Ticagrelor: Difference between revisions
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==Adult Dosing== | ==Adult Dosing== | ||
*ACS: | *ACS: 180mg (two 90mg tablets) loading dose | ||
**PO vs OG vs NG (depending on mental status) | **PO vs OG vs NG (depending on mental status) | ||
*ACS patients who have received a loading dose of [[Clopidogrel]] may be started on Ticagrelor | *ACS patients who have received a loading dose of [[Clopidogrel]] may be started on Ticagrelor | ||
*Maintenance: | *Maintenance: 90mg twice daily | ||
==Pediatric Dosing== | ==Pediatric Dosing== | ||
| Line 18: | Line 18: | ||
*Renal Dosing | *Renal Dosing | ||
**Adult | **Adult | ||
*** No adjustment necessary | |||
**Pediatric | **Pediatric | ||
*Hepatic Dosing | *Hepatic Dosing | ||
**Adult | **Adult | ||
*** Mild impairment - no adjustment necessary | |||
*** Moderate impairment - not defined but use caution as undergoes hepatic metabolism | |||
*** Severe impairment - avoid use | |||
**Pediatric | **Pediatric | ||
| Line 41: | Line 45: | ||
**Atrial fibrillation | **Atrial fibrillation | ||
**Hypertension (4%) | **Hypertension (4%) | ||
**Chest pain | **[[Chest pain]] | ||
**Hypotension (3%) | **[[Hypotension]](3%) | ||
*CNS | *CNS | ||
**Headache (7%) | **Headache (7%) | ||
| Line 49: | Line 53: | ||
**Syncope/pre-syncope/loss of consciousness (2%) | **Syncope/pre-syncope/loss of consciousness (2%) | ||
*GI | *GI | ||
**Diarrhea, nausea (4%). | **[[Diarrhea]], nausea (4%). | ||
*Hematologic | *Hematologic | ||
**Non–CABG-related bleeding (9%) | **Non–CABG-related bleeding (9%) | ||
| Line 61: | Line 65: | ||
*Excretion: 26% excreted in urine (less than 1% as ticagrelor and the active metabolite); 58% excreted in feces | *Excretion: 26% excreted in urine (less than 1% as ticagrelor and the active metabolite); 58% excreted in feces | ||
*Mechanism of Action: Reversibly binds to the P2Y 12 class of adenosine diphosphate (ADP) receptors on platelets to prevent signal transduction and platelet activation | *Mechanism of Action: Reversibly binds to the P2Y 12 class of adenosine diphosphate (ADP) receptors on platelets to prevent signal transduction and platelet activation | ||
==Indications by Condition== | |||
''The following table is automatically generated from disease/condition pages across WikEM.'' | |||
{{#ask:[[Has DrugName::Ticagrelor]] | |||
|?Has Indication=Indication | |||
|?Has Dose=Dose | |||
|?Has Context=Context | |||
|?Has Route=Route | |||
|?Has Population=Population | |||
|format=table | |||
|headers=plain | |||
|mainlabel=- | |||
|sort=Has Indication | |||
|limit=50 | |||
}} | |||
==See Also== | ==See Also== | ||
[[Antiplatelet]] | *[[Antiplatelet medications]] | ||
*[[Antiplatelet agent reversal]] | |||
==References== | ==References== | ||
<references/> | <references/> | ||
[[Category: | [[Category:Pharmacology]] | ||
Ticagrelor: Drug information. UpToDate. www.uptodate.com. Accessed April 2, 2019. | |||
Latest revision as of 21:58, 20 March 2026
General
- Type: Antiplatelet
- Dosage Forms: Pill
- Common Trade Names: Brilenta
Adult Dosing
- ACS: 180mg (two 90mg tablets) loading dose
- PO vs OG vs NG (depending on mental status)
- ACS patients who have received a loading dose of Clopidogrel may be started on Ticagrelor
- Maintenance: 90mg twice daily
Pediatric Dosing
- Undetermined
Special Populations
- Pregnancy Rating: Category C
- Lactation: Undetermined
- Renal Dosing
- Adult
- No adjustment necessary
- Pediatric
- Adult
- Hepatic Dosing
- Adult
- Mild impairment - no adjustment necessary
- Moderate impairment - not defined but use caution as undergoes hepatic metabolism
- Severe impairment - avoid use
- Pediatric
- Adult
Contraindications
- Allergy to class/drug
- History of:
- Intracranial hemorrhage
- Active pathological bleeding, such as peptic ulcer or intracranial hemorrhage
- Severe hepatic impairment
Adverse Reactions
Serious
- Major coronary artery bypass graft (CABG)–related bleeding (86%)[1]
- Digoxin: Because of inhibition of the P-gp transporter, digoxin concentrations may be elevated, increasing the risk of toxicity.
- Monitor digoxin concentrations with initiation of, or any change in, ticagrelor therapy
Common
- Cardiovascular
- Ventricular pause (6%)
- Atrial fibrillation
- Hypertension (4%)
- Chest pain
- Hypotension(3%)
- CNS
- Headache (7%)
- Dizziness (5%)
- Fatigue (3%)
- Syncope/pre-syncope/loss of consciousness (2%)
- GI
- Diarrhea, nausea (4%).
- Hematologic
- Non–CABG-related bleeding (9%)
- Pulmonary
- Dyspnea (14%)
- Cough (5%)
Pharmacology
- Half-life: 7 hours (ticagrelor) and 9 hours (active metabolite)
- Metabolism: liver (CYP3A4)
- Excretion: 26% excreted in urine (less than 1% as ticagrelor and the active metabolite); 58% excreted in feces
- Mechanism of Action: Reversibly binds to the P2Y 12 class of adenosine diphosphate (ADP) receptors on platelets to prevent signal transduction and platelet activation
Indications by Condition
The following table is automatically generated from disease/condition pages across WikEM.
| Indication | Dose | Context | Route | Population |
|---|---|---|---|---|
| ST-segment elevation myocardial infarction | 180 mg PO loading | P2Y12 antiplatelet (may reduce mortality vs clopidogrel) | PO | Adult |
See Also
References
- ↑ http://www.drugs.com/cdi/ticagrelor.html -- Accessed April 2015
Ticagrelor: Drug information. UpToDate. www.uptodate.com. Accessed April 2, 2019.