Indications
Brilinta (active ingredient: ticagrelor) is a prescription medication indicated for the following:
- Acute Coronary Syndrome (ACS): Brilinta is used for the treatment of acute coronary syndrome, including unstable angina (UA), non-ST elevation myocardial infarction (NSTEMI), and ST-elevation myocardial infarction (STEMI), in combination with aspirin.
- History of Myocardial Infarction (MI): It is also indicated for the prevention of atherothrombotic events in patients with a history of myocardial infarction (MI) beyond the acute event.
Brilinta belongs to a class of drugs known as platelet aggregation inhibitors or antiplatelet agents, specifically P2Y12 platelet inhibitors, which work by inhibiting platelet activation and aggregation, thereby reducing the risk of blood clot formation and subsequent cardiovascular events.
Uses and Dosage
BRILINTA (ticagrelor) is a tablet to be taken orally. For patients who are unable to swallow tablets whole, BRILINTA tablets can be crushed, mixed with water, and drunk. The mixture can also be administered via a nasogastric tube (CH8 or greater). It is important to flush the nasogastric tube through with water after administration of the mixture. Additionally, the dose should be adjusted in patients with renal impairment.
In the management of Acute Coronary Syndrome (ACS), Brilinta (ticagrelor) should be initiated with a 180 mg loading dose. This should be followed by 90 mg twice daily during the first year after an ACS event. After one year, the dosage should be reduced to 60 mg twice daily for maintenance.
For prevention of first heart attack or stroke in patients with coronary artery disease (CAD), adults should take 60 milligrams (mg) of BRILINTA two times a day. Your doctor may also give you a maintenance dose of 75 to 100 mg aspirin once a day to be taken together with this medicine.
Side Effects
Common Side Effects of Using Brilinta (Ticagrelor):
- Dizziness
- Fatigue
- Headache
- Nausea
- Shortness of breath
Serious Side Effects of Using Brilinta (Ticagrelor):
- Breathing problems
- Confusion
- Easy bruising
- Fainting
- Interrupted breathing during sleep
- Irregular heartbeat
- Palpitations
- Serious bleeding
- Signs of blood clotting problems (fever, red or purple pinpoint-sized spots on the skin)
- Trouble speaking
- Vision changes
Form and Strength
Brilinta and its generic alternative Ticagrelor are available in the following forms and strengths:
Brilinta: Tablet
- 60 mg
- 90 mg
Ticagrelor: Tablet
- 60 mg
- 90 mg
Caution
- This is due to their ability to block the P2Y12 component of the adenosine diphosphate (ADP) receptor, which is responsible for platelet activation and aggregation. As a result, platelet function is inhibited, leading to an increased risk of bleeding.
- Patients with uremia, liver disease, thrombocytopenia, or other acquired conditions that put them at higher risk of bleeding may be more likely to experience bleeding from BRILINTA. Talk to a doctor or healthcare provider to determine the risks and benefits of taking BRILINTA and whether it is an appropriate treatment option.
- The use of BRILINTA (ticagrelor) with maintenance doses of aspirin above 100 mg has been shown to reduce the effectiveness of BRILINTA. Therefore, after the initial loading dose of aspirin, it is recommended to use BRILINTA with a maintenance dose of aspirin of 75-100 mg per day.
- If a patient develops new, prolonged, or worsened dyspnea that is determined to be related to BRILINTA, no specific treatment is required; continue BRILINTA without interruption if possible. In the case of intolerable dyspnea requiring discontinuation of BRILINTA, consider prescribing another antiplatelet agent such as aspirin or clopidogrel.
- Discontinuation of BRILINTA will increase the risk of myocardial infarction, stroke, and death. If BRILINTA must be temporarily discontinued clinicians should restart it as soon as possible.
Frequently Asked Questions (FAQ)
What is the contraindication of ticagrelor?
The use of ticagrelor is contraindicated in patients with active pathological bleeding, in those with a history of intracranial hemorrhage, and in patients with severe hepatic impairment.
Why is Brilinta given with aspirin?
You will usually be prescribed aspirin with Brilinta to reduce the chance of a blood clot forming. Using Brilinta and aspirin together is called “dual antiplatelet therapy”. Do not stop either of these medications without speaking to your doctor first, as that can increase your risk of a heart attack, stroke, or death.
How long should a patient take Brilinta?
Brilinta is meant to be used as a long-term treatment. Current treatment guidelines recommend that most people who take Brilinta should be on the drug for at least 6 to 12 months.
Can I take Brilinta at night?
Most patients are prescribed one 90 mg dose of Brilinta twice daily for 12 months. The medication should be taken around the same time each day (i.e., one tablet in the morning and one in the evening).
Resources
- https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/022433s020lbl.pdf
- https://www.mayoclinic.org/drugs-supplements/ticagrelor-oral-route/side-effects/drg-20075070?p=1
- https://www.brilinta.com/results-with-brilinta/safety-and-side-effects.html
- https://www.everydayhealth.com/drugs/brilinta-ticagrelor
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