Ticagrelor

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Generic Name of Ticagrelor - Learn More

Ticagrelor

Ticagrelor Precaution - What You Need to Know

Before starting treatment with Ticagrelor, patients must consult their healthcare provider to ensure the medication is appropriate for their specific condition. Ticagrelor is an antiplatelet drug used primarily to reduce the risk of cardiovascular events such as heart attacks and strokes, but there are important precautions to consider:

- Risk of Bleeding: Ticagrelor increases the risk of bleeding, including major and minor bleeding events. Patients should be monitored for signs of bleeding, such as unusual bruising, prolonged bleeding from cuts, or blood in urine or stools. It is crucial to inform a healthcare provider before undergoing any surgical or dental procedures.
- History of Stroke or TIA: Although Ticagrelor is used to reduce the risk of further cardiovascular events, patients with a history of ischemic stroke or transient ischemic attack (TIA) should be closely monitored. Ticagrelor may not be appropriate for individuals with a recent history of hemorrhagic stroke.
- Liver Impairment: Ticagrelor is metabolized in the liver, so patients with moderate to severe hepatic impairment should use the drug cautiously, as it may lead to an increased risk of side effects due to altered drug metabolism.
- Asthma and Respiratory Conditions: Ticagrelor may worsen symptoms in patients with a history of asthma or other respiratory diseases, as it has been associated with shortness of breath in some individuals.
- Renal Impairment: While Ticagrelor does not require dose adjustments in mild renal impairment, patients with severe renal dysfunction should be carefully monitored. The drug may have an increased effect in individuals with compromised kidney function.

Patients should regularly follow up with their healthcare provider during treatment to assess any changes in health status and ensure proper dosing.

Ticagrelor Indication - Uses and Benefits

Ticagrelor is indicated for the prevention of thrombotic cardiovascular events, primarily in individuals with conditions such as:

- Acute Coronary Syndrome (ACS): Ticagrelor is used in patients with ACS, including those with unstable angina or non-ST elevation myocardial infarction (NSTEMI) and ST elevation myocardial infarction (STEMI). It helps prevent blood clots that could lead to heart attacks or worsen existing cardiovascular events.
- Post-Myocardial Infarction (MI): Ticagrelor is prescribed to reduce the risk of subsequent heart attacks, strokes, or cardiovascular death in patients who have experienced a previous heart attack.
- Chronic Coronary Artery Disease (CAD): In patients with stable coronary artery disease who are at high risk for cardiovascular events, Ticagrelor can reduce the occurrence of heart attacks and strokes.
- Prevention of Stent Thrombosis: Ticagrelor is commonly prescribed following percutaneous coronary interventions (PCI) such as angioplasty or stent placement to prevent clot formation around the stent.

The drug is used in combination with aspirin for greater antiplatelet efficacy, especially in preventing further cardiovascular complications.

Ticagrelor Contraindications - Important Warnings

There are several contraindications to the use of Ticagrelor, as its effects can be harmful in certain conditions:

- Active Bleeding: Ticagrelor is contraindicated in patients with active bleeding conditions, such as gastrointestinal bleeding, intracranial hemorrhage, or other serious bleeding disorders, as it increases the risk of further bleeding.
- Severe Liver Impairment: In patients with severe hepatic impairment (Child-Pugh class C), Ticagrelor is contraindicated due to its metabolism in the liver. In such cases, the drug may accumulate in the body, increasing the risk of side effects.
- History of Intracranial Hemorrhage: Patients who have experienced an intracranial hemorrhage (bleeding in the brain) should not take Ticagrelor due to the heightened risk of bleeding in the brain.
- Hypersensitivity: Any history of allergic reactions to Ticagrelor or its components would preclude the use of the drug. This includes serious reactions such as anaphylaxis or severe rashes.
- Severe Renal Impairment: Although Ticagrelor does not require dose adjustments for mild renal impairment, it is contraindicated in individuals with severe renal dysfunction, as their bodies may struggle to eliminate the drug effectively, leading to increased risk of side effects.

It is crucial that patients disclose their full medical history to their healthcare provider before starting Ticagrelor therapy to ensure that it is a safe option.

Ticagrelor Side Effects - What to Expect

While Ticagrelor is effective in preventing thrombotic events, it can cause a variety of side effects. Common and serious side effects include:

- Common Side Effects:
- Bleeding: As an antiplatelet agent, Ticagrelor can cause bleeding, ranging from mild bruising to more serious events such as gastrointestinal bleeding or intracranial hemorrhage. Patients should be vigilant for signs of bleeding and seek immediate medical attention if they experience unusual bleeding.
- Dyspnea (Shortness of Breath): Ticagrelor has been associated with a sensation of breathlessness in some patients, which is typically mild but can be distressing. It is more common during the early stages of treatment and may resolve with continued use.
- Headache: Some patients experience headaches, which can be mild to moderate in intensity.
- Dizziness: Dizziness is a common side effect, particularly when standing up quickly, due to the blood-thinning effects of the medication.

- Serious Side Effects:
- Severe Bleeding: Major bleeding events such as gastrointestinal bleeding, intracranial hemorrhage, or internal bleeding are rare but serious side effects of Ticagrelor. These require immediate medical attention.
- Bradycardia: Ticagrelor can cause a slowing of the heart rate (bradycardia), which may be significant in some individuals. It is important for patients to be monitored for changes in heart rate, especially if they have a history of heart conditions.
- Liver Enzyme Elevations: In some cases, Ticagrelor can cause mild to moderate elevations in liver enzymes, which may require monitoring during long-term treatment.

Patients should report any unusual or severe side effects to their healthcare provider for proper evaluation and management.

Ticagrelor Pregnancy Category ID - Safety Information

3

Ticagrelor Mode of Action - How It Works

Ticagrelor is an oral antiplatelet medication that works by inhibiting platelet aggregation, thus reducing the risk of clot formation. Its mode of action involves:

- P2Y12 Receptor Inhibition: Ticagrelor acts by reversibly binding to the P2Y12 receptor on platelets. This receptor is involved in platelet activation and aggregation in response to adenosine diphosphate (ADP). By blocking this receptor, Ticagrelor reduces platelet activation and aggregation, which helps prevent the formation of blood clots.
- Reversible Action: Unlike other P2Y12 inhibitors (such as clopidogrel), Ticagrelor has a reversible effect on the P2Y12 receptor. This allows for a more rapid onset of action and faster recovery of platelet function once the drug is discontinued.
- Reduction of Thrombotic Events: By preventing platelet aggregation, Ticagrelor helps reduce the occurrence of thrombotic cardiovascular events such as heart attacks, strokes, and stent thrombosis, particularly in high-risk patients with conditions like acute coronary syndrome (ACS).

Ticagrelor Drug Interactions - What to Avoid

Ticagrelor can interact with several drugs, altering its effectiveness or increasing the risk of side effects. Key interactions include:

- Aspirin: Ticagrelor is often used in combination with low-dose aspirin. However, doses of aspirin greater than 100 mg daily can reduce the effectiveness of Ticagrelor. It is recommended that patients use a low dose of aspirin (less than 100 mg) when taking Ticagrelor to avoid diminishing its antiplatelet effect.
- CYP3A4 Inhibitors: Ticagrelor is metabolized by the CYP3A4 enzyme in the liver. Drugs that inhibit this enzyme, such as ketoconazole, itraconazole, clarithromycin, and ritonavir, can increase Ticagrelor levels, potentially leading to an increased risk of bleeding or other side effects. Dose adjustments may be necessary when Ticagrelor is used with these medications.
- CYP3A4 Inducers: Medications that induce CYP3A4, such as rifampin and phenytoin, may reduce the effectiveness of Ticagrelor by increasing its metabolism. Careful monitoring is recommended when these drugs are taken concurrently with Ticagrelor.
- Anticoagulants: The use of Ticagrelor in combination with anticoagulants (e.g., warfarin or direct oral anticoagulants) can increase the risk of bleeding complications. Monitoring of coagulation parameters is advised when these drugs are coadministered.
- NSAIDs: Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, can increase the risk of bleeding when used with Ticagrelor. Patients should exercise caution and consult their healthcare provider before combining Ticagrelor with NSAIDs.

Patients should inform their healthcare provider of all medications they are taking, including over-the-counter drugs, to avoid potentially harmful interactions.

Ticagrelor Adult Dose - Recommended Dosage

The typical adult dose of Ticagrelor for cardiovascular conditions is as follows:

- Acute Coronary Syndrome (ACS): The usual starting dose is 180 mg as a loading dose, followed by a maintenance dose of 90 mg twice daily. This maintenance dose is continued for up to 12 months following an ACS event.
- Post-PCI (Percutaneous Coronary Intervention): For patients undergoing PCI, the standard maintenance dose is

90 mg twice daily after an initial loading dose of 180 mg.

Patients should take Ticagrelor with or without food, but it should be taken at the same time each day for consistency.

Ticagrelor Child Dose - Dosage for Children

Ticagrelor is not recommended for use in children, as there is insufficient data on its safety and efficacy in pediatric populations. The drug is indicated for adult patients with cardiovascular conditions.

Patients should always follow their healthcare provider's instructions regarding dosing and monitoring during treatment with Ticagrelor.

Ticagrelor Renal Dose - Dosage for Kidney Conditions

For patients with renal impairment, Ticagrelor does not require any significant dose adjustments. However, it is recommended to use caution in those with severe renal dysfunction (e.g., end-stage renal disease). Patients with impaired kidney function should be closely monitored for potential side effects, especially bleeding risks.