Pricing
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All price changes →Indications & Uses
Ticaflow is indicated for:
Dosage Reference
Reference Information Only
Dosages shown are general references from official sources. Always consult your doctor or pharmacist for personalized dosing.
Adults:
Patients taking Ticagrelor should also take a daily low maintenance dose of acetylsalicylic acid (ASA) 75 to 150 mg unless specifically contraindicated. Acute coronary syndromes: Ticagrelor treatment should be started with a single 180 mg loading dose (two tablets of 90 mg) and then continued at 90 mg twice daily. Treatment with Ticagrelor twice daily is recommended for 12 months in ACS patients unless stopping it early is clinically indicated. History of myocardial infarction: Ticagrelor 60 mg twice daily is the recommended dose when extended treatment is required for patients with a history of MI of at least one year and a high risk of an atherothrombotic event. Treatment may be started without interruption as continuation therapy after the initial one year treatment with ticagrelor or another adenosine diphosphate (ADP) receptor inhibitor therapy in ACS patients with a high risk of an atherothrombotic event. Treatment can also be started up to 2 years from the MI, or within one year after stopping previous ADP receptor inhibitor treatment. There are limited data on the efficacy and safety of ticagrelor beyond 3 years of extended treatment. Switch therapy: If a switch is needed, the first dose of ticagrelor should be given 24 hours after the last dose of the other antiplatelet medication. Missed dose: A patient who misses a dose of ticagrelor should take only one tablet (their next dose) at its scheduled time. Elderly: No dose adjustment is required in elderly patients. Renal impairment: No dose adjustment is necessary for patients with renal impairment. No information is available on treating patients on renal dialysis, so ticagrelor is not recommended in these patients. Hepatic impairment: Ticagrelor has not been studied in patients with severe hepatic impairment, so its use in these patients is contraindicated. Only limited information is available in patients with moderate hepatic impairment. Dose adjustment is not recommended, but ticagrelor should be used with caution in these patients. No dose adjustment is necessary for patients with mild hepatic impairment. Pediatric population: The safety and efficacy of ticagrelor in children below the age of 18 years have not been established, and no data are available. Ticagrelor can be taken with or without food. Contraindications, warnings, and other details are noted separately.
Side Effects
Very Common: Blood disorder bleedings, Hyperuricaemia, Dyspnoea. Common: Gout/Gouty Arthritis, Dizziness, Syncope, Headache, Vertigo, Hypotension, Respiratory system bleedings, Gastrointestinal haemorrhage, Diarrhoea, Nausea, Dyspepsia, Constipation, Subcutaneous or dermal bleeding, Rash, Pruritus, Urinary tract bleeding, Blood creatinine increased, Postprocedural haemorrhage, Traumatic bleedings. Uncommon: Tumour bleedings, Hypersensitivity including angioedema, Confusion, Intracranial haemorrhage, Eye haemorrhage, Ear haemorrhage, Retroperitoneal haemorrhage, Muscular bleedings.
Cautions & Contraindications
Warnings & Precautions
Bleeding risk: In patients who are known to be at higher risk of bleeding, the decision to use Tigel should weigh that risk against its benefit in preventing atherothrombotic events. Where clinically appropriate, Tigel should be used cautiously in the following groups: patients prone to bleeding (for example, because of recent trauma, recent surgery, coagulation disorders, or active or recent gastrointestinal bleeding). Antifibrinolytic therapy (aminocaproic acid or tranexamic acid) and/or recombinant factor VIIa therapy may help improve haemostasis. Tigel may be restarted once the cause of the bleeding has been identified and brought under control. Surgery: Patients should tell their physicians and dentists that they are taking Tigel before any surgery is planned and before starting any new medicine. If a patient is scheduled for elective surgery and the antiplatelet effect is not wanted, Tigel should be stopped 5 days before the procedure. Patients with a prior ischaemic stroke: ACS patients who have had a prior ischaemic stroke can be treated with Tigel for up to 12 months. Patients at risk of bradycardic events: because clinical experience is limited in this group, Tigel should be used with caution in these patients. Dyspnoea: patients with asthma or chronic obstructive pulmonary disease (COPD) may face a greater absolute risk of experiencing dyspnoea while on Tigel, so it should be used with caution in those with a history of asthma and/or COPD. Creatinine elevations: creatinine levels may rise during treatment with Tigel. In ACS patients, it is recommended that renal function also be checked one month after starting Tigel, with particular attention to patients aged 75 years or older, those with moderate to severe renal impairment, and those also taking an angiotensin receptor blocker (ARB). Uric acid increase: hyperuricaemia may occur during treatment with Tigel, so caution is advised in patients with a history of hyperuricaemia or gouty arthritis. Other: based on a relationship seen in the PLATO trial between the maintenance dose of acetylsalicylic acid (ASA) and the relative efficacy of Tigel compared with clopidogrel, taking Tigel together with a high maintenance dose of ASA (above 300 mg) is not recommended. Premature discontinuation: stopping any antiplatelet therapy early, including Tigel, can raise the risk of cardiovascular (CV) death or myocardial infarction (MI) due to the patient's underlying disease. For this reason, premature discontinuation of treatment should be avoided.
Contraindications
Hypersensitivity to the active substance or any excipient; active pathological bleeding; history of intracranial haemorrhage; severe liver impairment.