Brand Brilinta

Ticagrelor is used along with low-dose aspirin (usually at dosages of 75-100 milligrams a day) to help prevent heart attack and stroke in people with heart problems (such as unstable angina, previous heart attack). It may also be used to prevent heart attack or stroke after certain heart surgeries (such as stent placement, coronary artery bypass graft-CABG, or angioplasty). Ticagrelor belongs to a class of drugs known as antiplatelet agents. It works by preventing certain blood cells (platelets) from sticking together and forming harmful blood clots. This "anti-platelet" effect helps keep blood flowing smoothly in your body.

Read the Medication Guide provided by your pharmacist before you start taking ticagrelor and each time you get a refill. If you have any questions, ask your doctor or pharmacist. Take this medication by mouth with or without food as directed by your doctor. Your doctor will direct you to start treatment with a higher "loading" dose (usually ticagrelor 180 milligrams and aspirin 325 milligrams), followed by a lower maintenance dose, usually one tablet by mouth twice a day and low-dose aspirin (usually 75-100 milligrams) once a day. Carefully follow your doctor's directions. See also Warning section. Take this medication regularly to get the most benefit from it. To help you remember, take it at the same times each day. Do not increase your dose or take this drug more often or for longer than prescribed. Your condition will not improve any faster, and your risk of side effects will increase. It is very important to continue taking this medication even if you feel well. Do not stop taking this medication without consulting your doctor.

Before taking ticagrelor, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details. Before using this medication, tell your doctor or pharmacist your medical history, especially of: bleeding problems (such as bleeding in the brain, hemophilia, ulcers, frequent nosebleeds), gout, liver disease, recent surgery, serious injury/trauma. This drug may make you dizzy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Limit alcoholic beverages. Daily use of alcohol, especially when combined with this medicine, may increase your risk for stomach bleeding. While you are taking this medication, it may take longer than usual for bleeding to stop if you have a cut or injury. Use caution with sharp objects like razors or nail cutters and avoid activities such as contact sports to lower the chance of getting cut, bruised, or injured. Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products). Your doctor or dentist may tell you to temporarily stop ticagrelor at least 5 days before surgery or a dental procedure. Carefully follow your doctor's or dentist's specific directions for when to stop or restart this medication. During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor. It is unknown if this drug passes into breast milk. Consult your doctor before breast-feeding.

If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval. Some products that may interact with this drug include: other drugs that can cause bleeding/bruising (including other antiplatelet drugs such as clopidogrel, NSAIDs such as ibuprofen, "blood thinners" such as warfarin). Other medications can affect the removal of ticagrelor from your body, which may affect how ticagrelor works. Examples include nefazodone, azole antifungals (such as itraconazole, ketoconazole), some HIV drugs (such as atazanavir, ritonavir), macrolide antibiotics (such as clarithromycin), rifamycins (such as rifampin), St. John's wort, drugs used to treat seizures (such as carbamazepine, phenytoin), among others. Ticagrelor can slow down the removal of other drugs from your body, which may affect how they work or increase the risk of side effects. Examples of affected drugs include digoxin, certain drugs used to treat high cholesterol (including lovastatin, simvastatin), among others. Check all prescription and nonprescription medicine labels carefully since many contain pain relievers/fever reducers (aspirin, NSAIDs such as ibuprofen or naproxen). These drugs are similar to ticagrelor and may increase your risk of side effects if taken together. However, low-dose aspirin to prevent heart attack or stroke (usually at dosages of 75-100 milligrams a day) should be continued unless your doctor instructs you otherwise. Ask your doctor or pharmacist for more details.

Shortness of breath, headache, dizziness, nausea, or nosebleed may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly. Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects. Although unlikely, serious bleeding may occur. Tell your doctor right away if you have any serious side effects, including: easy bruising/bleeding, bleeding that is severe or that you cannot control (such as a severe nosebleed that you cannot stop), bloody or black stools, vomit with blood or that looks like coffee grounds, bloody/red/pink/dark urine. A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing. This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist. In the US - Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Store the US product at room temperature. Store the Canadian product between 36-86 degrees F (2-30 degrees C). Keep the tablets in the original container or package, away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets. Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.