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BLOOD AND BLOOD FORMING ORGANS › ANTITHROMBOTIC AGENTS › ANTITHROMBOTIC AGENTS › Platelet aggregation inhibitors excl. heparin
ticagrelor
B01AC24
Forms & Strengths
- Oral tablets: 60 mg
- Oral tablets: 90 mg
Adult Dosing
- Acute coronary syndrome (ACS): Loading dose 180 mg once, followed by 90 mg twice daily
- Secondary prevention after myocardial infarction (past ACS): 60 mg twice daily (after initial 1 year on 90 mg twice daily)
- Co-administered with low-dose aspirin (75-100 mg daily)
Pediatric Dosing
- Safety and efficacy not established in pediatric patients (<18 years)
Indications
- Reduction of thrombotic cardiovascular events in patients with acute coronary syndrome (ACS)
- Reduction of recurrent myocardial infarction risk in patients with a history of myocardial infarction
Mechanism of Action
- Reversible, direct P2Y12 platelet ADP receptor antagonist
- Prevents ADP-mediated platelet activation and aggregation
Contraindications
- Active pathological bleeding (e.g., intracranial hemorrhage, peptic ulcer)
- History of intracranial hemorrhage
- Severe hepatic impairment
- Hypersensitivity to ticagrelor or any component of the product
Adverse Reactions
- Bleeding (major and minor hemorrhage)
- Dyspnea
- Ventricular pauses / bradycardia
- Elevated serum uric acid
- Increased serum creatinine
Drug Interactions
- Strong CYP3A4 inhibitors (e.g., ketoconazole) increase exposure and bleeding risk (avoid)
- Strong CYP3A4 inducers (e.g., rifampin) significantly decrease efficacy (avoid)
- Aspirin doses >100 mg daily reduce effectiveness of ticagrelor (avoid)
- P-glycoprotein substrates (e.g., digoxin): ticagrelor may increase their serum concentrations
- Increased bleeding risk with concurrent anticoagulants, NSAIDs, or other antiplatelet agents
Curated Content: Needs Vetting Before Put to Clinical Use