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Brilinta

Generic Name: ticagrelor (tye KA grel or)
Brand Names: Brilinta



What is Brilinta?

Brilinta (ticagrelor) helps to prevent platelets in your blood from sticking together and forming a blood clot. An unwanted blood clot can occur with certain heart or blood vessel conditions.

Brilinta is used to lower your risk of having a stroke or serious heart problems after you have had a heart attack or severe chest pain (angina).

Brilinta may also be used for purposes not listed in this medication guide.

Important information
You should not use Brilinta if you have severe liver disease, any active bleeding (including a bleeding stomach ulcer), or a history of bleeding in the brain. Do not use this medicine just before heart bypass surgery (coronary artery bypass graft, or CABG).

You may need to stop using Brilinta for a short time before having surgery or dental work, to prevent excessive bleeding. Do not stop taking Brilinta without first talking to your doctor, even if you have signs of bleeding. Stopping this medicine may increase your risk of a heart attack or stroke.

 Looking Ahead: New Drug Approvals for 2017
SLIDESHOW
Looking Ahead: New Drug Approvals for 2017
Brilinta may cause you to bleed more easily, which can be severe or life-threatening. Avoid activities that may increase your risk of bleeding or injury.

Call your doctor or seek emergency medical attention if you have bleeding that will not stop. You may also have bleeding on the inside of your body, such as in your stomach or intestines. Call your doctor at once if you have black or bloody stools, red or pink urine, or if you cough up blood or vomit that looks like coffee grounds. These could be signs of bleeding in your digestive tract.

Many drugs (including some over-the-counter medicines and herbal products) can cause serious medical problems if you take them with Brilinta. It is very important to tell your doctor about all medicines you have recently used.

Before taking this medicine
You should not use Brilinta if you are allergic to ticagrelor, or if you have:

severe liver disease;
any active bleeding;
stomach ulcer or bleeding; or
a history of bleeding in the brain (such as from a head injury).
Do not use this medicine within 5 days before heart bypass surgery (coronary artery bypass graft, or CABG).

To make sure Brilinta is safe for you, tell your doctor if you have:

liver disease;
a serious heart condition such as "sick sinus syndrome" or "AV block" (unless you have a pacemaker);
asthma, COPD (chronic obstructive pulmonary disorder) or other breathing problem;
a history of stomach ulcer or colon polyps;
a history of stroke; or
a history of bleeding or blood clotting disorder.
Brilinta may cause you to bleed more easily, especially if you have:

a recent surgery or bleeding injury;
a disease affecting the blood vessels in your brain;
a history of stroke;
a history of bleeding problems;
a history of stomach or intestinal bleeding; or
if you are 65 or older.
It is not known whether Brilinta will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

It is not known whether ticagrelor passes into breast milk or if it could harm a nursing baby. You should not breast-feed while using this medicine.


How should I take Brilinta?
Take Brilinta exactly as prescribed by your doctor. Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Brilinta should be taken together with aspirin. Follow your doctor's instructions about how much aspirin you should take.

Do not take more aspirin than your doctor has prescribed. Taking too much aspirin can make Brilinta less effective.

This medicine can be taken with or without food. Take the medicine at the same time each day.

Because ticagrelor keeps your blood from coagulating (clotting), this medicine can also make it easier for you to bleed, even from a minor injury. Contact your doctor or seek emergency medical attention if you have any bleeding that will not stop.

Any doctor, dentist, surgeon, or other medical care provider who treats you should know that you are taking Brilinta. You may need to stop using the medicine for a short time before having surgery or dental work, to prevent excessive bleeding. Follow your doctor's instructions and start taking Brilinta again as soon as possible.

Do not stop taking Brilinta without first talking to your doctor, even if you have signs of bleeding. Use this medicine regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely. Stopping Brilinta may increase your risk of a heart attack or stroke.

Store at room temperature away from moisture and heat.

Brilinta dosing information
Usual Adult Dose for Acute Coronary Syndrome:

Initiate treatment with a 180 mg (two 90 mg tablets) loading dose given orally and continue treatment with 90 mg orally twice daily. After the initial loading dose of aspirin (usually 325 mg), use a daily maintenance dose of aspirin of 75 to 100 mg.

Maintenance doses of aspirin above 100 mg decreased the effectiveness of Brilinta. Avoid maintenance doses of aspirin above 100 mg daily.

See also: Dosage Information (in more detail)

What happens if I miss a dose?
Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Overdose can cause excessive bleeding.

What should I avoid while taking Brilinta?
While you are taking Brilinta, do not take NSAIDs (nonsteroidal anti-inflammatory drugs) without your doctor's advice. NSAIDs include ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib (Celebrex), diclofenac, indomethacin, meloxicam, and others.

Avoid activities that may increase your risk of bleeding or injury. Use extra care to prevent bleeding while shaving or brushing your teeth.

Avoid drinking alcohol. It may increase your risk of bleeding in your stomach or intestines.

Ask a doctor or pharmacist before using any cold, allergy, pain, or sleep medication. Aspirin (sometimes abbreviated as ASA) is contained in many combination medicines. Taking certain products together can cause you to get too much aspirin which can increase your risk of bleeding. Check the label to see if a medicine contains aspirin or ASA.


Brilinta side effects
Get emergency medical help if you have signs of an allergic reaction to Brilinta: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

a nosebleed or other bleeding that will not stop;
shortness of breath or a light-headed feeling (like you might pass out), even with mild exertion or while lying down;
easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin;
red or pink urine:
pale skin, weakness, fever, or jaundice (yellowing of the skin or eyes);
signs of stomach bleeding - bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds;
heart attack symptoms - chest pain or pressure, pain spreading to your jaw or shoulder, nausea, sweating; or
signs of a stroke - sudden numbness or weakness (especially on one side of the body), sudden severe headache, slurred speech, problems with vision or balance.
Common Brilinta side effects may include:

headache, mild dizziness;
cough; or
nausea, diarrhea.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

What other drugs will affect Brilinta?
Many drugs can interact with ticagrelor. Not all possible interactions are listed here. Tell your doctor about all your current medicines and any you start or stop using, especially:

imatinib;
lovastatin (Advicor, Altoprev, Mevacor) or simvastatin (Zocor, Simcor, Vytorin, Juvisync);
nefazodone;
St. John's wort;
an antibiotic - clarithromycin, telithromycin;
antifungal medicine - itraconazole, ketoconazole, posaconazole, voriconazole;
heart or blood pressure medicine - digoxin, nicardipine, quinidine;
antiviral medicine to treat hepatitis or HIV/AIDS - atazanavir, boceprevir, cobicistat, delavirdine, efavirenz, fosamprenavir, indinavir, nelfinavir, ritonavir, saquinavir, telaprevir;
seizure medicine - carbamazepine, phenytoin; or
tuberculosis medicine - isoniazid, rifampin.
This list is not complete and many other drugs can interact with Brilinta. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Give a list of all your medicines to any healthcare provider who treats you.
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