Ticagrelor
About Ticagrelor
Ticagrelor is an oral prescription medicine used to reduce the risk of serious cardiovascular events, such as heart attacks or strokes, in people who have experienced a heart attack or severe chest pain. It works by preventing blood cells called platelets from sticking together and forming harmful clots. This keeps blood flowing smoothly through your arteries, protecting your heart and brain.
To get the full benefit, you must take Ticagrelor every day exactly as prescribed, typically twice daily. It is important to take it consistently at the same times each day, and you can take it with or without food. Combining this medicine with a heart-healthy diet low in saturated fats and regular, doctor-approved exercise can significantly improve your long-term cardiovascular results.
While taking Ticagrelor, you may experience mild side effects such as easy bruising, minor nosebleeds, or a mild feeling of shortness of breath. However, if you experience severe, uncontrollable bleeding, blood in your urine or stools, or sudden and severe breathing difficulties, you must contact your doctor or seek emergency medical help immediately.
Before starting Ticagrelor, discuss your complete medical history with your doctor, especially if you have asthma, chronic obstructive pulmonary disease (COPD), a history of bleeding problems, or liver issues. Do not take this medicine if you have active internal bleeding, such as a bleeding stomach ulcer, or if you have a history of bleeding in the brain.
Certain medicines, such as strong pain relievers, blood thinners, and some herbal supplements, can interact with Ticagrelor and greatly increase your risk of bleeding, while smoking can further damage your blood vessels. If you are pregnant, planning to become pregnant, breastfeeding, or an older adult, consult your doctor to discuss whether this medicine is safe and appropriate for your specific situation.
Uses of Ticagrelor
• Prevents heart attack and stroke: Helps lower the risk of future heart attacks and strokes, especially in patients with a history of heart attack or blocked arteries.
• Prevents blood clots: Lowers the formation of blood clots by preventing the platelets from sticking together.
• Enhanced effect with aspirin: Commonly used with low-dose aspirin to enhance its protective effect against clot-related events.
Medicinal Benefits
Ticagrelor helps reduce the risk of harmful blood clot formation by preventing platelets from sticking together. By improving blood flow through the blood vessels, it supports cardiovascular health and helps protect against serious complications. This medicine offers several key benefits:
- Lowers the risk of future heart complications: By keeping blood thin and flowing, Ticagrelor significantly reduces the likelihood of experiencing another life-threatening heart attack or stroke, giving you peace of mind during your recovery.
- Protects newly placed stents: For patients who have undergone angioplasty, this medication helps ensure that the newly placed stent remains open and clear, supporting a safer and smoother recovery process.
- Provides reversible protection: Because the effect of this medication wears off more quickly than some other blood thinners once stopped, it offers your healthcare team greater flexibility and control if you ever need unexpected surgery.
Directions for Use
Please follow these step-by-step instructions for taking this medication:
- Swallow the tablet whole with a full glass of water. You can take this medication with or without food.
- If you have trouble swallowing tablets, talk to your doctor or pharmacist about alternative ways to take it, such as crushing the tablet and mixing it with water.
- Take your doses at the same times every day to maintain a steady level of the medicine in your body.
- Always follow your doctor's exact instructions regarding your dosing schedule, and never stop taking this medicine without consulting them first, as stopping early can increase your risk of a heart attack.
Storage
Side Effects of Ticagrelor
Common Side Effects (Usually mild):
- Easy bruising or small purple spots on the skin
- Mild nosebleeds or bleeding from minor cuts that takes longer to stop
- Mild shortness of breath, especially when resting or during light activity
- Dizziness or a lightheaded feeling
Serious Side Effects (Call a doctor right away):
- Uncontrolled or severe bleeding that you cannot stop
- Coughing up blood or vomiting material that looks like coffee grounds
- Pink, red, or brown urine, or black, tarry stools
- Signs of a severe allergic reaction, such as swelling of the face, lips, tongue, or throat, or difficulty breathing
- Fainting or an unusually slow heartbeat
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Drug Warnings
- Inform all healthcare providers, including dentists, surgeons, and specialists, that you are taking Ticagrelor before any procedure is scheduled.
- Do not stop taking this medication suddenly without discussing it with your cardiologist, as stopping abruptly increases your risk of a blood clot or heart attack.
- Monitor yourself daily for unusual bruising or bleeding, and report any prolonged bleeding from minor cuts to your doctor.
- Avoid taking aspirin or other pain relievers like ibuprofen unless specifically instructed by your doctor, as these can increase your risk of stomach bleeding.
- If you experience a fall, a blow to the head, or any major trauma, seek medical evaluation immediately, even if you feel fine, to rule out internal bleeding.
Drug Interactions
Before using Ticagrelor, it is important to understand how it may interact with other medicines, foods, or existing health conditions.
Drug-Drug Interactions
- Blood thinners (e.g., warfarin): Taking Ticagrelor with anticoagulant medicines may significantly increase the risk of bleeding, including serious or prolonged bleeding episodes. Your doctor may need to monitor you more closely during treatment.
- Nonsteroidal anti-inflammatory drugs (NSAIDs) (e.g., ibuprofen, naproxen): Combining Ticagrelor with NSAIDs may increase the risk of bleeding, particularly in the stomach or intestines.
- Certain anti-seizure medicines: Some anticonvulsants may reduce the effectiveness of Ticagrelor by lowering its blood levels, potentially increasing the risk of treatment failure. Dose adjustments or alternative therapies may be required.
- Tuberculosis medicines (e.g., rifampicin): Certain medicines used to treat tuberculosis can affect how your body processes Ticagrelor, potentially reducing its effectiveness.
- HIV medicines: Some antiretroviral medicines may either increase or decrease the levels of Ticagrelor in the bloodstream, affecting its safety or effectiveness. Your doctor may recommend additional monitoring.
- Aspirin (greater than 100 mg daily): Higher doses of aspirin may reduce the effectiveness of Ticagrelor and may also increase the risk of bleeding. Only use aspirin as directed by your healthcare provider.
Drug-Food Interactions
- Grapefruit and grapefruit juice: Grapefruit products may increase the concentration of Ticagrelor in the body by affecting how it is metabolised. This may increase the likelihood of side effects and should generally be avoided during treatment.
Drug-Disease Interactions
- Liver disease: Use Ticagrelor with caution if you have a history of liver impairment. Because the medicine is processed by the liver, reduced liver function may increase drug exposure and the risk of adverse effects.
- Active bleeding disorders: Do not use Ticagrelor if you have an active bleeding condition, such as a bleeding stomach ulcer, ongoing gastrointestinal bleeding, or another significant bleeding disorder.
- History of intracranial bleeding: Patients with a previous history of bleeding within the brain may be at increased risk of serious bleeding complications and should discuss the risks and benefits of treatment with their doctor before using Ticagrelor.
Drug-Drug Interactions Checker List:
Safety Advice
Alcohol
unsafeIt is unsafe to consume alcohol since it may worsen the side effects, such as dizziness.
Pregnancy
cautionPlease consult the doctor. There are no adequate and well-controlled studies on pregnant women. Your doctor will prescribe only if the benefits outweigh the risks.
Breast Feeding
cautionTicagrelor may pass into breast milk and may cause side effects in a breastfed child. Please consult your doctor before starting Ticagrelor.
Driving
cautionDo not drive or operate machinery if you experience dizziness or drowsiness while using Ticagrelor.
Liver
cautionLet your doctor know if you had or have any history of liver disease or hepatic impairment. Your doctor will weigh the benefits and potential risks before prescribing Ticagrelor. However, Ticagrelor is not recommended in patients with severe liver problems.
Kidney
cautionLet your doctor know if you had or have any history of kidney diseases/conditions. Your doctor will weigh the benefits and potential risks before prescribing Ticagrelor. However, Ticagrelor is not recommended in patients with severe kidney problems.
Children
unsafeTicagrelor is not recommended for children below the age of 18 years. The safety and effectiveness of Ticagrelor have not been established in children.
Habit Forming
Diet & Lifestyle Advise
- Eat a heart-healthy diet rich in vegetables, fruits, whole grains, and lean proteins to support overall vascular health.
- Limit foods high in saturated fats and sodium to help manage your blood pressure and cholesterol levels.
- Avoid activities or contact sports that carry a high risk of injury, falls, or bruising, as your blood will take longer to clot.
- Use a soft-bristled toothbrush and an electric shaver to minimise the risk of bleeding from your gums or skin.
- Stay well-hydrated and avoid excessive alcohol intake, as alcohol can increase your risk of stomach bleeding when taken with this medication.
Special Advise
- Avoid activities that may increase your risk of bleeding or injury. Use extra care to prevent bleeding while shaving or brushing your teeth.
- Do not stop taking Ticagrelor without consulting your doctor, as it may increase the risk of a heart attack or stroke.
- Let your doctor know if you are due to undergo any surgery or procedure.
- Do not take doses of aspirin higher than what your doctor tells you to take.
Patients Concern
Disease/Condition Glossary
Blood clot: Blood clot is an aggregation of blood that changes from a liquid to a gel-like state. Clotting is a natural process that prevents you from losing too much blood in surgery, cuts, accidents, and trauma. When a clot forms inside the veins, it won't always dissolve independently and can become an even life-threatening situation.
Heart attack: Heart attack occurs when a blood clot blocks the blood flow to the heart. This blockage of arteries is often an accumulation of fat, cholesterol, and other substances, which form a plaque in the arteries that feed the heart (coronary arteries). During a heart attack (myocardial infarction), the blood supply which nourishes the heart with oxygen is cut off. This causes the heart muscle to die. Heart attack signs include chest pain, upper body pain, sweating, nausea, fatigue, and trouble breathing.
Stroke: When our brain does not get sufficient oxygen and blood supply, it starts dying within a few minutes, leading to a heart attack or stroke.
Acute coronary syndrome: Acute coronary syndrome is most often caused by plaque rupture or clot formation in the heart's arteries. The symptoms may include heart attack-like chest pressure, chest pressure while resting or doing light activity, or sudden heart stoppage.
FAQs
Ticagrelor is primarily used to prevent heart attack or stroke in people at high risk of heart disease. It‚ helps to prevent blood clots in people with acute coronary syndrome (the heart doesn't receive enough oxygen) who have had stents placed in blood vessels in their heart.
Ticagrelor contains Ticagrelor, which works by preventing platelets from sticking together and forming a blood clot.
Yes, taking Ticagrelor can increase the risk of bleeding. So, please be very cautious while cutting fingernails or toenails, shaving, or using sharp objects to avoid bleeding.
Do not stop taking Ticagrelor without consulting your doctor or cardiologist. Stopping treatment too early may increase your risk of blood clots, heart attack, or stroke. If you are scheduled for surgery, a dental procedure, or another medical treatment, inform your healthcare provider that you are taking Ticagrelor. Your doctor will decide whether the medicine should be temporarily stopped and when it should be restarted.
There might be a problem if you take herbal therapies with Ticagrelor, especially those that affect blood, like Ginkgo Biloba, Grapefruits, St John's wort plant extract used as an antidepressant. Taking these can increase your risk of bleeding. Tell your doctor if you are using any herbal supplements before taking Ticagrelor.
Ticagrelor may cause shortness of breath, making it difficult to breathe in people with asthma or COPD. Hence, it should be used with caution. Please consult your doctor if you have asthma or breathing problems.
Do not drink grapefruit juice while taking Ticagrelor. Grapefruit juice may increase the blood-thinning effect of the medicine.
Ticagrelor contains ticagrelor, which, when taken with clopidogrel, may increase the risk of bleeding. Consult the doctor before taking other medicines with Ticagrelor.
Ticagrelor may cause blood in urine. Consult the doctor if you experience this.
Ticagrelor might lower the blood pressure. Let the doctor know if you are taking anti-hypertensives (blood pressure-lowering medicines). Regular monitoring of blood pressure levels is advised.
Ticagrelor can be taken with other medicines if prescribed by the doctor. Before starting Ticagrelor inform the doctor if you are taking any other medicines to prevent interactions.
Ticagrelor is an antiplatelet medicine which inhibits the aggregation of platelets that may cause a heart attack or stroke.
It is best to limit or avoid alcohol while taking Ticagrelor. Alcohol may irritate the stomach lining and increase the risk of bleeding, particularly stomach bleeding. If you drink alcohol regularly, discuss this with your doctor.
Ticagrelor may cause significant, sometimes fatal bleeding. Inform the doctor if you have/had a condition that causes you to bleed more easily than normal; bleeding in your stomach, intestines, or brain; a stomach ulcer; polyps (abnormal growths in the lining of the large intestine); a stroke or mini-stroke; or liver disease. Seek immediate medical attention if you experience unexplained, severe, long-lasting, or uncontrollable bleeding; red or black, tarry stools; pink or brown urine; vomit that is bloody or that looks like coffee grounds; or coughing up blood or blood clots.
Ticagrelor works within 30 minutes of taking the first dose.
Apply firm, direct pressure to the cut with a clean cloth. Because Ticagrelor prevents clotting, minor bleeding may take longer than usual to stop. If the bleeding does not stop after several minutes of direct pressure, seek medical attention. Talk to your doctor or pharmacist.
You should only take aspirin with Ticagrelor if your doctor has explicitly prescribed them together. However, taking high doses of aspirin (above 100 mg daily) can actually make Ticagrelor less effective, so always follow your doctor's exact instructions. Talk to your doctor or pharmacist.
A mild feeling of shortness of breath is a common side effect of Ticagrelor, especially during the first few weeks of treatment. If this feeling is severe, gets worse, or is accompanied by chest pain, contact your doctor immediately. Talk to your doctor or pharmacist.
You should avoid taking nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen without consulting your doctor, as they can significantly increase your risk of stomach bleeding. Talk to your doctor or pharmacist.
The safety of Ticagrelor during pregnancy is not fully established. You must discuss the benefits and potential risks with your doctor before using this medication if you are pregnant or planning to become pregnant. Talk to your doctor or pharmacist.
The duration of your treatment depends entirely on your specific heart condition and the type of stent you received. It is typically prescribed for 6 to 12 months, or sometimes longer, but you must continue taking it until your cardiologist tells you to stop. Talk to your doctor or pharmacist.
