Brilinta, pills 60mg, 168pcs

Composition

Composition of 1 tablet:

Active ingredient:

ticagrelor – 60 or 90 mg;

additional components:

sodium carboxymethyl starch,

mannitol,

magnesium stearate,

calcium hydrophosphate,

hyprolose;

film coating:

titanium dioxide (E171),

macrogol 400,

talc,

hypromellose,

90 mg-iron oxide yellow dye,

60 mg-iron oxide red dye and black oxide.

Pharmacological action

Brilinta ® contains ticagrelor, a member of the cyclopentyltriazolopyrimidine chemical class, which is a selective and reversible antagonist of direct-acting P2Y12 receptors and prevents ADP-mediated P2Y12-dependent platelet activation and aggregation.

Ticagrelor does not prevent ADP binding, but its interaction with the P2Y12 platelet receptor prevents ADP-induced signal transduction. Since platelets are involved in the initiation and/or development of thrombotic complications of atherosclerosis, inhibition of platelet function has been shown to reduce the risk of cardiovascular events such as death, myocardial infarction or stroke.

Ticagrelor has an additional mechanism of action, increasing local concentrations of endogenous adenosine by inhibiting the endogenous equilibrium nucleoside transporter (ENT-1).

Adenosine is formed locally at sites of hypoxia and tissue damage by release from ATP and ADP. Ticagrelor inhibits ENT-1 and prolongs the T 1/2 of adenosine, thereby increasing its local extracellular concentration, enhancing the local adenosine response. Ticagrelor has no clinically significant direct effect on adenosine receptors (A1, A2 A, A2 B, A3) and is not metabolized to adenosine.

Adenosine has the following effects, which include: vasodilation, cardioprotection, inhibition of platelet aggregation, modulation of inflammation, and the occurrence of dyspnea, which may affect the clinical profile of ticagrelor.

In healthy volunteers and in patients with acute coronary syndrome (ACS), ticagrelor was shown to enhance the following effects of adenosine: vasodilation (estimated as an increase in coronary blood flow in healthy volunteers; headache), inhibition of platelet function (in vitro in whole human blood), and shortness of breath. However, the association of elevated local concentrations of adenosine with clinical outcomes (morbidity and mortality) has not been proven.

Indications

For the prevention of atherothrombotic complications in patients with acute coronary syndrome (unstable angina, non-ST-segment elevation myocardial infarction, or ST-segment elevation myocardial infarction [STEMI]), including patients receiving drug therapy and patients undergoing percutaneous coronary intervention or coronary artery bypass grafting.

Contraindications

— hypersensitivity to ticagrelor or any component of the drug;

active pathological bleeding;

intracranial hemorrhage in history;

— moderate or severe hepatic impairment;

— concomitant use of ticagrelor with potent inhibitors of CYP3A4 (e. g., ketoconazole, with clarithromycin, nefazodone, ritonavir, and atazanavir);

— children and adolescence to 18 years (due to the lack of data about the effectiveness and safety of use in this group of patients).

The drug should be used with caution in patients with a predisposition to the development of bleeding (for example, due to a recent injury, recent surgery, blood clotting disorders, active or recent gastrointestinal bleeding); in patients with concomitant therapy with drugs that increase the risk of bleeding (i. e. NSAIDs, oral anticoagulants and/or fibrinolytics) within 24 hours before taking Brilinta®; in patients with an increased risk of bradycardia (for example, patients with Non-pacemaker SSS, with grade II or III AV block; syncope associated with bradycardia) due to insufficient clinical experience with Brilinta®; in combination with drugs that cause bradycardia; in patients with bronchial asthma and COPD (if the patient reports a new episode of shortness of breath, prolonged shortness of breath or worsening of shortness of breath, an examination should be performed, and in case of intolerance, treatment with ticagrelor should be discontinued). When using Brilinta®, an increase in serum creatinine may occur, and therefore it is necessary to evaluate renal function in accordance with routine clinical practice, paying special attention to patients aged 75 years and older, patients with moderate to severe renal insufficiency, and patients receiving therapy with angiotensin receptor antagonists. Caution should be exercised in patients with a history of hyperuricemia or gouty arthritis. As a preventive measure, ticagrelor should be avoided in patients with hyperuricemic nephropathy. The combined use of ticagrelor and acetylsalicylic acid in a high maintenance dose (more than 300 mg) is not recommended. When using digoxin and Brilinta® together, careful clinical and laboratory monitoring is recommended (heart rate, if there are clinical indications, also ECG and digoxin concentration in the blood). There are no data on the concomitant use of ticagrelor with potent P-glycoprotein inhibitors (for example, verapamil and quinidine), so concomitant therapy with these drugs should be carried out with caution. Use during pregnancy and lactation Data on the use of Brilinta® in pregnant women are not available or limited. Brilinta® is not recommended for use during pregnancy. Since the risk to the newborn/children cannot be excluded, it is not recommended to use Brilinta® during breastfeeding. In experimental animal studies, ticagrelor caused a slight decrease in maternal weight gain, a decrease in the viability of the newborn and its body weight, and a slowdown in growth. Available pharmacodynamic and toxicological data in animals have shown that ticagrelor and its active metabolites are excreted in breast milk. Use in patients with impaired liver function In patients with mild hepatic insufficiency, no dose adjustment is required. Brilinta® has not been studied in patients with moderate or severe hepatic insufficiency, so its use in this category of patients is contraindicated. Use in patients with impaired renal function Patients with renal insufficiency do not need to adjust the dose of the drug. There is no information on the use of Brilinta® in patients on hemodialysis, so its use in these patients is not indicated. Use in children The safety and efficacy of Brilinta® in children and adolescents under 18 years of age according to an adult-approved indication has not been established. Use in elderly patients No dose adjustment is required in elderly patients. When using Brilinta®, serum creatinine may increase, and therefore it is necessary to evaluate renal function in accordance with routine clinical practice, paying special attention to patients aged 75 years and older.

Side effects

According to the PLATO study, the most common adverse reactions reported in patients treated with ticagrelor were shortness of breath, bruising, and nosebleeds. Description of some adverse reactions Bleeding The following definitions of bleeding were used in the PLATO study:

Big fatal/life-threatening bleeding: fatal or intracranial hemorrhage, or bleeding into the cavity of the pericardium with cardiac tamponade; or hypovolemic shock or severe hypotension caused by bleeding and requiring pressors or surgery, or clinically overt bleeding accompanied by a decrease in hemoglobin level of more than 50 g/l, or requiring transfusion of 4 or more units of whole blood or red blood cells.

– Large other bleeding: causing significant disability of the patient (for example, intraocular hemorrhage with irreversible loss of vision), or clinically obvious bleeding accompanied by a decrease in hemoglobin levels by 30-50 g/l, or requiring a transfusion of 2-3 units of whole blood or red blood cells.

– Minor bleeding: requires medical intervention to stop or treat the bleeding (for example, a nosebleed requiring a hospital visit for nasal tamponade).

Brilinta® and clopidogrel did not differ in the frequency of major bleeding in general according to the PLATO criteria (11.6%/year and 11.2%/year, respectively), fatal/life-threatening bleeding according to the PLATO criteria (5.8%/year in both groups). However, the frequency of large and small PLATO bleedings was higher in the ticagrelor group (16.1%) compared to clopidogrel (14.6%, p=0.0084). Age, gender, body weight, race, geographic region, comorbidities, concomitant therapy, and medical history, including prior stroke and transient ischemic attack, did not affect the incidence of major bleeding events in general and unrelated to PLATO procedures. No groups with an increased risk of bleeding were identified.

CABG-related bleeding. In the PLATO study,42% of 1,584 patients (12% of the cohort) who underwent CABG developed major fatal / life-threatening hemorrhages without significant differences in both treatment groups. CABG-related fatal bleeding was reported in 6 patients in each treatment group. Non-CABG-related bleeding and non-procedure-related bleeding.Brilinta® and clopidogrel did not differ in the incidence of major fatal / life-threatening bleeding not associated with CABG according to the PLATO criteria, but when Brilinta® was used, major bleeding occurred more often overall according to the PLATO study definition (4.5% / year compared to 3.8% / year; p=0.0264).

Excluding cases of CABG-related bleeding, the ticagrelor group experienced more bleeding (3.1% / year) than the clopidogrel group (2.3% / year; p=0.0058). Discontinuation of treatment due to non-procedure-related bleeding was more frequent with ticagrelor (2.9%) compared to clopidogrel (1.2%, p Intracranial hemorrhage. The ticagrelor group developed more non-procedure-related intracranial bleeds (n=27 bleeds in 26 patients,0.3%) than the clopidogrel group (n=14 bleeds,0.2%), of which 11 bleeds on ticagrelor and 1 on clopidogrel were fatal. However, there were no significant differences in the total number of fatal bleeds.

Dyspnea Adverse events in the form of dyspnea (dyspnea, dyspnea at rest, dyspnea during exercise, paroxysmal nocturnal dyspnea and nocturnal dyspnea) in combination developed in 13.8% of patients receiving Brilinta® and in 7.8% of patients taking clopidogrel. The researchers estimated that 2.2% of patients in the ticagrelor group had shortness of breath associated with therapy. Most cases of shortness of breath were mild or moderate in intensity and were a single episode immediately after the start of therapy.

Approximately 30% of all cases of dyspnea resolved within 7 days. More often, dyspnea developed in elderly patients, in patients with congestive heart failure, COPD, or bronchial asthma at the beginning of the study. 0.9% of patients stopped taking Brilinta due to shortness of breath.

Shortness of breath was not associated with the development of a new or worsening existing heart or lung disease. Brilinta® does not affect the indicators of external respiratory function. Laboratory deviations in serum creatinine concentrations increased by more than 30% in 25.5% of patients and by more than 50% in 8.3% of patients receiving Brilinta®. Creatinine elevation was more than 50% more common in patients over 75 years of age, in patients with severe renal insufficiency when included in the study, and in patients receiving angiotensin receptor antagonist therapy.

The total number of renal adverse events was 4.9% in patients on ticagrelor, but the researchers associated them with taking the drug in 0.6% of cases. Serum uric acid concentrations increased above ULN in 22% of patients receiving Brilinta®. Adverse events associated with hyperuricemia were observed in 0.5% of cases on ticagrelor, of which researchers associated with taking ticagrelor 0.05% of cases. Gouty arthritis was observed in 0.2% of patients treated with ticagrelor, none of these cases were considered by the researcher to be related to taking the drug.

Post-marketing use The following are the adverse reactions that have been reported with post-marketing use of Brilinta®. Since reports are received spontaneously from a population of unknown size, it is not always possible to reliably estimate the frequency of development. Immune system disorders: hypersensitivity reactions, including angioedema.

Interaction

Effects of other medicinal products on Brilinta® Medicinal products that are metabolized by the CYP3A4 isoenzyme CYP3A4 inhibitors. Potent CYP3A4 inhibitors: concomitant use of ketoconazole with ticagrelor increases the Cmax and AUC of ticagrelor by 2.4 and 7.3 times, respectively.

Cmax and AUC of the active metabolite decreased by 89% and 56%, respectively. Other potent CYP3A4 inhibitors (clarithromycin, nefazodone, ritonavir, and atazanavir) will have similar effects, so their combined use with Brilinta® is contraindicated.

Moderate CYP3A4 inhibitors: concomitant use of diltiazem with ticagrelor increases the Cmax of ticagrelor by 69%, and the AUC by 2.7 times, while reducing the Cmax of the active metabolite by 38%, and the AUC does not change. Ticagrelor does not affect the plasma concentrations of diltiazem. Other moderate CYP3A4 inhibitors (e. g., amprenavir, aprepitant, erythromycin, fluconazole) may be administered concomitantly with Brilinta. Cyclosporine (inhibitor of P-gp and CYP3A4).

Concomitant use of cyclosporine (at a dose of 600 mg) with ticagrelor increases the Cmax and AUC of ticagrelor by 2.3 and 2.8 times, respectively. At the same time, there is an increase in the AUC of the active metabolite by 32% and a decrease in Cmax by 15%. Ticagrelor does not affect the plasma concentration of cyclosporine. Inducers of CYP3A4.

Co-use of rifampicin with ticagrelor reduces the Cmax and AUC of ticagrelor by 73% and 86%, respectively. The cmax of the active metabolite does not change, and the AUC decreases by 46%. Other inducers of CYP3A4 (e. g., phenytoin, carbamazepine, and phenobarbital)are likely to reduce exposure to Brilinta. Potent inducers of CYP3A4 may reduce the exposure and efficacy of Brilinta.

Other medications. According to the results of pharmacological interaction studies, concomitant use of ticagrelor with heparin, enoxaparin and acetylsalicylic acid or desmopressin does not affect the pharmacokinetics of ticagrelor, its active metabolite and ADP-dependent platelet aggregation.

If there are clinical indications for the use of drugs that affect hemostasis, they should be used with caution in combination with Brilinta®. There are no data on the concomitant use of Brilinta® with potent P-glycoprotein inhibitors (for example, verapamil and quinidine) that can increase the exposure of ticagrelor. If combined use cannot be avoided, then combination therapy should be carried out with caution.

Effect of Brilinta® on other medicinal products Medicinal products that are metabolized by the CYP3A4 isoenzyme Simvastatin: concomitant use of ticagrelor and simvastatin increases the Cmax and AUC of simvastatin by 81% and 56%, respectively; the cmax and AUC of simvastatin acid increase by 64% and 52%, respectively, while in some cases these indicators increase by 2-3 times.

Concomitant use of simvastatin at a dose higher than 40 mg / day with ticagrelor may lead to the development of side effects of simvastatin. Therefore, if this combination is necessary, the ratio of potential risk and benefit of therapy should be evaluated. Concomitant use of Brilinta® with simvastatin and lovastatin in doses exceeding 40 mg is not recommended.

Atorvastatin: concomitant use of atorvastatin and ticagrelor increases the Cmax and AUC of atorvastatin acid metabolites by 23% and 36%, respectively. A similar increase in Cmax and AUC values is observed for all atorvastatin acid metabolites. These changes were found to be clinically insignificant. Similar effects to statins metabolized by CYP3A4 cannot be excluded.

In the PLATO study,93% of patients in the group treated with ticagrelor and various statins did not show any undesirable signs regarding the safety of statins. Ticagrelor is a moderate CYP3A4 inhibitor. Concomitant use of Brilinta® and CYP3A4 substrates with a narrow therapeutic index (for example, cisapride or ergot alkaloids) is not recommended, as ticagrelor may increase exposure to these drugs.

Drugs that are metabolized by the CYP2C9 isoenzyme When ticagrelor and tolbutamide were co-administered, the plasma concentrations of none of these drugs did not change. This indicates that ticagrelor is not an inhibitor of the CYP2C9 isoenzyme, and it is unlikely that it affects the CYP2C9-mediated metabolism of drugs such as warfarin and tolbutamide. Oral contraceptives Co-use of ticagrelor, levonorgestrel, and ethinyl estradiol increases

ethinyl estradiol exposure by approximately 20%, but does not affect the pharmacokinetics of levonorgestrel. No clinically significant effect on the effectiveness of contraception is expected when levonorgestrel, ethinyl estradiol and Brilinta are co-administered. P-gp substrate (including digoxin and cyclosporine) Concomitant use of digoxin with ticagrelor increases the Cmax and AUC of digoxin by 75% and 28%, respectively.

When co-administered with ticagrelor, the average Cmin of digoxin increased by 30%, in some cases-by 2 times. The cmax and AUC of ticagrelor did not change with digoxin. Therefore, appropriate clinical and/or laboratory monitoring is recommended when Brilinta® is co-administered with P-gp-dependent drugs with a narrow therapeutic index, such as digoxin and cyclosporine.

Other concomitant therapy Caution should be exercised when Brilinta is co-administered with drugs that may cause bradycardia. However, in the PLATO study, no clinically significant adverse events were observed when combined with one or more drugs that can cause bradycardia (for example,96% – beta-blockers,33% – calcium antagonists, including diltiazem and verapamil, and 4% – digoxin).

In the PLATO study, Brilinta® was primarily co-administered with acetylsalicylic acid, proton pump inhibitors, statins, beta-blockers, ACE inhibitors, and angiotensin receptor antagonists for long-term use, as well as with heparin, low-molecular-weight heparins, and glycoprotein IIb/IIIa receptor inhibitors for intravenous use as part of short-term therapy.

Based on the results of these studies, no clinically significant undesirable interaction was detected.Co-use of Brilinta® with heparin, enoxaparin, or desmopressin did not affect APTT, activated clotting time (ABC), or factor Xa studies, but due to potential pharmacodynamic interactions, caution is required when co-use with drugs that affect hemostasis.

Due to reports of subcutaneous hemorrhages associated with the use of selective serotonin reuptake inhibitors (for example, paroxetine, sertraline and citalopram), caution is recommended when they are co-administered with Brilinta®. When grapefruit juice was consumed daily in large volumes (200 ml 3 times / day), a twofold increase in ticagrelor exposure was noted. Such an increase in ticagrelor exposure is not expected to be clinically relevant for most patients.

How to take, course of use and dosage

The drug is taken orally, regardless of food intake. The use of Brilinta® should begin with a single loading dose of 180 mg (2 tablets of 90 mg) and then continue taking 90 mg 2 times a day.

For patients with difficulty swallowing, the tablet (or 2 tablets – in the case of taking a loading dose) should be crushed to a fine powder, stirred into 1/2 cup of drinking water and immediately drink the resulting suspension. Mix the leftovers with an additional 1/2 cup of drinking water and drink the resulting suspension. The suspension can also be administered via a nasogastric tube (CH 8 or larger).

After use of the suspension, the nasogastric tube should be flushed with water so that the dose of the drug completely enters the patient’s stomach. At the same time, in the absence of specific contraindications, acetylsalicylic acid is prescribed (from 75 mg to 150 mg with constant intake), daily. Interruptions in therapy should be avoided.

If Brilinta is missed, the patient should only take one 90 mg tablet (the next dose) at the scheduled time. If necessary, patients taking clopidogrel may be switched to Brilinta®. It is recommended to continue therapy with Brilinta® for 12 months, unless there is a clinical need for early withdrawal of the drug. Data on the use of ticagrelor for more than 12 months are limited.

In patients with acute coronary syndrome, early withdrawal of any antiplatelet therapy, including Brilinta, may increase the risk of cardiovascular death or myocardial infarction as a result of the underlying disease. Premature discontinuation of the drug should be avoided.

Elderly patients do not need to adjust the dose. Patients with renal insufficiency do not need to adjust the dose of the drug. There is no information on the use of Brilinta® in patients on hemodialysis, so its use in these patients is not indicated. No dose adjustment is required in patients with mild hepatic insufficiency.

Brilinta® has not been studied in patients with moderate or severe hepatic insufficiency, so its use in this category of patients is contraindicated. The safety and efficacy of Brilinta® in children and adolescents under 18 years of age as indicated in adults has not been established.

Special instructions

Risk of bleeding In patients with acute coronary syndrome treated with Brilinta® and acetylsalicylic acid, there was an increased risk of non-CABG major bleeding and bleeding requiring increased medical attention, such as large + small bleeding as defined by PLATO, but the risk of fatal/life-threatening bleeding did not increase. When prescribing Brilinta®, the ratio of the benefits of preventing atherothrombotic events and the risk in patients with an increased likelihood of bleeding should be evaluated.

If clinically indicated, Brilinta® should be used with caution in the following patient groups — – predisposition of patients to develop bleeding (for example, due to a recent injury, a recent operation, blood clotting disorders, active or recent bleeding from the gastrointestinal tract).

The use of Brilinta® is contraindicated in patients with active pathological bleeding, a history of intracranial hemorrhage, moderate or severe hepatic insufficiency; — concomitant use of drugs that may increase the risk of bleeding (for example, NSAIDs, oral anticoagulants and/or fibrinolytics taken within 24 hours before taking Brilinta®). There are no data on the hemostatic efficacy of platelet transfusions when using Brilinta®; Brilinta® can inhibit transfused platelets in the blood. Since the concomitant use of Brilinta® and desmopressin did not reduce the standardized bleeding time, it is unlikely that desmopressin will effectively stop bleeding.

Antifibrinolytic therapy (aminocaproic acid or tranexamic acid) and / or recombinant factor Vlla may enhance hemostasis. After determining the cause of bleeding and stopping it, you can resume therapy with Brilinta®.

Surgical procedures The patient should inform the doctor about the use of Brilinta®before a planned operation or starting to take new medications. In patients undergoing CABG, the incidence of major bleeding with Brilinta® was the same as with clopidogrel on all days after discontinuation of therapy, except on day 1, when the incidence of major bleeding was higher with Brilinta®. If the patient is undergoing elective surgery and an antithrombotic effect is not desired, therapy with Brilinta® should be discontinued 7 days before surgery.

Patients at risk of developing bradycardia Due to the detection of mainly asymptomatic pauses in a previous clinical study, patients with an increased risk of developing bradycardia (for example, patients without a pacemaker who were diagnosed with SSS, AV block of the heart II or III degree; syncope associated with bradycardia) were not included in the main study to evaluate the safety and effectiveness of Brilinta®. Therefore, due to the limited clinical experience of using the drug in these patients, it is recommended to prescribe Brilinta® with caution to such patients.

Additional caution should be exercised when Brilinta is co-administered with drugs that may cause bradycardia. However, there were no clinically significant side effects when co-administered with one or more drugs that may cause bradycardia (for example,96% beta-blockers,33% calcium channel blockers, including diltiazem and verapamil, and 4% digoxin). In a sub-study using daily Holter ECG monitoring in the ticagrelor group compared to clopidogrel, more patients in the acute phase of acute coronary syndrome (ACS) had ventricular pauses >3 seconds.

An increase in the number of ventricular pauses recorded by daily Holter monitoring during ticagrelor use was observed more often in patients with chronic heart failure compared to the general population in the acute phase of ACS, but not in the first month. Pauses in these patients were not accompanied by subsequent undesirable clinical consequences (fainting and pacemaker installation).

Dyspnea Dyspnea when using Brilinta® is usually mild or moderate in intensity, often disappears as therapy continues with the drug. Patients with asthma/COPD may have an increased absolute risk of shortness of breath when taking Brilinta. In patients with bronchial asthma/COPD, ticagrelor should be used with caution. The mechanism of shortness of breath when taking ticagrelor is not clear.

If the patient develops a new episode of shortness of breath, persists or worsens shortness of breath during the use of Brilinta®, then a full examination should be carried out, and in case of intolerance, the drug should be discontinued. Increased creatinine When taking Brilinta®, the creatinine level may increase.

The mechanism of this effect is not known. Assessment of renal function should be performed one month after starting the drug, and then in accordance with routine clinical practice, paying special attention to patients aged 75 years and older, patients with moderate or severe renal insufficiency and receiving therapy with angiotensin receptor antagonists. Elevated uric acid levels In patients receiving ticagrelor, there is a higher risk of hyperuricemia than with clopidogrel. Caution should be exercised in patients with a history of hyperuricemia or gouty arthritis.

As a preventive measure, ticagrelor should be avoided in patients with hyperuricemic nephropathy. Other indications Based on the observed interaction between acetylsalicylic acid in the maintenance dose and the effectiveness of ticagrelor compared to clopidogrel, the combined use of acetylsalicylic acid in a high maintenance dose (more than 300 mg) and Brilinta® is not recommended.

Concomitant use of Brilinta with potent CYP3A4 inhibitors (e. g. ketoconazole, clarithromycin, nefazodone, ritonavir, and atazanavir) is contraindicated, as it may significantly increase ticagrelor exposure. Concomitant use of Brilinta with potent CYP3A4 inducers (e. g. rifampicin, phenytoin, carbamazepine, and phenobarbital) is not recommended, as concomitant use may reduce the exposure and efficacy of ticagrelor.

Concomitant use of Brilinta® and CYP3A4 substrates with a narrow therapeutic index (for example, cisapride and ergot alkaloids) is not recommended, as ticagrelor may increase exposure to these drugs.

Concomitant use of Brilinta with simvastatin or lovastatin at a dose greater than 40 mg is not recommended. When digoxin and Brilinta are used together, careful clinical and laboratory monitoring is recommended (heart rate, and if there are clinical indications, also ECG and digoxin concentration in the blood).

There are no data on the co-use of ticagrelor with potent P-glycoprotein inhibitors (for example, verapamil and quinidine), which can increase the exposure of ticagrelor. If this combination cannot be avoided, then treatment should be carried out with caution.

Influence on the ability to drive motor vehicles and manage mechanisms

No studies have been conducted on the effect of Brilinta® on the ability to drive vehicles and manage mechanisms. Brilinta® does not affect or slightly affects the ability to drive vehicles and mechanisms. Dizziness and confusion have been reported during treatment for acute coronary syndrome. In case of development of these phenomena, patients should be careful when driving a car and other mechanisms.

Form of production

Brilintu is produced in the form

of film-coated tablets: pink color, on one of the sides with the inscription “60”.

Active ingredient

Ticagrelor

Conditions of release from pharmacies

By prescription

Dosage form

Tablets

Purpose

For adults as directed by your doctor

Indications

Thrombophlebitis, Prevention of heart attacks and strokes, Prevention of thrombosis, Myocardial infarction, Angina