Brilinta 90mg (Ticagrelor)

Brilinta general information

What is Brilinta used for?

Brilinta tablets 90mg are used to prevent the formation of blood clots (thrombosis) in people with cardiovascular disease, particularly acute coronary conditions, such as recent heart attack (myocardial infarction) or unstable angina (chest pain), to reduce risk of another heart attack or stroke and to reduce risk of death due to cardiovascular disease.  Brilinta tablets 90mg should be used in addition to aspirin, which is another anti-clotting medication that helps reduce the risk of another heart attack and prevent death due to cardiovascular disease.

How does Brilinta work?

Brilinta tablets 90mg contain ticagrelor a specific and potent inhibitor of platelet aggregation (clumping), which is part of the process that leads to the formation of a blood clot (thrombosis) to plug an injured blood vessel and stop bleeding.  Platelets (or thrombocytes) can also be induced to aggregate when they come in contact with a ruptured atherosclerotic plaque, which is when an artery wall is hardened by build-up of cholesterol, a process called atherosclerosis.  A blood clot formed in this way may end up blocking the artery cutting off blood supply to various parts of the body.  This can result in heart attack if the coronary arteries (supplying blood to the heart) become blocked and the heart becomes starved of oxygen; or stroke if the arteries to the brain become blocked, causing oxygen starvation to the brain.  Platelet aggregation is dependent on a chemical called adenosine diphosphate (ADP) that activates platelets to aggregate by binding to a platelet receptor called P2Y12.  Ticagrelor in Brilinta tablets 90mg binds selectively and reversibly to the P2Y12 receptor on platelets, blocking the action of adenosine and thereby, inhibiting platelet activation and aggregation.  By inhibiting platelet aggregation at the site of blood vessel damage due to atherosclerosis, Brilinta tablets 90mg keeps the blood flowing and reduces risk of thrombosis in people who have cardiovascular disease and who are at risk of heart attack or stroke.  Ticagrelor in Brilinta tablets 90mg has a rapid onset of action and its effect is maintained for up to 8 hours.

What does Brilinta contain?

Brilinta tablets contain active ingredient ticagrelor 90mg, an inhibitor of platelet aggregation that is used to treat acute cardiovascular disease to prevent thrombosis.  They also contain mannitol (E421), dibasic calcium phosphate magnesium stearate (E470b), sodium starch glycolate, hydroxypropyl-cellulose (E463), talc, titanium dioxide (E171), ferric oxide yellow (E172), polyethylene-glycol 400, hypromellose (E464)

Preventing heart attack and stroke with Brilinta

Brilinta tablets 90mg contain ticagrelor, a potent inhibitor of platelet aggregation (clumping) that is used to prevent the formation of blood clots (thrombosis) in people with cardiovascular disease, particularly acute coronary conditions, such as recent heart attack (myocardial infarction) or unstable angina (chest pain), to reduce risk of another heart attack or stroke and to reduce risk of death due to cardiovascular disease.  Platelet aggregation results in the formation of a blood clot (thrombosis) to plug an injured blood vessel and stop bleeding.  In atherosclerotic arteries (artery wall hardened by cholesterol build up) there is a risk that the atherosclerotic plaque may rupture and induce platelet aggregation and blood clot formation, which may block the artery cutting off blood supply to the heart or brain causing a heart attack or stroke.  Ticagrelor in Brilinta tablets 90mg binds to a specific receptor on platelets, blocking adenosine dependent platelet activation, which inhibits platelet aggregation.  By inhibiting platelet aggregation at the site of blood vessel damage, Brilinta tablets 90mg keeps the blood flowing and reduces risk of thrombosis in people who have cardiovascular disease and this reduces the risk of heart attack or stroke.  

What are the side effects of Brilinta?

The most commonly reported side effects when taking Brilinta tablets 90mg include: bleeding and bruising more than usual or increased bleeding time, nose bleed (epistaxis), gastrointestinal haemorrhage, dyspnoea (shortness of breath), abdominal pain, dyspepsia (upset stomach), diarrhoea, constipation, dizziness, headache, rash, itching.

When should Brilinta not be used?

You should not use Brilinta tablets 90mg if you:

• are allergic to ticagrelor or any ingredients in Brilinta
• are pregnant or are breastfeeding
• have liver disease
• have a medical condition that is causing bleeding such as a stomach ulcer or intracranial bleeding
• are having surgery (including dental work)
• have bradycardia (low heart beat and you do not have a pacemaker, without discussion with your doctor
• have asthma or other chronic lung condition, without discussion with your doctor
• are taking medicines that interact with Brilinta, including, the antifungal ketoconazole, the antibiotics clarithromycin and rifampicin, ritonavir and atazanavir for HIV, the anticonvulsants phenytoin, carbamazepine and phenobarbital, statins like simvastatin or atorvastatin for high cholesterol, the immunosuppressant cyclosporine, diltiazem for irregular heartbeat, cisapride for reflux, ergot alkaloids for migraine, digoxin for heart failure, antidepressant SSRIs like paroxetine, sertraline and citalopram, non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen, blood thinners like  heparins and warfarin

What medications interact with Brilinta?

Several medications interact with Brilinta tablets 90mg and should either not be taken while you are taking Brilinta or only after discussion and instruction from your doctor:

• Drugs that cause a serious reaction with Brilinta: antidepressant SSRIs like paroxetine, sertraline and citalopram, non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen, blood thinners like  heparins and warfarin may increase risk of bleeding
• Drugs that affect Brilinta: the antifungal ketoconazole, the antibiotics clarithromycin and rifampicin, ritonavir and atazanavir for HIV, the anticonvulsants phenytoin, carbamazepine and phenobarbital, the immunosuppressant cyclosporine, diltiazem for irregular heartbeat
• Drugs that are affected by Brilinta: statins like simvastatin or atorvastatin for high cholesterol, cisapride for reflux, ergot alkaloids for migraine, digoxin for heart failure

How should Brilinta be taken?

You should take your Brilinta tablets 90mg swallowed whole with or without food.  The starting dose should be a double loading dose of 2 tablets of Brilinta tablets 90mg taken at the same time, followed by a single tablet twice daily morning and evening, and at the same time each day, in conjunction with aspirin as advised by your doctor.  You should continue to take your Brilinta tablets 90mg for 12 months and you should not stop taking your Brilinta tablets 90mg unless recommended otherwise by your doctor, as this may increase risk of heart attack or stroke. 

How long should you take Brilinta?

You should continue to take your Brilinta tablets 90mg for 12 months and you should not stop taking your Brilinta tablets 90mg unless recommended otherwise by your doctor, as this may increase risk of heart attack or stroke. 

Missed dose of Brilinta

If you miss a dose of Brilinta tablets 90mg take it as soon as you remember, unless it is time to take the next dose, then skip the missed dose.  Do not take a double dose.

How should Brilinta be stored?

You should store your Brilinta tablets 90mg below 25°C in a cool dry place.