Ticagrelor

Indications

Myocardial Infarction

Tigel tablet is used together with acetylsalicylic acid (ASA) to help prevent atherothrombotic events in adults who have acute coronary syndromes (ACS), or who have had a myocardial infarction (MI) in the past and are at high risk of another atherothrombotic event.

⚠️ Always consult a registered physician before taking any medicine.

Pharmacology

Ticagrelor is a P2Y12 receptor antagonist. The P2Y12 receptor couples with Gαi2 and other Gi proteins, which inhibit adenylyl cyclase. Gi mediated signalling also activates PI3K, Akt, Rap1b, and potassium channels. The downstream effects of these activities mediate hemostasis and lead to platelet aggregation. By blocking the P2Y12 receptor, ticagrelor reduces the development of occlusive thromboses, which can lower the risk of myocardial infarction and ischemic stroke.

Pregnancy & Breastfeeding

Ticagrelor is not recommended for use during pregnancy. Studies in animals have found that ticagrelor and its active breakdown products pass into breast milk, and a risk to the nursing infant cannot be ruled out. The decision to stop breastfeeding or to stop/avoid ticagrelor treatment should weigh the benefit of breastfeeding for the child against the benefit of the medicine for the mother.

⚠️ Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.

Dosage Reference

⚠️ Reference ranges from official sources only. Consult your doctor 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.

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Indications

Pharmacology

Pregnancy & Breastfeeding

Dosage Reference

Side Effects & Interactions

Side Effects

Key Interactions