Prevention of thrombotic events (CV death, MI & stroke) in patients w/ acute coronary syndromes (ACS) [unstable angina, non-ST elevation MI (NSTEMI) or ST elevation MI (STEMI)] including those managed medically & w/ percutaneous coronary intervention (PCI) or CABG. Prevention of stroke in patients w/ acute ischaemic stroke or transient ischaemic attack.
ACS Initially 180 mg as single loading dose (two 90-mg tab), then continue at 90 mg bid. Duration of treatment: At least 12 mth. Patient initiated on 90 mg bid may continue treatment w/ 60 mg bid w/o interruption after 1 yr. May be given in combination w/ ASA 75-150 mg daily (unless specifically contraindicated).
View Brilinta overdosage for action to be taken in the event of an overdose.
Administration
May be taken with or without food: For patients w/ swallowing difficulties, crush tab to a fine powd & mix in ½ glass of water. Drink immediately. Rinse glass w/ another ½ glass of water & drink. Mixt may be administered via a nasogastric tube (≥CH8). Flush tube w/ water after administration.
Contraindications
Hypersensitivity. Active pathological bleeding. History of intracranial hemorrhage. Severe hepatic impairment.
Increased risk for bleeding in patients w/ a propensity to bleed (eg, due to recent trauma, recent surgery, active or recent GI bleeding, or moderate hepatic impairment) or who are at increased risk of trauma; concomitant use of drugs that may increase risk of bleeding (eg, NSAIDS, oral anticoagulants &/or fibrinolytics w/in 24 hr of ticagrelor). Patients who require surgery. Discontinue treatment 5 days prior surgery in patients to undergo elective surgery & if antiplatelet effect is not desired. History of MI w/ prior ischemic stroke. Increased risk of bradycardic events (eg, patients w/o pacemaker w/ sick sinus syndrome, 2nd- or 3rd-degree AV block or bradycardic-related syncope). Dyspnoea. Central sleep apnoea including Cheyne-Stokes respiration has occurred. TTP. False -ve results in platelet function test for heparin induced thrombocytopenia. Not recommended w/ high maintenance dose of ASA (>300 mg). Avoid co-administration w/ strong CYP3A4 inhibitors (eg, ketoconazole, clarithromycin, nefazodone, ritonavir, & atazanavir). Avoid premature discontinuation of treatment. May affect ability to drive or operate machinery. Moderate hepatic impairment. Pregnancy. Not recommended during lactation. Childn <18 yr.
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