WARNING

Ticagrelor is a medication commonly prescribed to reduce the risk of blood clots in people with certain heart conditions, such as acute coronary syndrome or a history of heart attack. While it can be effective in preventing serious cardiovascular events, there are potential risks associated with its use. Some of these risks include:

• Bleeding: One of the most significant risks of taking Ticagrelor is an increased tendency to bleed. This can range from minor bruising to more severe bleeding events, such as gastrointestinal bleeding or bleeding in the brain.
• Shortness of breath: Some individuals may experience shortness of breath while taking Ticagrelor. This side effect should be reported to a healthcare professional immediately, as it could indicate a more serious underlying issue.
• Allergic reactions: Allergic reactions to Ticagrelor are rare but can be severe. Symptoms may include rash, itching, swelling of the face, lips, or throat, and difficulty breathing. Anyone experiencing these symptoms should seek medical attention immediately.
• Liver problems: In rare cases, Ticagrelor can cause liver problems, such as elevated liver enzymes. Symptoms of liver problems may include yellowing of the skin or eyes (jaundice), dark urine, or persistent nausea and vomiting.
• Bradyarrhythmia: Some patients may experience slowing of the heart rate (bradyarrhythmia) while taking Ticagrelor. This is more common in patients with a history of certain heart conditions or those taking other medications that affect heart rhythm.
• Adverse interactions: Ticagrelor can interact with other medications, potentially increasing the risk of side effects or reducing its effectiveness. It’s important to inform healthcare providers of all medications being taken, including over-the-counter drugs and supplements.
• Withdrawal effects: Abruptly stopping Ticagrelor can increase the risk of cardiovascular events, including heart attack or stroke. It’s important to follow a healthcare provider’s instructions when discontinuing this medication.

As with any medication, the decision to use Ticagrelor should be made in consultation with a healthcare professional who can assess the individual’s specific medical history and risk factors. They can provide guidance on the appropriate dosage and monitor for any potential side effects or complications.

Why is this medication prescribed?

Ticagrelor is prescribed primarily for its antiplatelet properties, meaning it helps prevent the formation of blood clots. It’s commonly used in the following scenarios:

• Acute Coronary Syndrome (ACS): This includes conditions like unstable angina or myocardial infarction (heart attack). Ticagrelor is often prescribed alongside aspirin to reduce the risk of further cardiovascular events in individuals with ACS.
• History of Heart Attack or Stroke: People who have previously experienced a heart attack or stroke are often prescribed Ticagrelor to prevent future events.
• Coronary Stent Placement: After undergoing a procedure to insert a coronary stent, Ticagrelor may be prescribed to prevent blood clots from forming on the stent.

How should this medicine be used?

Ticagrelor is typically taken orally, and the recommended dosage is usually 90 milligrams (mg) twice daily. It’s important to follow the instructions provided by a healthcare professional regarding the dosage and duration of treatment, as it can vary based on individual factors and medical history.

Ticagrelor should be taken with a full glass of water, with or without food. It’s essential to take it consistently at the same times each day to maintain stable blood levels of the medication.

If a dose of Ticagrelor is missed, it should be taken as soon as remembered, unless it is almost time for the next scheduled dose. In that case, the missed dose should be skipped, and the regular dosing schedule should be resumed. It’s crucial not to double the dose to make up for a missed one.

As with any medication, it’s essential to inform healthcare providers of all medications being taken, including over-the-counter drugs and supplements, to prevent potential interactions or adverse effects. Additionally, any concerns or side effects experienced while taking Ticagrelor should be discussed with a healthcare professional promptly.

Other uses for this medicine

• While ticagrelor is primarily used for ACS, there has been research into its potential use in other conditions such as:
  • Peripheral artery disease (PAD)
  • Prevention of recurrent strokes
• However, its use in these conditions is not as widespread as its use in ACS, and it’s crucial to consult with a healthcare professional for guidance on its appropriate use.

What special precautions should I follow?

As for special precautions to follow when taking Ticagrelor, individuals should be aware of the following:

• Bleeding Risk: Ticagrelor increases the risk of bleeding, so it’s essential to inform healthcare providers of any history of bleeding disorders or if taking other medications that also increase bleeding risk.
• Bradyarrhythmia: Ticagrelor can cause slowing of the heart rate (bradyarrhythmia), especially in individuals with certain heart conditions. Monitoring for signs of bradyarrhythmia is important during treatment.
• Liver Function: Ticagrelor can affect liver function, so regular monitoring of liver enzymes may be necessary, particularly in individuals with pre-existing liver disease.
• Allergic Reactions: Individuals with known hypersensitivity to Ticagrelor or any of its components should avoid its use. Allergic reactions, while rare, can be severe and require immediate medical attention.
• Drug Interactions: Ticagrelor can interact with other medications, including certain blood thinners, antifungal medications, and HIV protease inhibitors. It’s essential to inform healthcare providers of all medications being taken to prevent potential interactions.
• Pregnancy and Breastfeeding: The safety of Ticagrelor during pregnancy and breastfeeding has not been established, so it should be used with caution in these populations, only if the potential benefits outweigh the risks.

As always, individuals should consult with their healthcare provider for personalized advice regarding the use of Ticagrelor and any associated precautions.

What special dietary instructions should I follow?

There are no specific dietary restrictions associated with Ticagrelor. However, maintaining a healthy and balanced diet is essential for overall cardiovascular health. Avoid excessive alcohol consumption, as it can increase the risk of bleeding.

What should I do if I forget a dose?

If you forget to take a dose of Ticagrelor, take it as soon as you remember, unless it is almost time for your next scheduled dose. In that case, skip the missed dose and continue with your regular dosing schedule. Do not double the dose to make up for a missed one. If you are unsure about what to do, consult your healthcare provider or pharmacist for guidance.

What side effects can this medication cause?

Ticagrelor, like any medication, can cause side effects. Common side effects of Ticagrelor may include:

• Bleeding: This is the most significant side effect associated with Ticagrelor. It can range from minor bruising to more severe bleeding events, such as gastrointestinal bleeding or bleeding in the brain.
• Shortness of Breath: Some individuals may experience shortness of breath while taking Ticagrelor. If this symptom occurs, it should be reported to a healthcare professional immediately.
• Allergic Reactions: While rare, allergic reactions to Ticagrelor can occur. Symptoms may include rash, itching, swelling of the face, lips, or throat, and difficulty breathing. Anyone experiencing these symptoms should seek medical attention promptly.
• Liver Problems: Ticagrelor can rarely cause liver problems, such as elevated liver enzymes. Symptoms of liver problems may include yellowing of the skin or eyes (jaundice), dark urine, or persistent nausea and vomiting.
• Bradyarrhythmia: Some patients may experience slowing of the heart rate (bradyarrhythmia) while taking Ticagrelor. This is more common in patients with a history of certain heart conditions or those taking other medications that affect heart rhythm.
• Adverse Interactions: Ticagrelor can interact with other medications, potentially increasing the risk of side effects or reducing its effectiveness. It’s essential to inform healthcare providers of all medications being taken to prevent potential interactions.
• Withdrawal Effects: Abruptly stopping Ticagrelor can increase the risk of cardiovascular events, including heart attack or stroke. It’s important to follow a healthcare provider’s instructions when discontinuing this medication.

It’s crucial to note that not everyone will experience these side effects, and some individuals may experience side effects not listed here. Additionally, the benefits of Ticagrelor in reducing the risk of serious cardiovascular events generally outweigh the potential risks for most people. If you have concerns about side effects or experience any unusual symptoms while taking Ticagrelor, it’s essential to discuss them with your healthcare provider.

What should I know about storage and disposal of this medication?

Storage and Disposal:

• Store Ticagrelor at room temperature away from light and moisture.
• Keep it out of reach of children and pets.
• Do not store Ticagrelor in the bathroom, as moisture can affect its effectiveness.
• Do not use Ticagrelor if it has expired or if you notice any signs of tampering or damage to the packaging.
• Dispose of expired or unused Ticagrelor properly according to local regulations or guidelines. You can ask your pharmacist for instructions on how to safely dispose of medications.

In case of emergency/overdose

• In case of an overdose of Ticagrelor or if you suspect someone has taken too much of the medication, seek emergency medical attention immediately.
• Symptoms of an overdose may include excessive bleeding, vomiting blood, black or tarry stools, and other signs of severe bleeding.

What other information should I know?

• Inform healthcare providers of all medications you are taking, including prescription drugs, over-the-counter medications, vitamins, and supplements, to prevent potential interactions with Ticagrelor.
• Attend all scheduled medical appointments for monitoring and follow-up while taking Ticagrelor.
• Avoid drinking alcohol excessively while taking Ticagrelor, as it can increase the risk of bleeding.
• Carry a medical alert card or wear a medical alert bracelet to inform healthcare providers that you are taking Ticagrelor, especially if you need emergency medical treatment or surgery.
• If you are planning any dental procedures or surgeries, inform your dentist or surgeon that you are taking Ticagrelor.
• Report any unusual or severe side effects experienced while taking Ticagrelor to your healthcare provider promptly.

Overall, it’s essential to follow your healthcare provider’s instructions carefully when taking Ticagrelor and to seek medical attention if you have any concerns or experience any unexpected symptoms.