Highlights for ticagrelor

  1. Ticagrelor oral tablet is only available as a brand-name drug. It’s not available as a generic drug. Brand name: Brilinta.
  2. Ticagrelor comes only in the form of a tablet you take by mouth.
  3. Ticagrelor is used to improve heart health in people who have had a heart attack, or who have a condition called acute coronary syndrome (ACS). Ticagrelor helps prevent problems such as heart attack or stroke. It also helps prevent blood clots in people with ACS who have had stents placed in blood vessels in their heart.

Important warnings

FDA warning

  • This drug has black box warnings. These are the most serious warnings from the Food and Drug Administration (FDA). Black box warnings alert 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 your doctor tells you to take.

Other warnings

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

What is ticagrelor?

Ticagrelor is a prescription drug. It comes as an oral tablet.

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

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 improve heart health in people who have had a heart attack, or who have a condition called acute coronary syndrome (ACS). With this condition, your heart doesn’t receive enough oxygen.

Ticagrelor helps prevent problems such as heart attack or stroke. It also helps prevent blood clots in people with ACS who have had stents placed in blood vessels in their heart. This drug is used together with aspirin.

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 risk of having another heart problem.

Ticagrelor side effects

Ticagrelor oral tablet doesn’t cause drowsiness, but it can cause other side effects.

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 (increases your risk of 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 911 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
  • 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

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.

Ticagrelor may interact with other medications

Ticagrelor oral tablet 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.

Examples of drugs that can cause interactions with ticagrelor are listed below.

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 dosage of your cholesterol 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. You may have increased risk of bleeding, shortness of breath, and other side effects.
    • HIV drugs, such as saquinavir, nelfinavir, indinavir, atazanavir, and ritonavir. You may have increased risk of bleeding, shortness of breath, and other side effects.
    • Macrolide antibiotics, such as clarithromycin and telithromycin. You may have increased 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 above 100 mg per day)
  • 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.

Ticagrelor warnings

This drug comes with several warnings.

Allergy warning

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

  • trouble breathing
  • swelling of your throat or tongue

If your symptoms are severe, call 911 or go to the nearest emergency room right away.

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

Alcohol interaction warning

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.

Warnings for people with certain health conditions

For people with a history of intracranial hemorrhage: If you’ve had bleeding within your skull in the past, you shouldn’t take this drug. Ticagrelor raises your risk of having another intracranial hemorrhage.

For 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.

For 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.

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

For people with heart rhythm problems: Tell your doctor if you have problems with your heart rhythm (arrhythmias) before taking ticagrelor. Ask them if ticagrelor is safe for you to use.

Warnings for other groups

For 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 right away if you’re pregnant or planning to become pregnant. This drug should only be used if the potential benefit justifies the potential risk.

For women who are breastfeeding: Ticagrelor may pass into breast milk and may cause side effects in a child who is breastfed. Talk to your doctor if you breastfeed your child. You may need to decide whether to stop breastfeeding 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.

How to take ticagrelor

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

Dosage for acute coronary syndrome

Brand: Brilinta

  • Form: oral tablet
  • Strengths: 60 mg, 90 mg

Adult dosage (ages 18 years and older)

  • Typical starting dosage: 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.
  • Dosage decreases: After one year, your doctor will decrease your dosage 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 children 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 speak with your doctor or pharmacist about dosages that are right for you.

Take as directed

Ticagrelororal tablet is used for long-term treatment. It 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 of 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 do so.

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 911 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.

Important considerations for taking ticagrelor

Keep these considerations in mind if your doctor prescribes ticagrelor for you.

General

You can take ticagrelor with or without food.

  • Take this drug at the same time every day.
  • You can cut or crush the tablet. You can crush and mix it water to make it easier to swallow.

Storage

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

Refills

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 harm your medication.
  • You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled container 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 your:

  • 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 dosage 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.

Availability

Not every pharmacy stocks this drug. When filling your prescription, be sure to call ahead to make sure your pharmacy carries it.

Prior authorization

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.

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.