Brilinta

The active ingredient in Brilinta is ticagrelor which is an antiplatelet medication. Antiplatelets are a type of blood thinner. Brilinta isn’t an anticoagulant drug. It inhibits the receptor on the surface of blood platelets to keep them from sticking together and potentially obstructing blood flow. By stopping unnecessary blood clots, Brilinta reduces the risk of strokes, heart attacks, and cardiovascular death, especially in people at high risk.

Follow all directions given to you by your doctor and read all documents provided, including the full Prescribing Information, FDA-Approved Product Labeling, Instructions for Use, and Medication Guide before using Brilinta. However, the following is a synopsis of the general guidelines for the use of Brilinta:

• Brilinta is usually taken orally twice a day, with or without food.
• The tablet should be swallowed whole and not crushed or chewed unless directed by a doctor.
• If you have trouble swallowing the pill, you may crush it, mix it with water, stir, and drink the mixture immediately.
• Take Brilinta regularly to maximize its benefits.
• Take it at the same time each day to help you remember.
• If you miss a dose, skip it and take the next dose at the normal time. Do not take two doses at once.
• Do not increase the dose, take it more often, or use it longer than prescribed.
• Stopping Brilinta without consulting your doctor can increase the risk of heart attack or stroke, especially if you have had a stent placed. Always follow your doctor's advice before discontinuing the medication.

The most common side effects of Brilinta seen in clinical trials as compared to placebo include:

• Shortness of breath
• Minor bleeding including nosebleeds
• Nausea
• Diarrhea
• Slow heart rate (bradycardia)
• Dizziness

Some individuals may experience serious side effects while using Brillinta. These side effects may require immediate medical attention. If you experience any of the following, contact your healthcare provider or seek emergency medical help:

• Severe, life-threatening allergic reactions, including anaphylaxis (hives, swelling of your tongue or throat, and shortness of breath)
• Increased risk of serious bleeding, with symptoms such as:
• Bleeding that you cannot stop
• Red or black stool
• Pink, red, or brown urine
• Vomit that is bloody or looks like coffee grounds
• Liver damage
• Your liver will process and get rid of Brilinta from your body, however, this side effect is more likely to happen if you have severe liver problems.

These are not all of the possible side effects of Brilinta. You should always seek medical advice from your healthcare provider for any questions or concerns about your medical condition or treatment. Read all patient information, medication guides, or drug information sheets that come with this medication. You can also report adverse effects to the Food and Drug Administration at www.fda.gov/medwatch or 1-800-FDA-1088.

Before starting Brilinta, it is crucial to discuss any existing health conditions with your healthcare provider. You should be sure that your healthcare provider is aware of all your medical conditions, including if you have:

• Any active bleeding including ulcers or history of brain bleeding.
• Liver problems
• Any allergies or history of an allergic reaction to the ingredients in Brilinta.

Boxed Warning

Speak to your doctor and read the complete prescribing information document before using Brilinta.

There is a bleeding risk when taking Brilinta. Brilinta is an antiplatelet agent that can cause severe, sometimes fatal bleeding. Brilinta should not be used in patients with a history of active bleeding or intracranial hemorrhage (bleeding inside the skull).

Patients undergoing urgent coronary artery bypass graft (CABG) surgery should not take Brilinta. Stopping Brilinta’s antiplatelet therapy will increase the risk of new cardiovascular events, so if possible, manage bleeding without stopping Brilinta treatment.

If you have ACS, aspirin above 100 mg daily reduces the effectiveness of Brilinta.

Brilinta (ticagrelor) is contraindicated in the following situations:

• Active Bleeding
• History of Intracranial Hemorrhage
• Severe Liver Disease
• Allergy or Hypersensitivity

Brilinta starts to work quickly, typically within 30 minutes to 1 hour after the first dose. Its maximum effect begins to work within 2 to 4 hours.

When Brilinta is taken with other prescription drugs, over-the-counter medications, vitamins, and supplements, it may change how they work or increase the frequency or severity of side effects. Make sure that you tell your healthcare professional about anything that you are taking to avoid any negative drug interactions, including:

• Strong CYP3A4 inhibitors or CYP3A4 inducers, such as nefazodone, ritonavir, or phenobarbital.
• Opioids.
• Seizure medications such as carbamazepine or phenytoin.
• Tuberculosis medications such as rifampin.
• Antifungal medications such as ketoconazole, itraconazole, and voriconazole.
• Antibiotics such as clarithromycin.
• Other blood thinners or antiplatelet medications such as warfarin or clopidogrel.
• Cholesterol-lowering drugs such as simvastatin or lovastatin.
• Blood pressure medications or heart medications such as digoxin.
• HIV protease inhibitors such as atazanavir.
• NSAIDs such as ibuprofen or naproxen.
• Grapefruit juice.

For acute coronary syndrome, the loading dose is usually 180 mg taken once, and then a maintenance dose of 90 mg twice a day for one year. After one year, the maintenance dose is reduced to 60 mg twice a day.

The usual adult dose for coronary artery disease and myocardial infarction prophylaxis is one, 60 mg tablet twice a day. However, if you have a history of a heart attack, your dosage may change slightly to reduce the risk of a heart attack. If you are treating acute ischemic stroke, you will start with a 180 mg loading dose then take 90 mg twice daily for up to 30 days

A 75 to 100mg dose of aspirin is also often prescribed with Brilinta. Do not take more than the low-dose aspirin prescribed because of the risk of reversed effects.

Brilinta should be stored at room temperature, away from moisture and heat. Keep it out of reach of children and pets. Do not use Brilinta after the expiration date printed on the label.

Brilinta (ticagrelor) is manufactured by AstraZeneca, a global biopharmaceutical company

As of now, there is no generic version of Brilinta (ticagrelor) available in the United States or Canada.

To stop using Brilinta, it's important to consult with your healthcare provider for a safe discontinuation plan. Stopping abruptly may cause withdrawal symptoms or a return of your symptoms. Your doctor will likely recommend an alternative treatment to reduce these risks and monitor your progress during the process.

It is not known if Brilinta can harm your unborn baby so it should be used during pregnancy only if the potential benefit justifies the

possible risks to your unborn baby. Call your provider right away if you find out you are pregnant while taking Brilinta.

It is not known if Brilinta passes into breast milk so it should not be used during breastfeeding. Talk to your provider about ways to feed your baby if you are planning to breastfeed while taking this medication.