Ticagrelor

Ticagrelor is used to reduce your chance of having a heart attack, stroke, or death caused by a blocked artery or from a previous heart attack.

Ticagrelor is also used to lower your risk of blood clots if you have coronary artery disease (decreased blood flow to the heart) and have received stents to open blocked arteries.

Ticagrelor is also used to reduce the risk of a first heart attack or stroke if you have decreased blood flow to the heart.

Ticagrelor is also used to decrease the risk of stroke and death in adults who have a blockage or decreased blood flow in an artery that supplies blood to the brain.

Ticagrelor is usually taken with low-dose aspirin. Follow your doctor's dosing instructions carefully. Taking too much aspirin can make ticagrelor less effective.

Ticagrelor may also be used for reasons not mentioned in this medication guide.

Follow all directions on your prescription label and read all medication guides or instruction sheets. Ticagrelor is taken together with aspirin. Use these medicines exactly as directed.

Do not take more aspirin than your doctor has prescribed. Taking too much aspirin can make ticagrelor less effective.

Take ticagrelor at the same times each day, with or without food.

If you cannot swallow a tablet whole, crush the pill and mix it with water. Stir and drink this mixture right away. Add more water to the glass, stir, and drink right away.

Ticagrelor keeps your blood from coagulating (clotting) and can make it easier for you to bleed, even from a minor injury. Contact your doctor or seek emergency medical attention if you have any bleeding that will not stop.

To prevent excessive bleeding, you may need to stop using ticagrelor for a short time before a surgery, medical procedure, or dental work. Any healthcare provider who treats you should know that you are taking ticagrelor.

Do not stop taking ticagrelor without first talking to your doctor, even if you have signs of bleeding. Stopping the medicine could increase your risk of a heart attack or stroke.

Ticagrelor may affect medical testing for platelets in your blood and you may have false results. Tell the laboratory staff that you use ticagrelor.

Store at room temperature away from moisture and heat.

You should not use ticagrelor if you have any active bleeding or a history of bleeding in the brain. Do not use ticagrelor just before heart bypass surgery.

Ticagrelor may make you bleed more easily, which can be severe or life-threatening. Call your doctor or seek emergency medical help if you have bleeding that will not stop, black or bloody stools, red or pink urine, or if you cough up blood or vomit that looks like coffee grounds.

Tell your doctor about all your current medicines and any that you start or stop using. Many drugs can interact with ticagrelor.

Do not stop taking ticagrelor without first talking to your doctor, even if you have signs of bleeding. Stopping ticagrelor may increase your risk of a heart attack or stroke.

You should not use ticagrelor if you are allergic to it, or if you have:

• any active bleeding; or
• a history of bleeding in the brain (such as from a head injury).

Tell your doctor if you have ever had:

• a stroke;
• heart problems;
• a surgery or bleeding injury;
• bleeding problems;
• a stomach ulcer or colon polyps;
• liver disease; or
• asthma, COPD (chronic obstructive pulmonary disorder) or other breathing problem.

It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

You should not breastfeed while using ticagrelor.

Get emergency medical help if you notice signs of an allergic reaction: hives; trouble breathing; swelling of your face, lips, tongue, or throat.

Ticagrelor may lead to serious side effects. Contact your doctor immediately if you experience:

• slow heartbeats;
• nosebleeds, or any bleeding that won’t stop;
• shortness of breath even with light activity or while lying down;
• easy bruising, unusual bleeding, or purple or red spots under your skin;
• red, pink, or brown urine;
• black, bloody, or tarry stools; or
• coughing up blood or vomit that looks like coffee grounds.

Common side effects of ticagrelor may include:

• bleeding; or
• shortness of breath.

This is not a full list of side effects, and others may happen. Call your doctor for advice about side effects. You can report side effects to the FDA at 1-800-FDA-1088.

Skip the missed dose and take your next dose at the regular time. Do not take two doses at once.

Seek emergency medical help or call the Poison Help line at 1-800-222-1222. An overdose can lead to excessive bleeding.

Drinking alcohol while taking aspirin can raise your risk of stomach bleeding.

Avoid activities that could increase your chance of bleeding or injury. Be especially careful to prevent bleeding when shaving or brushing your teeth.

While taking ticagrelor with aspirin, do not use medicines for pain, fever, swelling, or cold/flu symptoms. They may have ingredients similar to aspirin (like salicylates, ibuprofen, ketoprofen, or naproxen). Taking certain products together can result in too much aspirin, which can increase your risk of bleeding.

Sometimes, it is not safe to use certain medications together. Some drugs can change the levels of other drugs in your blood, which may increase side effects or reduce how well the medications work.

Tell your doctor about all the medicines you are currently taking. Many drugs can affect ticagrelor, especially:

• antifungal medicine;
• antiviral medicine to treat HIV or AIDS;
• a blood thinner;
• cholesterol medication;
• heart or blood pressure medication;
• opioid medication;
• seizure medicine; or
• tuberculosis medicine.

This list is not complete, and many other drugs may affect ticagrelor. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.