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ticagrelor

Pronunciation: tye KA grel or

Brand: Brilinta

What is the most important information I should know about ticagrelor?

Ticagrelor keeps your blood from coagulating (clotting) to prevent unwanted blood clots that can occur with certain heart or blood vessel conditions. Because of this drug action, ticagrelor can make it easier for you to bleed, even from a minor injury. Contact your doctor or seek emergency medical attention if you have bleeding that will not stop.

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You may also have bleeding on the inside of your body, such as in your stomach or intestines. Call your doctor at once if you have black or bloody stools, or if you cough up blood or vomit that looks like coffee grounds. These could be signs of bleeding in your digestive tract.

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While you are taking ticagrelor, do not take aspirin or other NSAIDs (non-steroidal anti-inflammatory drugs) without your doctor's advice. NSAIDs include ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn, Naprelan, Treximet), celecoxib (Celebrex), diclofenac (Cataflam, Voltaren), indomethacin (Indocin), meloxicam (Mobic), and others.

Ticagrelor may cause you to bleed more easily, especially if you have: a history of bleeding problems, surgery or a medical emergency, a disease affecting the blood vessels in your brain, a history of stomach or intestinal bleeding, or if you are 65 or older.

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Many drugs (including some over-the-counter medicines and herbal products) can interact with ticagrelor. It is very important to tell your doctor about all medicines you have recently used.

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Ask your doctor before taking any medicine for pain, arthritis, fever, or swelling. These medicines may affect blood clotting and may also increase your risk of stomach bleeding.

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Any doctor, dentist, surgeon, or other medical care provider who treats you should know that you are taking ticagrelor.

What is ticagrelor?

Ticagrelor keeps the platelets in your blood from coagulating (clotting) to prevent unwanted blood clots that can occur with certain heart or blood vessel conditions.

Ticagrelor is used to lower your risk of having a stroke or serious heart problems after you have had a heart attack or severe chest pain (angina).

Ticagrelor may also be used for purposes not listed in this medication guide.

What should I discuss with my healthcare provider before taking ticagrelor?

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You should not use this medication if you are allergic to ticagrelor, or if you have:

  • severe liver disease;
  • any active bleeding;
  • stomach ulcer or bleeding; or
  • a history of bleeding in the brain (such as from a head injury).

To make sure you can safely take ticagrelor, tell your doctor if you have any of these other conditions:

  • liver disease;
  • asthma, COPD (chronic obstructive pulmonary disorder) or other breathing problem;
  • a history of stomach ulcer or colon polyps;
  • a history of stroke; or
  • a history of bleeding or blood clotting disorder.

Ticagrelor may cause you to bleed more easily, especially if you have:

  • a recent surgery or bleeding injury;
  • a disease affecting the blood vessels in your brain;
  • a history of stroke;
  • a history of bleeding problems;
  • a history of stomach or intestinal bleeding; or
  • if you are 65 or older.
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FDA pregnancy category C. It is not known whether ticagrelor will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

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It is not known whether ticagrelor passes into breast milk or if it could harm a nursing baby. You should not breast-feed while you are using ticagrelor.

How should I take ticagrelor?

Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

Ticagrelor should be taken together with aspirin. Follow your doctor's instructions about how much aspirin you should take.

Ticagrelor can be taken with or without food. Take the medicine at the same time each day.

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Because ticagrelor keeps your blood from coagulating (clotting) to prevent unwanted blood clots, this medicine can also make it easier for you to bleed, even from a minor injury. Contact your doctor or seek emergency medical attention if you have any bleeding that will not stop.

If you need surgery or dental work, tell the surgeon or dentist ahead of time that you are using ticagrelor. You may need to stop using the medicine for at least 5 days before having surgery, to prevent excessive bleeding. Follow your doctor's instructions and start taking ticagrelor again as soon as possible.

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Do not stop taking ticagrelor without first talking to your doctor, even if you have signs of bleeding. Use ticagrelor regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely. Stopping ticagrelor may increase your risk of a heart attack or stroke.

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Store at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

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Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Overdose can cause excessive bleeding.

What should I avoid while taking ticagrelor?

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While you are taking ticagrelor, do not take aspirin or other NSAIDs (non-steroidal anti-inflammatory drugs) without your doctor's advice. NSAIDs include ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn, Naprelan, Treximet), celecoxib (Celebrex), diclofenac (Cataflam, Voltaren), indomethacin (Indocin), meloxicam (Mobic), and others.

Avoid activities that may increase your risk of bleeding or injury. Use extra care to prevent bleeding while shaving or brushing your teeth.

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Avoid drinking alcohol. It may increase your risk of bleeding in your stomach or intestines.

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Ask a doctor or pharmacist before using any cold, allergy, pain, or sleep medication. Aspirin (sometimes abbreviated as ASA) is contained in many combination medicines. Taking certain products together can cause you to get too much aspirin which can increase your risk of bleeding. Check the label to see if a medicine contains aspirin or ASA.

What are the possible side effects of ticagrelor?

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Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

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Call your doctor at once if you have a serious side effect such as:

  • feeling light-headed or short of breath, even with mild exertion or while lying down;
  • nosebleed or other bleeding that will not stop;
  • bloody or tarry stools, blood in your urine;
  • coughing up blood or vomit that looks like coffee grounds;
  • chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling;
  • sudden numbness or weakness, especially on one side of the body;
  • sudden severe headache, confusion, problems with vision, speech, or balance;
  • pale skin, weakness, fever, or jaundice (yellowing of the skin or eyes); or
  • easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin.

Less serious side effects may include:

  • headache, mild dizziness;
  • cough; or
  • nausea, diarrhea.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect ticagrelor?

Tell your doctor about all other medicines you use, especially:

  • dexamethasone (Cortastat, Dexasone, Solurex, DexPak);
  • digoxin (Lanoxin);
  • nefazodone;
  • an antibiotic such as clarithromycin (Biaxin), erythromycin (E.E.S., EryPed, Ery-Tab, Erythrocin, Pediazole), rifabutin (Mycobutin), rifampin (Rifadin, Rifater, Rifamate), or telithromycin (Ketek);
  • antifungal medicine such as itraconazole (Sporanox), ketoconazole (Nizoral), miconazole (Oravig), or voriconazole (Vfend);
  • a blood thinner such as warfarin (Coumadin, Jantoven);
  • cholesterol-lowering medications such as lovastatin (Mevacor, Altoprev, Advicor) or simvastatin (Zocor, Simcor, Vytorin);
  • heart or blood pressure medication such as nicardipine (Cardene) or quinidine (Quin-G);
  • HIV or AIDS medication such as atazanavir (Reyataz), delavirdine (Rescriptor), efavirenz (Sustiva, Atripla), etravirine (Intelence), indinavir (Crixivan), nelfinavir (Viracept), nevirapine (Viramune), ritonavir (Norvir, Kaletra), or saquinavir (Invirase); or
  • seizure medication such as carbamazepine (Carbatrol, Equetro, Tegretol), felbamate (Felbatol), oxcarbazepine (Trileptal), phenobarbital (Solfoton), phenytoin (Dilantin), or primidone (Mysoline).

There may be other drugs that can interact with ticagrelor. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

Your pharmacist can provide more information about ticagrelor.


Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

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