day. Always follow the instructions given to you by your physician. There are many possible interactions between ticagrelor and other drugs and substances, such as many leading HIV medications, cholesterol cutters and alcohol. You should make your physician aware of every drug you are currently taking, as this is necessary to ensure your dosage is safe.

Taking ticagrelor carries with it a number of warnings. You should not drive until you are fully aware of how taking ticagrelor affects your body's reaction times, while you should also take care when carrying out activities which could cause cuts and bleeding, such as shaving.

Remember to store your ticagrelor in a safe place away from conditions such as heat, direct light and more. Keep this medication out of the reach of children in order to prevent accidental consumption, and take advice from a medical professional on how to appropriately dispose of any ticagrelor you no longer need.

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Last Reviewed:
December 23, 2017
Last Updated:
April 05, 2018
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