Generic
Ticagrelor
20 brands available in the market
At a glance
Ticagrelor is an antiplatelet drug used to prevent atherothrombotic events in patients with acute coronary syndromes (ACS) or a history of myocardial infarction (MI). It inhibits platelet activation and thrombus formation by blocking P2Y12 receptors.
Description
Ticagrelor is a P2Y12 receptor antagonist. It and its major metabolite reversibly interact with the platelet P2Y12 ADP-receptor, preventing signal transduction and platelet activation. Antagonism of the P2Y12 receptor reduces occlusive thromboses, lowering the risk of myocardial infarction and ischemic stroke.
Indications
- Acute coronary syndromes (ACS)
- Prevention of atherothrombotic events in high-risk patients with a history of myocardial infarction (MI)
Therapeutic class
Anti-platelet Drugs
Pharmacological class
P2Y12 Receptor Antagonist
Pharmacology
Ticagrelor and its major metabolite reversibly bind to the platelet P2Y12 ADP-receptor, preventing signal transduction and platelet activation. It inhibits ADP-mediated platelet aggregation, reducing thrombus formation.
Mechanism of action
Prevents platelet activation and thrombus formation by blocking P2Y12 receptors.
Dosage
Adult Dose (Oral):
- Acute coronary syndromes: Loading dose 180 mg (two 90 mg tablets); Maintenance 90 mg twice daily (first year)
- History of MI (>1 year): 60 mg twice daily
- With aspirin: Aspirin loading 325 mg, maintenance 75-100 mg/day (do not exceed 100 mg/day)
Administration
- Can be taken with or without food
- Swallow tablet whole; do not chew, crush, or break
- Take at the same time each day
Missed dose
If you miss a dose, take it as soon as you remember; if almost time for the next dose, skip it (take only one tablet); do not double the dose.
Side effects
Common Side Effects:
- Bleeding (most common)
- Dyspnea (shortness of breath)
- Hyperuricemia
- Dizziness, headache
- Diarrhea, nausea, constipation
- Rash, pruritus
Serious:
- Intracranial hemorrhage
- Serious bleeding
Precautions & warnings
- Increased bleeding risk; caution with shaving, sharp objects
- Do not use in severe hepatic impairment
- Inform physician before surgery or dental treatment (may need to stop 5 days prior)
- Dyspnea may occur initially; inform doctor if it worsens
Contraindications
- Active pathological bleeding
- History of intracranial hemorrhage
- Severe hepatic impairment
- Hypersensitivity to ticagrelor or components (angioedema)
Drug interactions
- Strong CYP3A4 inhibitors (clarithromycin, nefazodone, ritonavir, atazanavir): Contraindicated
- Strong CYP3A4 inducers (rifampicin): Reduced efficacy; discouraged
- Simvastatin/lovastatin >40 mg: Not recommended
- NSAIDs, anticoagulants, fibrinolytics: Increased bleeding risk
- SSRIs: Increased bleeding risk
Food interactions
Caution is advised when consuming alcohol with Ticagrelor; consult your doctor.
Use in pregnancy
Use in Pregnancy: May be unsafe; animal studies show harmful effects; use only if clearly needed; consult your doctor.
Pregnancy Category: C — always consult a doctor before taking during pregnancy.
Use in lactation
Use in Lactation: Information not available; consult your doctor.
Pediatric use
Safety and efficacy not established in children <18 years
Geriatric use
No dose adjustment required in elderly
Renal / hepatic impairment
Renal Impairment: Safe in kidney disease; no dose adjustment needed; limited information in dialysis patients; not recommended; consult your doctor.
Hepatic Impairment: Contraindicated in severe hepatic impairment; caution in moderate; consult your doctor.
Overdose effects
Tolerated in single doses up to 900 mg; overdose may cause dyspnea and ventricular pauses; provide symptomatic treatment.
Storage conditions
Store in a cool and dry place, protected from light; keep out of reach of children.
Chemical structure
Ticagrelor