Ticagrelor 90 mg is a prescription antiplatelet that helps prevent clot-related events after heart attack or stent placement. It blocks platelet activation to reduce new clots. This overview explains the mechanism, dosing schedules, side effects, and practical cautions. Use it to prepare for a discussion with your cardiology team.
Key Takeaways
- Mechanism and effect: Reversible P2Y12 blockade reduces platelet activation and clotting.
- Dosing details: Typically 90 mg twice daily with low-dose aspirin support.
- Safety profile: Bleeding and dyspnea are the most reported reactions.
- Precautions: Avoid with active bleeding; plan ahead for surgeries.
- Interactions: CYP3A modulators, certain statins, and grapefruit raise risks.
Ticagrelor 90 mg
Ticagrelor is a P2Y12 receptor antagonist (platelet blocker) used after acute coronary syndrome (ACS) or stent procedures. It helps lower the risk of myocardial infarction, stroke, or stent thrombosis by reducing platelet clumping. Unlike older thienopyridines, it is reversible and does not require metabolic activation. That property contributes to a faster onset and offset.
Patients may see the medicine listed by brand. For product specifics and tablet strengths, see Ticagrelor for monograph details, and review Brilinta for brand formulation information. If you are comparing options within heart medications, the Cardiovascular category provides a consolidated view of related therapies.
How It Works: Platelet Inhibition Explained
This therapy selectively and reversibly blocks the P2Y12 adenosine diphosphate (ADP) receptor on platelets. In plain terms, it prevents platelets from getting the “stickiness signal” that leads to clot formation. Onset is typically rapid after an oral dose, and antiplatelet effects wane faster after discontinuation compared to some alternatives. That pharmacology can aid scheduling for planned procedures when pauses are required.
People often ask, is ticagrelor a blood thinner? Clinically, it is an antiplatelet agent, which is one type of blood thinner aimed at platelet function rather than clotting proteins. For label-backed details, see the U.S. prescribing information for approved indications and safety guidance.
Recommended Dosage and Administration
After an ACS event or percutaneous coronary intervention (PCI), clinicians commonly start with a loading dose followed by maintenance dosing. Standard maintenance for adults is often described as brilinta 90 mg twice a day, combined with low-dose aspirin. Tablets are swallowed whole and taken consistently, with or without food, to maintain steady platelet inhibition. Do not change your dose without clinical advice.
Low-dose aspirin (usually 75–100 mg) is commonly paired to support dual antiplatelet therapy. Higher daily aspirin amounts can reduce this medicine’s effectiveness. If you are exploring broader medication context, see Cardiovascular Articles for therapy overviews and practice-focused explainers.
Aspirin Co-therapy and Missed Doses
Daily low-dose aspirin is typically continued unless a clinician advises otherwise. If a maintenance dose is missed, take it when remembered unless the next dose is near; do not double up to catch up. For planned dose interruptions, clinicians balance bleeding risk and thrombotic risk based on stent type, time since PCI, and recent ischemic events. Care teams also consider concomitant medicines, including anticoagulants and NSAIDs, which may compound bleeding risk. When individualizing a regimen, teams often review prior tolerance, adherence, and procedure timing.
Acute Care: STEMI and PCI Considerations
In emergency care, timing and loading strategies matter. Many protocols use a 180 mg loading dose before or during PCI when treating ST-elevation myocardial infarction (STEMI). That practice targets rapid platelet inhibition during reperfusion and early stent healing, while considering bleeding risk and access-site strategies. Local practice may vary based on catheterization lab protocols and hemodynamic status.
Clinical teams decide the ticagrelor loading dose in stemi within broader pathways that also include anticoagulation and aspirin. For context on other antiplatelet choices in catheterization workflows, review Prasugrel for an alternative option overview, and compare with Clopidogrel to understand differences in activation and onset.
Side Effects and Risks
Bleeding is the most common adverse effect, ranging from easy bruising to more serious events. Any sign of significant bleeding, such as black stools or prolonged nosebleeds, requires prompt clinical evaluation. Shortness of breath can occur; some patients describe mild air hunger without oxygen changes. Report new or worsening breathing symptoms, especially if they limit activity or occur at rest.
Clinicians sometimes hear about ticagrelor side effects shortness of breath during early therapy. Other reactions may include headache, dizziness, or increased uric acid. Conduction effects such as bradyarrhythmias can appear, particularly with underlying rhythm issues. For patient-facing detail on frequency and management, see the NHS medicines guidance on ticagrelor side effects and cautions for plain-language explanations.
Contraindications and Precautions
Key ticagrelor contraindications include active pathological bleeding, a history of intracranial hemorrhage, or severe hepatic impairment. Strong CYP3A inhibitors (e.g., ketoconazole) and inducers (e.g., rifampin) can cause clinically important exposure changes and are generally avoided. Patients with asthma, COPD, or baseline dyspnea may need closer monitoring for new respiratory symptoms. Those with sick sinus syndrome or AV block should be assessed for bradyarrhythmia risk.
Before surgeries or invasive procedures, clinicians typically plan a pause to lower bleeding risk. Your team will advise how many days to hold based on the procedure’s bleeding profile and your thrombotic risk. These plans also consider aspirin continuation, anesthesia approach, and any bridging strategies. For in-depth label context on procedural planning, consult the FDA-approved product label where perioperative timing is discussed.
Duration, Switching, and Stopping
Duration after ACS commonly extends through the first year, then is reassessed for ongoing risk. Some patients transition to a lower maintenance strength beyond 12 months if extended protection is desired and bleeding risk remains acceptable. Discussions weigh recent events, stent characteristics, age, and prior bleeding. Shared decision-making aligns therapy with risk tolerance and lifestyle factors.
Comparisons such as brilinta 60 mg vs 90 mg often arise when evaluating extended therapy. Switching to another P2Y12 inhibitor may be considered for intolerance or risk shifts. For evidence summaries on alternatives, see Clopidogrel 75 mg for maintenance considerations after stroke risk, and review Plavix when comparing brand and generic options.
Drug and Food Interactions
Always review new prescriptions, over-the-counter products, and supplements for interaction risks. Strong CYP3A inhibitors (e.g., clarithromycin) may raise levels, while strong inducers (e.g., carbamazepine) may reduce efficacy. Grapefruit products can raise exposure and may increase bleeding risk. Alcohol and NSAIDs can further elevate bleeding probability, especially when combined with antiplatelets or anticoagulants.
People often ask, can you take brilinta and atorvastatin together? Clinicians may co-prescribe them, but higher statin doses can raise myopathy risk and warrant monitoring. Review any unusual muscle pain or weakness promptly. For broader therapy context across the cardiac space, see Acebutolol Uses for beta-blocker background and Entresto Dose Recommendations for heart-failure medication considerations.
Costs and Access
Out-of-pocket costs vary by insurance design, pharmacy contracts, and tablet strengths. Branded and generic availability, deductibles, and regional pricing can influence monthly expenses. Ask your care team or pharmacist about optimization strategies, including formulary tiers and therapeutic alternatives that still meet your clinical goals. For product supply context and strengths, see Ticagrelor for packaging information and Brilinta when confirming brand-specific details.
Recap
This therapy reduces clot risk after ACS and stenting by inhibiting platelets. Dosing typically uses a loading step followed by consistent maintenance with low-dose aspirin. Side effects center on bleeding and breathing complaints, which warrant early reporting. Work with your team to align duration, interactions, and procedure timing with your risk profile.
Note: Always carry a medication list so emergency teams can factor antiplatelet effects into urgent care decisions.
This content is for informational purposes only and is not a substitute for professional medical advice.
