Ticagrelor | Side Effects, Dosage, Uses & More
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Generic Name:

ticagrelor, Oral tablet

All Brands

  • BRILINTA
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Highlights for ticagrelor

Oral tablet
1

Ticagrelor is used to treat people who have had a heart attack or severe chest pain because their heart was not getting enough oxygen. This is called acute coronary syndrome.

2

This drug comes in the form of a tablet you take by mouth.

3

Ticagrelor is only available as a brand-name drug called Brilinta. It’s not available as a generic drug.

4

The more common side effects of this drug include bleeding more easily than normal, increased uric acid levels in your body, and shortness of breath.

5

In some cases, ticagrelor can cause serious side effects. These can include major bleeding and shortness of breath.

IMPORTANT INFORMATION

FDA warning

This drug has a black box warning. This is the most serious warning from the Food and Drug Administration (FDA). A black box warning alerts doctors and patients about drug effects that may be dangerous.

Bleeding risk warning. This drug may cause you to bleed more easily. You shouldn’t take this drug if you have bleeding in your brain, a condition that causes you to bleed heavily, a problem with blood flow, or any other risk factors for bleeding. Don’t take ticagrelor before or after having heart bypass surgery.

Aspirin warning. You should take this drug with aspirin. However, you shouldn’t take more than 100 mg of aspirin per day because it will affect how well ticagrelor works. Don’t take higher doses of aspirin than what your doctor tells you to take.

Trouble breathing

This drug may make it harder for you to breathe. You shouldn’t take this drug if you continually have trouble breathing.

Drug features

Ticagrelor is a prescription drug. It’s available as an oral tablet.

Ticagrelor isn’t available as a generic drug. It’s only available as the brand-name drug Brilinta.

Ticagrelor may be used as part of a combination therapy. This means you may need to take it with other medications.

Why it's used

Ticagrelor is used to treat people who have had a heart attack or severe chest pain because their heart was not getting enough oxygen. This is called acute coronary syndrome.

This drug is used with aspirin to lower your chance of having another serious problem with your heart or blood vessels. These include a heart attack, stroke, or blood clots in your stent. These events can be fatal (cause death).

How it works

Ticagrelor belongs to a class of drugs called platelet inhibitors. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

Ticagrelor works by stopping platelets from clumping together and forming a clot. Platelets are blood cells that help with normal blood clotting. This drug can keep a clot from forming and blocking an artery. This lowers your chance of having another heart problem.

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ticagrelor Side Effects

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More Common Side Effects

The more common side effects of ticagrelor can include:

  • bleeding more easily than normal

  • increased levels of uric acid in your body. If your uric acid level gets too high, you may be at greater risk for developing gout.

  • shortness of breath

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious Side Effects

Call your doctor right away if you have serious side effects. Call 9-1-1 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Shortness of breath. Symptoms can include:

    • tightening in your chest
    • trouble breathing
    • discomfort in your upper body
  • Major bleeding. Symptoms can include:

    • bleeding that’s severe or that you cannot control
    • pink, red, or brown-colored urine
    • vomiting blood or vomit that looks like coffee grounds
    • red or black-colored stools that look like tar
    • coughing up blood or blood clots
Pharmacist's Advice
Healthline Pharmacist Editorial Team

Ticagrelor doesn’t cause drowsiness.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
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ticagrelor May Interact with Other Medications

Oral tablet

Ticagrelor can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Alcohol interaction

The use of drinks that contain alcohol can increase your risk of stomach side effects from ticagrelor. If you drink alcohol, talk to your doctor. You may need to be monitored for signs of bleeding.

Medications that might interact with this drug

Drugs that increase the risk of side effects
  • Increased side effects from other drugs: Taking ticagrelor with certain medications raises your risk of side effects from those drugs. Examples of these drugs include:
    • Cholesterol drugs, such as lovastatin and simvastatin. You may have muscle problems. Your doctor may adjust the dose of your statin drugs if you need to take them with ticagrelor.
    • Digoxin. Your doctor may monitor your digoxin blood levels.
  • Increased side effects from ticagrelor: Taking ticagrelor with certain medications raises your risk of side effects from ticagrelor. This is because the amount of ticagrelor in your body is increased. Examples of these drugs include:
    • Azole antifungals, such as ketoconazole, voriconazole, and itraconazole. These drugs may raise your risk of bleeding, shortness of breath, and other side effects.
    • Human immunodeficiency virus (HIV) drugs, such as saquinavir, nelfinavir, indinavir, atazanavir, and ritonavir. These drugs may raise your risk of bleeding, shortness of breath, and other side effects.
    • Macrolide antibiotics, such as clarithromycin and telithromycin. These drugs may raise your risk of bleeding, shortness of breath, and other side effects.

Drugs that can make ticagrelor less effective

When used with ticagrelor, these drugs can make ticagrelor less effective. This means it won’t work as well to treat your condition. This is because the amount of ticagrelor in your body is decreased. Examples of these drugs include:

  • Aspirin. Doses of aspirin above 100 mg per day reduce the effectiveness of ticagrelor.
  • Rifampin
  • Seizure drugs, such as phenytoin, carbamazepine, and phenobarbital

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

People with a history of intracranial hemorrhage

If you’ve had an intracranial hemorrhage (bleeding within your skull), you shouldn’t take this drug. Ticagrelor raises your risk of having another intracranial hemorrhage.

People with active bleeding

If you have active bleeding, such as a stomach ulcer, you shouldn’t take this drug. It may cause more bleeding.

People with liver problems

If you have liver problems or a history of liver disease, you may not be able to clear this drug from your body well. This may increase the levels of ticagrelor in your body and cause more side effects.

People with plans to have surgery

Tell your doctor or dentist that you are taking ticagrelor before you have any surgery or dental procedure. Your doctor may tell you to stop taking ticagrelor 5 days before surgery. This will lower your risk of bleeding with your surgery or procedure. Your doctor should tell you when to start taking this drug again, as soon as possible after surgery.

Pregnant women

Ticagrelor is a category C pregnancy drug. That means two things: 

  1. Research in animals has shown adverse effects to the fetus when the mother takes the drug.
  2. There haven’t been enough studies done in humans to be certain how the drug might affect the fetus.

Talk to your doctor if you’re pregnant or planning to become pregnant. This drug should only be used if the potential benefit justifies the potential risk to the fetus. 

Women who are breast-feeding

Ticagrelor may pass into breast milk and may cause side effects in a child who is breast-fed.

Talk to your doctor if you breast-feed your child. You may need to decide whether to stop breast-feeding or stop taking this medication.

For children

This medication hasn’t been studied in children. It shouldn’t be used in people younger than 18 years old.

When to call the doctor

Call your doctor right away if you become pregnant while taking this drug.

Allergies

Ticagrelor can cause a severe allergic reaction. Symptoms can include: 

  • trouble breathing
  • swelling of your throat or tongue 

If you have an allergic reaction, call your doctor or local poison control center right away. If your symptoms are severe, call 9-1-1 or go to the nearest emergency room. 

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).

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How to Take ticagrelor (Dosage)

Oral tablet

All possible dosages and drug forms may not be included here. Your dosage, drug form, and how often you take the drug will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

What are you taking this medication for?

Acute coronary syndrome

Brand: Brilinta

Form: Oral tablet
Strengths: 60 mg, 90 mg
Adult dosage (ages 18 years and older)
  • Typical starting dose: After an acute coronary syndrome event (such as unstable chest pain or heart attack), your first dose for the first day will be 180 mg. Then you should take 90 mg twice per day for the next year.
  • Dose decreases: After one year, your doctor will decrease your dose to 60 mg taken twice per day.
Child dosage (ages 0–17 years)

This medication hasn’t been studied in children. It shouldn’t be used in people younger than 18 years old.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Healthline Pharmacist Editorial Team

Ticagrelor comes with serious risks if you don’t take it as prescribed.

If you stop taking the drug suddenly or don’t take it at all

If you stop taking ticagrelor, you’ll have an increased risk for a heart attack, stroke, and death. Your doctor may tell you to stop taking this drug for a short time if you need to have surgery or treat serious bleeding. Only stop taking this medication if your doctor tells you to.

If you miss doses or don’t take the drug on schedule

Your medication may not work as well or may stop working completely. For this drug to work well, a certain amount needs to be in your body at all times.

If you take too much

You could have dangerous levels of the drug in your body. Symptoms of an overdose of this drug can include:

  • bleeding
  • nausea
  • vomiting
  • diarrhea

If you think you’ve taken too much of this drug, call your doctor or local poison control center. If your symptoms are severe, call 9-1-1 or go to the nearest emergency room right away.

What to do if you miss a dose

Take your dose as soon as you remember. But if you remember just a few hours before your next scheduled dose, take only one dose. Never try to catch up by taking two doses at once. This could result in dangerous side effects.

How to tell if the drug is working

You may not be able to feel this drug working in your body. However, it’s important to take this medication as prescribed by your doctor to help prevent a heart attack, stroke, and death.

Ticagrelor is used for long-term treatment.

Important considerations for taking ticagrelor
with or without food You can take ticagrelor with or without food
timing Take this drug at the same time every day
can cut or crush the tablet You can cut or crush the tablet. You can crush and mix it water to make it easier to swallow
storage Store this drug carefully See Details
medication is refillable A prescription for this medication is refillable See Details
Travel Travel See Details
Clinical monitoring Clinical monitoring See Details
not usually stocked Not every pharmacy stocks this drug. When filling your prescription, be sure to call ahead
prior authorization required Insurance See Details

Store this drug carefully

  • Store ticagrelor at room temperature. Keep it between 59°F and 86°F (15°C and 30°C).
  • Keep it away from light.
  • Don’t store this medication in moist or damp areas, such as bathrooms.

A prescription for this medication is refillable

You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Travel

When traveling with your medication:

  • Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
  • Don’t worry about airport x-ray machines. They can’t hurt your medication.
  • You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled box with you.
  • Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Clinical monitoring

Your doctor should monitor certain health issues. This can help make sure you stay safe while you take this drug. These issues include:

  • Kidney function. Your doctor may do blood tests to check how well your kidneys are working. If your kidneys aren’t working well, your doctor may decide to lower your dose of this drug.
  • Uric acid level. This drug could increase the amount of uric acid in your body. Your doctor may do a blood test to check your uric acid level. If your uric acid level gets too high, you may be at greater risk for developing gout. 

Insurance

Many insurance companies require a prior authorization for this drug. This means your doctor will need to get approval from your insurance company before your insurance company will pay for the prescription.

Are there any alternatives?

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other drug options that may work for you.

What does the pill look like?

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How Much Does ticagrelor Cost?

Oral tablet

We've partnered with GoodRx so you can compare prices, find discounts and save up to 80% on your next prescription. Check out the low coupon prices below — no insurance required.

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Lowest price for ticagrelor

Membership warehouse $314.96
Kroger Pharmacy $315.98
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These prices represent the lowest priced national pharmacies for ticagrelor on GoodRx. They may be lower than your insurance.

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These prices represent the lowest priced national pharmacies for ticagrelor on GoodRx. They may be lower than your insurance.

Content developed in collaboration with University of Illinois-Chicago, Drug Information Group

Medically reviewed by Creighton University, Center for Drug Information and Evidence-Based Practice on November 10, 2015

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
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