Please check your internet connection and try again.
# Ticagrelor
## Overview
Ticagrelor is an oral P2Y12 platelet inhibitor.
## Primary Indications
* To reduce the rate of thrombotic cardiovascular events in patients with acute coronary syndrome (ACS) or a history of myocardial infarction (MI).
## Adult Dosing
* **ACS:** 180 mg orally once as a 30mg loading dose, followed by 90 mg orally twice daily.
* **History of MI:** 60 mg orally twice daily.
* Duration of therapy should be guided by patient risk factors and clinical presentation.
## Pediatric Dosing
* Ticagrelor is not recommended for use in pediatric patients.
## Dose Adjustments
* No dose adjustments are necessary for hepatic or renal impairment.
## Contraindications
* Active pathological bleeding.
* History of transient ischemic attack (TIA) or stroke.
* Known hypersensitivity to ticagrelor or any component of the formulation.
## Adverse Effects
* **Most Common:** Dyspnea, bleeding (including fatal and life-threatening), bradycardia.
* **Serious:** Major bleeding, ventricular pauses, increased creatinine.
## Key Drug Interactions
* **CYP3A4 Inhibitors/Inducers:** Ticagrelor is a substrate of CYP3A4. Coadministration with strong CYP3A4 inhibitors may increase ticagrelor exposure, and coadministration with strong CYP3A4 inducers may decrease ticagrelor exposure.
* **Dual Antiplatelet Therapy (DAPT):** Increased risk of bleeding. Avoid concomitant use of other antiplatelet agents unless clinically indicated.
* **Anticoagulants:** Increased risk of bleeding. Monitor for signs of bleeding.
* **Statins:** Ticagrelor can increase statin concentrations. The clinical significance is unknown, but caution is advised, especially with high-dose statins.
## Monitoring
* Monitor for signs and symptoms of bleeding.
* Monitor for signs of bradycardia (e.g., dizziness, syncope).
* Periodic assessment of renal function may be warranted.
## Clinical Pearls
* Ticagrelor should be taken with or without food.
* If a dose is missed, the patient should take the next dose at the regularly scheduled time. Do not double the dose.
* Discontinuation of ticagrelor increases the risk of stent thrombosis, MI, and death. If possible, resume treatment as soon as possible after discontinuation.
* Ticagrelor is associated with reversible increases in serum uric acid.
***
*This information is intended for healthcare professionals. Always consult the current prescribing information and relevant clinical guidelines before making any treatment decisions.*
