Brilinta® 90 mg Tablets: Uses, Dosing, and Safety

What Brilinta® Is and How It Works

Brilinta® (ticagrelor) is an oral antiplatelet medicine used to reduce the risk of heart attack, stroke, and cardiovascular death after acute coronary syndrome or stent placement. The common strength is Brilinta 90 mg, taken twice daily with low-dose aspirin as directed. CanadianInsulin is a prescription referral service. Prescriptions are verified with your clinic, and orders are filled by licensed Canadian pharmacies. Many people with no insurance compare online options to manage out-of-pocket costs.

Brilinta blocks the platelet P2Y12 ADP receptor, which reduces platelet activation and clot formation. Its binding is reversible. A loading dose provides rapid platelet inhibition, and twice-daily dosing maintains effect. Approved uses include treatment after acute coronary syndrome (with or without stenting), reduction of risk of cardiovascular events in patients with a history of myocardial infarction, and a 30-day regimen with aspirin for minor ischemic stroke or high-risk transient ischemic attack.

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Dosage and Usage

• Initiation after acute coronary syndrome (ACS): Loading dose 180 mg once, then 90 mg twice daily. Use with low-dose aspirin (75–100 mg daily).
• After the first year post-ACS or prior MI: Many patients continue at 60 mg twice daily to reduce long-term risk, as directed by the prescriber.
• Minor ischemic stroke or high-risk TIA: 90 mg twice daily with aspirin for 30 days, then reassess antiplatelet strategy per clinician guidance.
• Administration: Swallow tablets whole, with or without food. For swallowing difficulty, tablets may be crushed, mixed with water, and swallowed immediately; rinse the glass and drink the residue. Crushed tablets may be given through a nasogastric tube per label instructions.
• Missed dose: If a dose is missed, the next dose is taken at the regular time. Do not double doses.
• Aspirin dose: Avoid maintenance aspirin doses above 100 mg daily, which can reduce Brilinta effectiveness.
• Surgery/dental procedures: For elective procedures with bleeding risk, therapy is typically stopped 5 days before, as directed by the surgeon and prescriber.
• Drug interactions: Avoid strong CYP3A inhibitors (e.g., ketoconazole, clarithromycin) and strong CYP3A inducers (e.g., rifampin, phenytoin). Use caution with anticoagulants, NSAIDs, and SSRIs/SNRIs due to increased bleeding risk.

• Storage: Store tablets at 20–25°C (68–77°F). Short excursions 15–30°C (59–86°F) are acceptable. Keep in the original container, tightly closed, and protect from moisture.
• Travel: Keep tablets in carry-on baggage with the original label. Use a small, dry pill organizer if needed, and carry a copy of the prescription.
• Home handling: Keep out of reach of children and pets. Do not use tablets that are damaged or show unusual discoloration.

Benefits and Savings

Brilinta reduces the chance of another heart attack or stroke after an ACS event. A loading dose provides rapid platelet inhibition. Ongoing twice-daily dosing maintains protection, and the effect is reversible. The medicine does not require genetic activation, which helps provide consistent platelet inhibition across patients compared with some alternatives.

Tablets can be crushed for patients with swallowing challenges. Brilinta is used alongside low-dose aspirin in most indications, and it has clear dosing transitions over time (for example, 90 mg twice daily in the first year after ACS, then 60 mg twice daily long-term as appropriate).

Many customers save 60–80% versus typical U.S. prices. Pricing may be competitive even without insurance when ordering through licensed Canadian pharmacies. See our promotions page for current offers, including any Brilinta coupon if available.

Side Effects and Safety

• Shortness of breath (dyspnea)
• Bruising or nosebleeds
• Bleeding gums or prolonged bleeding from cuts
• Dizziness or headache
• Nausea, diarrhea, or indigestion
• Raised uric acid levels

Serious risks include major bleeding, including gastrointestinal or intracranial hemorrhage. Brilinta is contraindicated in active bleeding and in patients with a history of intracranial hemorrhage. Avoid use in severe hepatic impairment. Caution is advised in patients with bradyarrhythmias, a history of syncope, or asthma/COPD given the risk of dyspnea. Concomitant anticoagulants, NSAIDs, or other agents that affect hemostasis increase bleeding risk. Seek emergency care for signs of severe bleeding.

Onset Time

After a 180 mg loading dose, platelet inhibition begins within 30 minutes, with near-maximal effect at about 2–4 hours. Without a loading dose, meaningful inhibition develops over several doses as steady state is reached in 2–3 days. Clinical risk reduction after ACS starts early during the initial treatment phase and continues with maintenance dosing. In minor ischemic stroke or high-risk TIA, the primary benefit is assessed over the first 30 days of therapy when used with aspirin.

Compare With Alternatives

Several antithrombotic options may be considered based on clinical history and bleeding risk:

Plavix (clopidogrel) is a once-daily thienopyridine that requires metabolic activation via CYP2C19. Reduced activation can occur in poor metabolizers or with interacting drugs. Brilinta provides reversible, direct P2Y12 inhibition without metabolic activation, and typically shows more rapid and consistent platelet inhibition. Dyspnea is more common with ticagrelor.

Xarelto (rivaroxaban) and apixaban are oral factor Xa inhibitors (anticoagulants), not antiplatelets. They are used for conditions such as atrial fibrillation and venous thromboembolism prevention/treatment. In selected coronary artery disease or peripheral artery disease populations, low-dose rivaroxaban plus aspirin may be used. These agents increase bleeding risk and are not interchangeable with Brilinta for ACS indications.

Choice among therapies depends on indication, time from index event, stent type, genetic and drug interaction considerations, bleeding risk, and clinician judgment.

Combination Therapy

• Low-dose aspirin (75–100 mg daily): Standard background therapy with Brilinta in most indications; avoid higher aspirin doses.
• Statins: Commonly co-prescribed after ACS to reduce LDL cholesterol and stabilize plaques.
• Beta-blockers and ACE inhibitors/ARBs: Used for secondary prevention in appropriate patients.
• Proton pump inhibitors (PPIs): Considered for gastrointestinal protection in patients at higher bleeding risk.
• Anticoagulants: Combination with warfarin or DOACs markedly increases bleeding risk and is used only when clearly indicated, with specialist oversight.
• Other agents affecting hemostasis: SSRIs/SNRIs and NSAIDs can raise bleeding risk; prescribers may adjust therapy accordingly.

Patient Suitability and Cost-Saving Tips

Brilinta may be appropriate for adults after an ACS event, after stent placement, for patients with a prior myocardial infarction continuing secondary prevention, or for a short-term course after a minor ischemic stroke or high-risk TIA. It is not suitable for patients with active pathological bleeding, a history of intracranial hemorrhage, or severe liver impairment.

Prescribers weigh ischemic risk against bleeding risk, patient age and comorbidities, prior bleeding history, and any planned procedures. Uric acid elevations and dyspnea may influence choice in susceptible patients. Concomitant medications and drug interaction profiles also shape the selection of antithrombotic therapy.

To reduce overall costs, consider multi-month fills when appropriate, compare strengths only as written on the prescription, and consolidate items in one shipment. Generic ticagrelor may offer savings if the prescriber approves substitution. Reorder reminders can help maintain continuity so therapy is not interrupted.

Authoritative Sources

AstraZeneca Brilinta healthcare professional site (prescribing information and resources)

Health Canada Drug Product Database: Ticagrelor product information

FDA Prescribing Information and Medication Guide for Brilinta

Order Brilinta® from CanadianInsulin: add to cart, upload your prescription, and we ship with prompt, express, cold-chain handling.

This page is for educational purposes only and does not replace advice from your healthcare professional. Always follow your prescriber’s instructions and the medication guide provided with the product.