Section 13 · Monograph
Ticagrelor
Reviewed Nov 2026FDA label
BrilintaAntiplatelet (P2Y12)
- Forms
- Tab: 60, 90mg
- Dose
- Minor stroke/high-risk TIA: 180mg load, then 90mg BID with aspirin for up to 30 days
- MOA
- Reversible P2Y12 receptor blockade
Black Box Warning
- Bleeding risk: do not use in active pathological bleeding or history of intracranial hemorrhage
- Aspirin maintenance doses above 100mg reduce effectiveness — avoid
Indications
- Acute coronary syndrome or history of MIFDA-labeled
- Acute ischemic stroke (NIHSS 5 or less) or high-risk TIA to reduce stroke riskFDA-labeled
- Coronary artery diseaseFDA-labeled
Mechanism of Action
- Reversible, direct-acting P2Y12 receptor antagonist (not a prodrug)
Full Dosing
Adult / usual
- Stroke/TIA: 180mg loading dose, then 90mg twice daily for up to 30 days with aspirin 75-100mg daily
Contraindications
- History of intracranial hemorrhage
- Active pathological bleeding
- Severe hepatic impairment
- Hypersensitivity
Drug Interactions
- Strong CYP3A4 inhibitors or inducers: avoid
- Simvastatin/lovastatin above 40mg: increased statin levels
- May raise digoxin levels
Adverse Effects
- Bleeding
- Dyspnea (common)
- Bradyarrhythmias and ventricular pauses
- Increased uric acid and creatinine
Monitoring Parameters
- Bleeding signs
- Renal function
- Dyspnea assessment
Pregnancy & Lactation
- Limited data; avoid unless benefit justifies risk
- Unknown whether present in milk