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Ticagrelor tablets

Brilique

You will be given two 90 mg tablets to take as your first dose. After this, take one 90 mg tablet twice a day, preferably in the morning and evening.

It is likely you will be prescribed ticagrelor for a period of up to twelve months. If there is a need for you to take it for longer than this, your dose will be reduced to 60 mg twice daily.

The most common unwanted effects are an increased risk of bleeding, and feeling short of breath.

At a glance

  • Ticagrelor is a medicine that helps prevent blood clots.

  • It is prescribed for people who have had a heart attack or acute coronary syndrome.

  • You will also take aspirin alongside ticagrelor.

  • Take your tablets twice a day, usually for up to 12 months.

  • Tell your doctor if you have bleeding conditions, breathing difficulties, or other heart conditions.

  • Common side-effects include shortness of breath and easy bruising or bleeding.

  • If you are having an operation, tell the medical staff you are taking ticagrelor.

Continue reading below

About ticagrelor tablets

Type of medicine

An antiplatelet medicine

Used for

Preventing clots from forming in blood vessels (in people with acute coronary syndrome or in people who have previously had a heart attack)

Also called

Brilique®

Available as

Tablets and melt-in-the-mouth (orodispersible) tablets

In your blood there are 'sticky' cells called platelets. When you cut yourself, the platelets stick to each other (clot) to seal the wound. Sometimes platelets stick to each other inside an artery - this is called a thrombus. If a thrombus forms in a blood vessel around your heart, this reduces the flow of blood to your heart. The term acute coronary syndrome (ACS) covers a range of disorders that are caused by this underlying problem. It may mean that you have had a heart attack, or that you have angina pain that is not well controlled. Antiplatelet medicines reduce the stickiness of platelets, and this helps prevent the platelets from sticking to the inside of an artery and forming a thrombus. This reduces the chances of you having a heart attack or stroke.

Ticagrelor is an antiplatelet medicine. Your doctor will also prescribe aspirin for you to take alongside ticagrelor. Aspirin is another antiplatelet medicine. A course of treatment with ticagrelor typically lasts for up to 12 months, whereas treatment with aspirin is likely to be lifelong.

If you require a procedure to open a blocked artery in your heart because you have already had a heart attack or because you have unstable angina, you could be given a single dose of ticagrelor during the procedure.

Some medicines are not suitable for people with certain conditions, and sometimes a medicine can only be used if extra care is taken. For these reasons, before you start taking ticagrelor tablets it is important that your doctor knows:

  • If you have a condition which causes bleeding, such as a recent wound or a stomach ulcer.

  • If you have any breathing difficulties, such as asthma or chronic obstructive pulmonary disease (COPD). Ticagrelor can make these conditions worse.

  • If you have any other heart condition, or an abnormal heart rate.

  • If you have ever had a stroke caused by bleeding in your brain, a condition called intracranial haemorrhage.

  • If you have ever been told you have high blood levels of uric acid, or gout.

  • If you are pregnant or breastfeeding.

  • If you have any problems with the way your liver works.

  • If you have ever had an allergic reaction to a medicine.

  • If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines.

Continue reading below

  • Before you start the treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about ticagrelor, and it will also provide you with a full list of the side-effects which you could experience from taking it.

  • Take the tablets exactly as your doctor tells you to. On the first day of treatment, you will be given two 90 mg tablets to take at the same time so that you get sufficient medicine into your bloodstream to begin with. After this, you will be prescribed a dose of 90 mg twice a day. A course of treatment with ticagrelor often lasts for up to 12 months. If you have had a heart attack, your doctor may want you to continue to take ticagrelor even after the 12-month course has finished. If so, it will be at a lower dose of 60 mg twice daily.

  • Try to take your doses around the same times of day each day, preferably in the morning and the evening. This will help you to remember to take ticagrelor regularly.

  • Most people find that they can swallow the tablet whole with a drink of water. However, you can crush the tablet into a fine powder and take it stirred into a small glass of water if you prefer, providing that you swallow the mixture straight after making it.

  • For people who have swallowing difficulties there is also a melt-in-the-mouth (orodispersible) tablet. If you have been prescribed this tablet, tear open the blister foil and carefully remove the tablet. Place the tablet on your tongue where it will dissolve in a few seconds. You can swallow it with or without a drink of water. It is a good idea to have a few sips of water before taking your tablet, so that your mouth is moist. Make sure your hands are dry when handling the tablet.

  • You can take ticagrelor tablets either with or without food.

  • If you forget to take a dose, take it as soon as you remember, unless it is nearly time for your next dose. In which case take the next dose when it is due and leave out the forgotten dose. Do not take two doses together to make up for a missed dose.

  • Try to keep all your regular appointments with your doctor. This is so your doctor can check on your progress.

  • If you buy any medicines, check with a pharmacist that they are suitable for you to take with ticagrelor tablets. Some medicines, called non-steroidal anti-inflammatory drugs (NSAIDs), can increase the risk of bleeding, so check with a pharmacist before you buy any painkillers. Also, do not take any preparations containing aspirin that have not been prescribed for you by your doctor. Several medicines for pain relief and cold relief that can be bought at retail outlets contain aspirin or ibuprofen - you should not take these, so check the label carefully before you buy.

  • If you are due to have an operation, before the treatment is due, tell the person carrying out the treatment that you are taking ticagrelor. This is because any bleeding may take longer than normal to stop so your treatment may need to be interrupted for a short while before the operation. You should also let your dentist know that you are taking ticagrelor before you receive any dental treatment.

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Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the more common ones associated with ticagrelor. The best place to find a full list of the side-effects which can be associated with your medicine, is from the manufacturer's printed information leaflet supplied with the medicine. Alternatively, you can find an example of a manufacturer's information leaflet in the reference section below. Speak with your doctor or pharmacist if any of the following continue or become troublesome.

Very common ticagrelor side-effects (these affect more than 1 in 10 people)


What can I do if I experience this?

Feeling short of breath

Let your doctor know if this becomes troublesome

Bleeding, bruising, nosebleeds. Stopping bleeding could take longer than normal

Let your doctor know if you notice any unusual or unexpected bleeding or bruising

High levels of uric acid (a symptom of gout)

Your doctor may check for this

Common ticagrelor side-effects (these affect fewer than 1 in 10 people)

What can I do if I experience this?

Feeling dizzy or faint

If troublesome, speak with your doctor

Headache

Drink plenty of water and ask your pharmacist to recommend a suitable painkiller. If the headaches continue, speak with your doctor

Gastric upset (such as feeling sick (nausea), indigestion, constipation or diarrhoea)

If troublesome, speak with your doctor

Skin rash

If troublesome, speak with your doctor

If you experience any other symptoms which you think may be due to the tablets, speak with your doctor or pharmacist for further advice.

  • Keep all medicines out of the reach and sight of children.

  • Store in a cool, dry place, away from direct heat and light.

Important information about all medicines

Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.

This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.

Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.

If you have any questions about this medicine ask your pharmacist.

Report side effects to a medicine or vaccine

If you experience side effects, you can report them online through the Yellow Card website.

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Unsure about mixing medicines?

Check for possible interactions between medicines, supplements and foods before taking them together.

Frequently asked questions

What is acute coronary syndrome (ACS) and how does ticagrelor help?

Acute Coronary Syndrome (ACS) refers to a group of conditions caused by a blocked blood vessel around your heart, which reduces blood flow. This can lead to a heart attack or poorly controlled angina pain. Ticagrelor is an antiplatelet medicine that makes your platelets less sticky, preventing them from clumping together and forming a clot (thrombus) in your arteries. This action helps to reduce your risk of having a heart attack or stroke.

Why do I need to take aspirin with ticagrelor?

Your doctor will prescribe aspirin for you to take alongside ticagrelor. Aspirin is also an antiplatelet medicine. Taking both medications together provides a stronger effect in preventing platelets from sticking together and forming harmful blood clots in your arteries.

How long will I need to take ticagrelor?

A typical course of treatment with ticagrelor usually lasts for up to 12 months. However, if you have had a heart attack, your doctor might recommend that you continue taking ticagrelor even after this 12-month period, though it would be at a lower dose of 60 mg twice daily. Aspirin, when prescribed alongside ticagrelor, is generally expected to be a lifelong treatment.

What should I do if I normally take an over-the-counter painkiller?

If you buy any medicines, including painkillers, it is important to check with a pharmacist to ensure they are safe to take with ticagrelor. Some painkillers, such as non-steroidal anti-inflammatory drugs (NSAIDs) and medicines containing aspirin or ibuprofen, can increase the risk of bleeding. You should not take any preparations containing aspirin that have not been specifically prescribed for you by your doctor. Always check the label carefully before buying any pain or cold relief medicines.

What should I do if I need to have surgery or dental work?

If you are scheduled for an operation or any dental treatment, it's crucial to inform the healthcare professional or dentist that you are taking ticagrelor. This is because ticagrelor can make bleeding take longer to stop than usual. Your treatment with ticagrelor might need to be temporarily stopped before the procedure to manage this risk.

Can ticagrelor make my breathing problems worse?

Yes, if you have pre-existing breathing difficulties, such as asthma or chronic obstructive pulmonary disease (COPD), ticagrelor can potentially worsen these conditions. It is important to inform your doctor about any breathing problems you have before starting treatment with ticagrelor.

Further reading and references

Continue reading below

About the authorView full bio

Author image

Helen Allen, MPharm

Pharmacist, Medical Author

MPharm

Helen Allen qualified as a Pharmacist in 1979 and spent 3 years as the drug information leaflets' author for EMIS.

About the reviewer

Author image

Sid Dajani

Sultan Dajani qualified at the London School of Pharmacy in 1994 and became the youngest elected member of the Royal Pharmaceutical Society council since its founding in 1842.

Article history

The information on this page is written and peer reviewed by qualified clinicians.

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