Brilinta Dosage/Direction for Use

Patients taking Brilinta should also take a daily low maintenance dose of ASA 75-150 mg, unless specifically contraindicated.
Acute coronary syndromes: Brilinta treatment should be initiated with a single 180 mg loading dose (two tablets of 90 mg) and then continued at 90 mg twice daily.
Treatment with Brilinta 90 mg twice daily is recommended for 12 months in ACS patients unless discontinuation is clinically indicated (see Pharmacology: Pharmacodynamics under Actions).
History of myocardial infarction: Brilinta 60 mg twice daily is the recommended dose when an extended treatment is required for patients with a history of MI of at least one year and a high risk of an atherothrombotic event (see Pharmacology: Pharmacodynamics under Actions). Treatment may be started without interruption as continuation therapy after the initial one-year treatment with Brilinta 90 mg or other adenosine diphosphate (ADP) receptor inhibitor therapy in ACS patients with a high risk of an atherothrombotic event. Treatment can also be initiated up to 2 years from the MI, or within one year after stopping previous ADP receptor inhibitor treatment. There are limited data on the efficacy and safety of Brilinta beyond 3 years of extended treatment.
If a switch is needed, the first does of Brilinta should be administrered 24 hours following the last dose of other antiplatelet medication.
Missed dose: Lapses in therapy should also be avoided. A patient who misses a dose of Brilinta should take only one tablet (their next dose) at its scheduled time.
Special populations: Elderly: No dose adjustment is required in elderly (see Pharmacology: Pharmacokinetics under Actions).
Renal impairment: No dose adjustment is necessary for patients with renal impairment (see Pharmacology: Pharmacokinetics under Actions). No information is available concerning treatment of patients on renal dialysis and therefore ticagrelor is not recommended in these patients.
Patients with Hepatic impairment: Ticagrelor has not been studied in patients with severe hepatic impairment and its use in these patients is therefore contraindicated (see Contraindications). Only limited information is available in patients with moderate hepatic impairment. Dose adjustment is not recommended, but ticagrelor should be used with caution (see Precautions and Pharmacology: Pharmacokinetics under Actions). No dose adjustment is necessary for patients with mild hepatic impairment (see Pharmacology: Pharmacokinetics under Actions).
Paediatric population: The safety and efficacy of ticagrelor in children below the age of 18 years in the approved adult indication has not been established. No data are available (see Pharmacology: Pharmacodynamics and Pharmacokinetics under Actions).
Method of administration: For oral use.
Brilinta can be administered with or without food.
For patients who are unable to swallow the tablet(s) whole, the tablets can be crushed to a fine powder and mixed in half a glass of water and drunk immediately. The glass should be rinsed with a further half glass of water and the contents drunk. The mixture can also be administered via a nasogastric tube (CH8 or greater). It is important to flush the nasogastric tube through with water after administration of the mixture