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Ticagrelor Uses, Dosage, Side Effects & Warnings | DrugsAtlas

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Therapeutic Class
Antiplatelet Agent
Subclass
P2Y12 Receptor Antagonist (Reversible, Direct-acting)
Speciality
Cardiology
Schedule (India)
Schedule H
Routes
Oral
Formulations
  • Tablets: 60 mg, 90 mg

Adult indications

INDICATIONS + DOSING — FOR CLINICIAN USE ONLY

Primary Indications (Approved / Standard in India)

1. Acute Coronary Syndrome (ACS) — Unstable Angina, NSTEMI, STEMI (with or without PCI)
Adults — In Combination with Low-Dose Aspirin:
Parameter Recommendation
Starting dose 180 mg loading dose (two 90 mg tablets) as single dose
Titration Not applicable
Usual maintenance dose 90 mg orally twice daily
Maximum dose 180 mg/day (90 mg twice daily)
Duration Up to 12 months from index event
Clinical Notes:
  • Always administer with low-dose aspirin (75–100 mg once daily)
  • Do NOT use aspirin doses >100 mg/day — may reduce ticagrelor efficacy
  • Loading dose given as early as possible at presentation
  • No need for CYP2C19 genotyping (unlike clopidogrel)
  • Contraindicated in patients with history of intracranial haemorrhage

2. Secondary Prevention of Atherothrombotic Events — High-Risk Patients with History of MI (≥12 Months Post-MI)
Adults — Long-Term Secondary Prevention:
Parameter Recommendation
Starting dose 60 mg orally twice daily
Titration Not applicable
Usual maintenance dose 60 mg twice daily
Maximum dose 120 mg/day (60 mg twice daily)
Duration Up to 3 years from index MI
Clinical Notes:
  • Initiate after completion of initial 12-month therapy with 90 mg twice daily
  • Continue low-dose aspirin (75–100 mg once daily) concomitantly
  • Indicated for patients with high-risk features (diabetes, multivessel CAD, recurrent MI, age ≥65, CKD)
  • Reassess bleeding risk periodically during extended therapy

Pre-Operative Management

Clinical Scenario Recommendation
Elective surgery requiring discontinuation Stop ticagrelor at least 5 days before surgery
Urgent CABG Avoid ticagrelor initiation if urgent CABG planned; discontinue at least 3–5 days prior if already on therapy
Minor procedures (dental, skin) May continue with caution; assess bleeding risk

Secondary Indications – Adults Only (Off-label)

Indication Dose Duration Supervision Evidence Basis
Minor Ischaemic Stroke or High-Risk TIA (in CYP2C19 loss-of-function carriers) — OFF-LABEL
Loading: 180 mg; Maintenance: 90 mg BD 21–30 days in combination with aspirin Specialist only (Neurology) CHANCE-2 trial; not standard practice in India; requires genotyping
Post-Transcatheter Aortic Valve Implantation (TAVI) — OFF-LABEL
90 mg BD with low-dose aspirin 3–6 months Specialist only (Interventional Cardiology) Limited RCT data; not superior to clopidogrel in some trials
Paediatric indications

PAEDIATRIC DOSING (Specialist Only)

Primary Indications

Regulatory Status: NOT approved for paediatric use in India.
Age Restriction: Not recommended below 18 years of age.

Secondary Indications – Paediatric (Off-label)

  • NOT AVAILABLE in India — no paediatric dosing established in Indian guidelines
  • International studies in congenital heart disease exist but not adopted in Indian practice
  • LMWH or aspirin remain preferred antiplatelet/anticoagulant options in paediatric cardiac conditions
  • Use only in exceptional circumstances under specialist paediatric cardiology/haematology supervision
Minimum Age Statement:
Not recommended below 18 years of age except in highly specialised settings with paediatric cardiology supervision.
Renal Adjustments
No dose adjustment required based on renal function:
Renal Function Recommendation
Mild impairment (eGFR 60–89 mL/min) No adjustment
Moderate impairment (eGFR 30–59 mL/min) No adjustment
Severe impairment (eGFR 15–29 mL/min) No adjustment; use with caution due to increased bleeding risk
ESRD (eGFR <15 mL/min) not on dialysis Limited data; use with caution
Haemodialysis Limited data; ticagrelor unlikely to be dialysed significantly; use with caution
Note: Ticagrelor may transiently increase serum creatinine (reversible, not indicative of nephrotoxicity).
Hepatic adjustment
Contraindications
  • Active pathological bleeding (e.g., GI haemorrhage, intracranial bleeding)
  • History of intracranial haemorrhage (ICH) — regardless of cause or timing
  • Severe hepatic impairment (Child-Pugh C)
  • Known hypersensitivity to ticagrelor or any excipient
  • Concomitant use with strong CYP3A4 inhibitors (e.g., ketoconazole, itraconazole, ritonavir, nelfinavir, clarithromycin)
  • Concomitant use with strong CYP3A4 inducers (e.g., rifampicin, phenytoin, carbamazepine, phenobarbital)
Cautions
  • Bradyarrhythmias — sinus node dysfunction, second or third degree AV block (without permanent pacemaker); risk of ventricular pauses
  • Asthma or COPD — dyspnoea is common adverse effect; may exacerbate respiratory symptoms
  • History of hyperuricaemia or gout — ticagrelor increases uric acid levels
  • Moderate hepatic impairment (Child-Pugh B) — increased drug exposure
  • Bleeding diathesis or recent significant bleeding
  • Concomitant use with anticoagulants — markedly increased bleeding risk
  • Recent major surgery or trauma
  • Planned surgery or invasive procedure — discontinue at least 5 days prior
  • Elderly (>75 years) — increased bleeding risk
  • Low body weight (<60 kg) — potentially increased exposure
  • Concomitant use with moderate CYP3A4 inhibitors (diltiazem, verapamil)
  • Concomitant use with drugs that increase bleeding risk (NSAIDs, SSRIs)
Pregnancy
Parameter Details
Risk category Not formally assigned in India; animal studies show embryo-fetal toxicity at supratherapeutic doses
Preferred alternatives Low-dose aspirin (if antiplatelet indicated); clopidogrel has more established (though limited) safety data
When may be used Only if no suitable alternative and potential benefit clearly justifies risk; specialist decision (cardiology + obstetrics)
Monitoring Maternal bleeding risk; fetal growth monitoring; plan delivery with haematology/cardiology input
Lactation
Parameter Details
Compatibility Not recommended — unknown if excreted in human breast milk; excreted in animal milk
Drug levels in milk Unknown in humans; expected to be low based on protein binding
Preferred alternatives Clopidogrel (more established safety) or low-dose aspirin if antiplatelet required
Infant monitoring If exposure occurs: monitor for bleeding, bruising, feeding difficulties
Elderly
Parameter Recommendation
Starting dose Same as younger adults — 180 mg loading, then 90 mg twice daily for ACS
Titration Not applicable
Special risks Increased bleeding risk (particularly GI and intracranial); falls risk; polypharmacy with interacting drugs; assess renal and hepatic function
Monitoring Close monitoring for bleeding; regular haemoglobin checks; assess for dyspnoea and bradycardia
Note: Age alone is not a contraindication; benefit in reducing cardiovascular events generally outweighs bleeding risk in appropriately selected elderly patients.
Major drug interactions
Drug/Class Mechanism/Effect Recommendation
Strong CYP3A4 inhibitors (ketoconazole, itraconazole, voriconazole, ritonavir, nelfinavir, clarithromycin) Marked increase in ticagrelor exposure → high bleeding risk
Contraindicated — avoid concomitant use
Strong CYP3A4 inducers (rifampicin, phenytoin, carbamazepine, phenobarbital, St. John's Wort) Significant reduction (~60%) in ticagrelor levels → loss of efficacy
Contraindicated — avoid concomitant use
Anticoagulants (warfarin, rivaroxaban, apixaban, dabigatran, LMWH) Additive bleeding risk
Avoid unless specifically indicated (e.g., AF with ACS) — specialist supervision mandatory
Digoxin Ticagrelor inhibits P-glycoprotein → increased digoxin levels (up to 75%) Monitor digoxin levels; consider dose reduction; watch for toxicity
Aspirin doses >100 mg/day Reduced ticagrelor efficacy demonstrated in PLATO trial
Avoid — use only low-dose aspirin (75–100 mg/day)
Moderate drug interactions
Drug/Class Effect Recommendation
Moderate CYP3A4 inhibitors (diltiazem, verapamil, fluconazole, erythromycin) Modest increase in ticagrelor levels Use with caution; monitor for bleeding and dyspnoea
Simvastatin, lovastatin Ticagrelor increases statin levels via CYP3A4 inhibition Limit simvastatin to ≤40 mg/day; consider atorvastatin or rosuvastatin (less interaction)
Cyclosporine Increased ticagrelor exposure via P-gp and CYP3A4 inhibition Monitor closely; avoid if possible
NSAIDs (diclofenac, ibuprofen, naproxen) Additive GI bleeding risk Avoid chronic use; use short courses with gastroprotection
SSRIs/SNRIs (fluoxetine, sertraline, venlafaxine) Increased bleeding tendency Monitor for bleeding; counsel patient
Proton pump inhibitors No significant interaction (unlike clopidogrel) Can be used together for gastroprotection
Other P2Y12 inhibitors (clopidogrel, prasugrel) Overlapping mechanism; no additive benefit; bleeding risk
Avoid combination
Common Adverse effects
  • Dyspnoea (up to 14%) — usually mild, transient; rarely requires discontinuation
  • Bleeding — minor (bruising, epistaxis, gingival bleeding, haematuria)
  • Elevated serum creatinine (reversible; not true nephrotoxicity)
  • Hyperuricaemia (usually asymptomatic)
  • Headache
  • Dizziness
  • Nausea
  • Diarrhoea
  • Back pain
Serious Adverse effects
Adverse Effect Clinical Action
Major bleeding (GI haemorrhage, intracranial haemorrhage, retroperitoneal bleeding)
Immediate discontinuation; supportive care; platelet transfusion may have limited efficacy (reversible inhibitor); hospitalisation
Ventricular pauses (>3 seconds) Usually occur in first week; typically asymptomatic; monitor ECG in high-risk patients (elderly, sinus node dysfunction); generally resolve with continued therapy
Bradyarrhythmias (symptomatic — syncope, presyncope) Evaluate for pacemaker requirement; consider alternative antiplatelet
Severe hypersensitivity / Angioedema Discontinue immediately; emergency management
Gout flare Treat acute gout; consider alternative antiplatelet if recurrent
Thrombotic Thrombocytopenic Purpura (TTP) Very rare; discontinue immediately; urgent haematology referral
Note: Unlike thienopyridines (clopidogrel, prasugrel), ticagrelor is a reversible inhibitor — platelet function recovers within 3–5 days of discontinuation.
Monitoring requirements
Baseline:
  • Complete blood count (haemoglobin, platelet count)
  • Renal function (serum creatinine, eGFR)
  • Liver function tests
  • Serum uric acid
  • ECG (assess baseline rhythm, PR interval)
  • Bleeding risk assessment
After Initiation:
  • Clinical assessment for dyspnoea and bradycardia in first week
  • Monitor for bleeding at 2–4 weeks
  • Repeat haemoglobin if bleeding symptoms or unexplained fatigue
  • Serum creatinine at 1 month (expect mild increase; usually not clinically significant)
Long-term Monitoring:
  • Complete blood count every 3–6 months
  • Renal function every 6 months
  • Serum uric acid if history of gout or symptoms
  • Clinical assessment for bleeding at each visit
  • Reassess indication and bleeding risk annually
Pre-Operative:
  • Document when last dose taken
  • Ensure ≥5 days discontinuation before elective major surgery
  • Liaise with surgical team regarding timing of resumption
Brands in India
Originator:
  • Brilinta (AstraZeneca)
Generic/Licensed Brands:
  • Ticavag (Intas)
  • Ticabid (Zydus Cadila)
  • Ticari (Lupin)
  • Tigrelor (Torrent)
  • Ticamet (Sun Pharma)
  • Axcer (Mankind)
  • Brilor (Cipla)
Fixed-Dose Combinations:
  • Ticagrelor 90 mg + Aspirin 75 mg (available from select manufacturers)
Price range (INR)
Formulation Approximate Price per Tablet
Tablet 60 mg ₹30–₹65
Tablet 90 mg ₹40–₹80
  • Not currently under NPPA price control
  • Not included in NLEM 2022
  • Significant price variation between originator and generic brands
  • Generic options substantially more affordable
  • May be available through government hospital procurement for ACS management in tertiary centres
Clinical pearls
  1. Superior to clopidogrel in ACS — PLATO trial demonstrated significant reduction in cardiovascular death, MI, and stroke compared to clopidogrel; preferred P2Y12 inhibitor for most ACS patients in Indian cardiology practice
  2. Aspirin dose matters — use ONLY low-dose aspirin (75–100 mg/day); higher doses reduce ticagrelor efficacy (post-hoc PLATO analysis); common prescribing error to avoid
  3. Dyspnoea is expected and usually manageable — occurs in ~14% of patients; typically mild, transient, and self-limiting; does not require discontinuation in most cases; counsel patients proactively
  4. No CYP2C19 dependency — unlike clopidogrel, ticagrelor does not require hepatic activation; more predictable antiplatelet effect; useful when clopidogrel resistance suspected or confirmed
  5. Reversible inhibition — platelet function recovers faster (3–5 days) compared to thienopyridines; advantageous if urgent surgery needed, but daily compliance critical due to shorter duration of effect
  6. Switching protocols — when switching FROM clopidogrel to ticagrelor: give ticagrelor loading dose without clopidogrel loading; when switching FROM ticagrelor to clopidogrel: give clopidogrel 600 mg loading dose 24 hours after last ticagrelor dose
  7. Ventricular pauses — usually occur in first week; generally asymptomatic and benign; avoid in patients with sick sinus syndrome or high-grade AV block without pacemaker
Version
RxIndia v1.0 — 05 Jun 2025
Reference
    • CDSCO approved product inserts
    • Indian Pharmacopoeia
    • API Textbook of Medicine
    • AIIMS Cardiology Treatment Protocols
    • Cardiological Society of India — ACS Management Guidelines
    • ICMR Guidelines on STEMI and ACS Management
    • Goodman & Gilman's The Pharmacological Basis of Therapeutics (supportive)
    • Harrison's Principles of Internal Medicine (supportive)
    • PLATO trial (primary efficacy data)
    • PEGASUS-TIMI 54 trial (extended secondary prevention)
    • CHANCE-2 trial (for stroke off-label context only)

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