Ticagrelor may cause serious or life-threatening bleeding. Tell your doctor if you currently have or have had a condition that causes you to bleed more easily than normal; if you have recently had surgery or been injured in any way; or if you have or have ever had a stomach ulcer; bleeding in your stomach, intestines, or brain; a stroke or mini-stroke; or a condition that may cause bleeding in your intestines such as polyps (abnormal growths in the lining of the large intestine); Your doctor will probably tell you not to take ticagrelor if you may need heart bypass surgery (a certain type of open-heart surgery) right away. While you are taking ticagrelor, you will probably bruise and bleed more easily than usual or bleed for longer than usual and may be more likely to have nosebleeds. If you experience any of the following symptoms, call your doctor immediately: bleeding that is unexplained, severe, long-lasting, or uncontrollable; pink or brown urine; red or black, tarry stools; vomit that is bloody or that looks like coffee grounds; or coughing up blood or blood clots.
tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take while taking ticagrelor. Make sure you tell your doctor if you are taking medications that may increase your risk of bleeding. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
If you are having surgery, including dental surgery, or any type of medical procedure, tell your doctor or dentist that you are taking ticagrelor. Your doctor will probably tell you to stop taking ticagrelor at least 5 days before your surgery is scheduled.
You will be given the Medication Guide when you begin treatment with ticagrelor and each time you refill your prescription. Read the information carefully and ask your doctor or pharmacist if you have any questions. You can also visit https://www.fda.gov/Drugs/DrugSafety/ucm085729.htm to obtain the Medication Guide.
Talk to your doctor about the risks of taking ticagrelor.
Why is this medicine prescribed?
Ticagrelor is used to reduce risk of heart attack or stroke in certain high-risk patients. It is also used to reduce risk of blood clots in certain high-risk patients. Ticagrelor is in a class of medications called antiplatelet medications. It works by preventing platelets (a type of blood cell) from collecting and forming clots that may cause a heart attack or stroke.
Are there other uses for this medicine?
This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.
How should this medicine be used?
Ticagrelor comes as a tablet to take by mouth. Take with or without food two times a day. Take ticagrelor at around the same times every day.
Take ticagrelor exactly as directed. Ask your doctor or pharmacist to explain any part you do not understand. Do not take more or less of it or take it more often than prescribed by your doctor.
If you are unable to swallow ticagrelor tablets, crush the tablet and mix it with water. Drink the mixture right away. Refill the glass with water, stir, and again drink the mixture right away. If you have a nasogastric (NG) tube, your doctor or pharmacist will tell you how to prepare and give ticagrelor through an NG tube.
Your doctor may tell you to take a low dose of aspirin (less than 100 mg) during your treatment with ticagrelor. Many over-the-counter (OTC) medications contain aspirin, so be sure to read all labels carefully. Do not take additional aspirin or aspirin-containing products during your treatment with ticagrelor without talking to your doctor.
Ticagrelor will help prevent serious problems with your heart and blood vessels only as long as you take the medication. Continue to take ticagrelor even if you feel well. Do not stop taking ticagrelor without talking to your doctor. If you stop taking ticagrelor, there is a higher risk that you may have a heart attack or stroke. If you have a stent, there is also a higher risk that you could develop a blood clot in the stent if you stop taking ticagrelor too soon.
What special precautions should I follow?
Before taking ticagrelor,
- tell your doctor and pharmacist if you are allergic to this drug, any part of this drug, or any other drugs, foods or substances. Tell your doctor or pharmacist about the allergy and what symptoms you had.
- the following nonprescription product may interact with ticagrelor: St. John's Wort, aspirin, and non-steroidal anti-inflammatory medications such as ibuprofen (Advil®, Motrin®) and naproxen (Aleve®). Be sure to let your doctor and pharmacist know that you are taking these medications before you start taking ticagrelor. Do not start these medications while taking ticagrelor without discussing with your healthcare provider.
- tell your doctor if you have or have ever had an irregular heartbeat that is not corrected by a pacemaker, a type of lung disease such as chronic obstructive pulmonary disease (COPD; a group of diseases that affect the lungs and airways), or asthma or liver disease.
- tell your doctor if you are pregnant or plan to become pregnant. If you become pregnant while taking ticagrelor, call your doctor.
- tell your doctor if you are breastfeeding or plan to breastfeed. You should not breastfeed if you are taking ticagrelor.
What special dietary instructions should I follow?
Talk to your doctor about eating grapefruit and drinking grapefruit juice while taking this medication.
What should I do if I forget to take a dose?
Skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.
What should I do in case of overdose?
In case of overdose, call the poison control helpline at 1-800-222-1222
. Information is also available online at https://www.poisonhelp.org/help . If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.
Symptoms of overdose may include the following:
- bleeding
- nausea
- vomiting
- diarrhea
- irregular heartbeat
What side effects can this medicine cause?
Ticagrelor may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
- dizziness
- nausea
- diarrhea
Some side effects can be serious. If you experience any of these symptoms or those listed in the IMPORTANT WARNING section, call your doctor immediately:
- shortness of breath that occurs while you are at rest, after a small amount of exercise, or after any physical activity
- chest pain
- fast, slow, pounding, or irregular heartbeat
- slowed or irregular breathing
- swelling of the face, throat, tongue, lips, and eyes
Ticagrelor may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online ( https://www.fda.gov/Safety/MedWatch ) or by phone (
1-800-332-1088).What should I know about storage and disposal of this medication?
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).
Keep all medication out of sight and reach of children as many containers are not child-resistant. Always lock safety caps. Place the medication in a safe location - one that is up and away and out of their sight and reach https://www.upandaway.org
Dispose of unneeded medications in a way so that pets, children, and other people cannot take them. Do not flush this medication down the toilet. Use a medicine take-back program. Talk to your pharmacist about take-back programs in your community. Visit the FDA's Safe Disposal of Medicines website https://goo.gl/c4Rm4p for more information.
What other information should I know?
Keep all appointments with your doctor and the laboratory. Your doctor may order certain lab tests to check your body's response to ticagrelor.
Before having any laboratory test, tell your doctor and the laboratory personnel that you are taking ticagrelor.
Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.
Keep a written list of all of the prescription and nonprescription (over-the-counter) medicines vitamins, minerals, and dietary supplements you are taking. Bring this list with you each time you visit a doctor or if you are admitted to the hospital. You should carry the list with you in case of emergencies.