What is Brilinta?

Brilinta (ticagrelor) is an antiplatelet medication manufactured by AstraZeneca that prevents blood clot formation. It reduces the risk of heart attacks and strokes in people with various conditions, such as a history of myocardial infarction (MI), unstable angina (severe chest pain), and acute coronary syndrome (ACS). It also decreases the risk of blood clots for patients with a stent placed to treat ACS and lowers the risk of a first heart attack or stroke in those with coronary artery disease. Additionally, Brilinta reduces the risk of stroke in high-risk patients with transient ischemic attack (TIA) and acute ischemic stroke. However, it should not be used before coronary artery bypass graft (CABG) surgery.

How does Brilinta work?

Brilinta is an antiplatelet, not an anticoagulant, which means its active ingredient ticagrelor inhibits the receptor on the surface of blood platelets. This stops them from sticking together and potentially obstructing blood flow. By stopping unnecessary blood clots, Brilinta prevents heart attacks, strokes, and other serious health events, including cardiovascular death.

What doses of Brilinta are available?

The dosage of Brilinta depends on the medical condition it is treating and how you respond to the treatment. All treatment is taken orally. 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.

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.

How do you use Brilinta?

Brilinta is usually taken orally twice a day after the initial treatment. It can be taken with or without food, but 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 or mix it with water. Stir and drink this mixture right away.

It is essential to take Brilinta regularly to get the most benefits from it. It is recommended to take it at the same time each day to help you remember. If you miss a dose, do not take two doses at once. Skip the dose, and take the next dose at the normal time. Do not increase the dose or take it more often or for longer than prescribed. If you stop taking Brilinta without consulting your doctor, you may have an increased risk of a heart attack or stroke.

What are the side effects of Brilinta?

The most common side effects of Brilinta include:

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

Brilinta can rarely cause serious side effects, including:

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

Seek medical attention immediately if you have any of the severe side effects. Contact your healthcare professional for medical advice about any possible adverse effects you experience while taking Brilinta. You can report your adverse effects to the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

Brilinta drug interactions

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 you speak to your doctor and read the medication guide as well as the prescribing information before using Brilinta. Some drug interactions with Brilinta include:

Strong CYP3A4 inhibitors or CYP3A4 inducers, such as nefazodone, ritonavir, or phenobarbital.
Opioids.
- Decreasing Brilinta is recommended if opioids are necessary, and starting on a different parenteral antiplatelet.
More than 40 mg per day of simvastatin or lovastatin.
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, such as warfarin.
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.

Boxed warnings

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 intense, 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 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 precautions

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 bleeds.
A newborn baby and are breastfeeding.
- Breastfeeding is not recommended with Brilinta use.
Any allergies or history of an allergic reaction to the ingredients in Brilinta.
- Seek medical attention immediately if you do experience symptoms.

Make sure you do not:

Drink grapefruit juice while taking Brilinta.
- Grapefruit juice might increase the risk of bleeding.

Is there a generic available for Brilinta?

Currently, there is no generic version of Brilinta and one is not expected to hit the market in the United States until 2024.

How do you store Brilinta?

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.