Ticagrelor, known by its brand name Brilinta, is an antiplatelet medication. It prevents platelets from clumping together, helping maintain blood flow and preventing blood clots in the arteries. It is prescribed to reduce the risk of serious cardiovascular events like heart attack and stroke, especially in individuals who have experienced acute coronary syndrome (ACS) or a history of myocardial infarction.
Standard Dosing by Condition
For individuals experiencing acute coronary syndrome (ACS), treatment begins with an initial 180 milligram (mg) oral loading dose. Following this, a maintenance dose of 90 mg is administered twice daily for one year. The first maintenance dose is generally taken 6 to 12 hours after the loading dose.
For patients with a history of heart attack, extended treatment beyond the first year may involve a reduced maintenance dose. After completing one year of the 90 mg twice daily regimen, the dosage may be lowered to 60 mg taken twice daily. This lower dose is intended for long-term prevention of cardiovascular events.
In cases of high-risk coronary artery disease (CAD) without a prior heart attack or stroke, ticagrelor is used to reduce the risk of a first myocardial infarction or stroke. The typical dosage in this scenario is 60 mg administered twice daily. This application is often considered for patients at elevated risk, such as those with type 2 diabetes mellitus.
For patients experiencing an acute ischemic stroke or a high-risk transient ischemic attack (TIA), a specific dosing regimen is followed. Treatment starts with a 180 mg loading dose, taken once. This is then followed by a maintenance dose of 90 mg twice daily, continued for up to 30 days. The initial maintenance dose should be administered 6 to 12 hours after the loading dose.
Managing Your Dosing Schedule
Ticagrelor is typically taken twice daily, with doses spaced approximately 12 hours apart to maintain consistent levels. It can be taken with or without food, providing flexibility. For individuals who have difficulty swallowing pills whole, tablets can be crushed and mixed with water for easier administration.
If a dose of ticagrelor is missed, skip that particular dose. Then, take your next scheduled dose at the regular time. Do not take a double dose to compensate, as this could increase the risk of side effects.
In the event of a suspected overdose, it is important to contact a poison control center or seek immediate emergency medical attention. The primary concern with an overdose of ticagrelor is the increased risk of excessive bleeding, given its function as an antiplatelet agent. Prompt medical evaluation is necessary to manage any potential complications.
Dosage Considerations for Specific Situations
Ticagrelor is almost always prescribed alongside a daily low-dose aspirin, typically ranging from 75 mg to 100 mg. This combination, known as dual antiplatelet therapy, provides enhanced protection against blood clots. Avoid high doses of aspirin (above 100 mg daily), as this can reduce the effectiveness of ticagrelor.
Dosage adjustments for ticagrelor are generally not necessary based on age, kidney impairment, or mild liver impairment. However, it is not recommended for individuals with severe liver impairment due to increased medication exposure.
Before undergoing any planned surgical procedures, including dental work, a healthcare provider will likely instruct patients to temporarily stop taking ticagrelor. This is typically done about 5 days prior to the procedure to minimize the risk of bleeding complications. Patients should never discontinue the medication on their own without first consulting their cardiologist or other prescribing healthcare professional, as stopping it prematurely can increase the risk of cardiovascular events.
Treatment Duration
The duration for which ticagrelor is taken is determined by a healthcare provider, taking into account the patient’s specific medical history and overall risk profile. This personalized approach ensures the medication is used for an appropriate length of time.
For many conditions, treatment is typically recommended for a specific period, such as at least 12 months following an acute event. For some patients at high risk for future cardiovascular events, therapy may be extended beyond this initial period, often involving a lower maintenance dose. This extended therapy aims to provide ongoing protection.
It is important for patients not to stop taking ticagrelor prematurely or without specific medical advice. Discontinuing the medication before the recommended duration can significantly increase the likelihood of experiencing another heart attack or stroke. Any changes to the treatment plan should always be made in consultation with a healthcare professional.