Ticagrelor is an antiplatelet agent of the cyclopentyltriazolopyrimidines (CPTP) group that selectively and reversibly antagonizes the P2Y12 platelet receptor for adenosine diphosphate (ADP), preventing ADP-mediated platelet activation and aggregation. It has an antiaggregant effect that is faster and more intense than that achieved by clopidogrel. Ticagrelor is coadministered with acetylsalicylic acid (ASA) for the prevention of atherothrombotic events in patients with acute coronary syndromes or a history of myocardial infarction and high risk of developing an atherothrombotic event.
Ticagrelor is contraindicated in cases of drug hypersensitivity, in patients with active pathological bleeding or with a history of intracranial haemorrhage and / or severe hepatic impairment. Do not administer ticagrelor in concomitance with potent CYP3A4 inhibitors (ketoconazole, clarithromycin, nefazodone, ritonavir and atazanavir).
Risk/benefit in patients with high known risk of hemorrhage shoul be evaluated. Cautions should be taken in: patients with moderate hepatic failure, patients with history of hyperuricemia or gouty arthritis, patients at risk of bradycardia events (no pacemaker with sinus node dysfunction syndrome, AV block of 2nd or 3rd degree or syncope) which ate having drugs known to induce bradycardia, patients with a propensity for bleeding (recent trauma or surgery, coagulation disorders, active or recent gastrointestinal bleeding) or on concomitant treatment with medicinal products that may increase the risk of bleeding (NSAIDs, oral anticoagulants and / or fibrinolytics) within 24 hours for the administration of ticagrelor. When surgery is scheduled, discontinue treatment at least 7 days before.
Ticagrelor is not recommended in patients with previous ischemic stroke for more than 1 year, renal dialysis, uric acid nephropathy or concomitant treatment with high maintenance doses of ASA (> 300 mg). Not recommended in patients with moderate hepatic impairment. There is an increased risk of dyspnea in patients with a history of asthma and / or COPD; in patients with acute coronary syndrome ACS (especially in those over 75 years of age, or with moderate / severe renal insufficiency or treatment with ARB, angiotensin receptor antagonists) is mandatory to control renal function after 1 month and then on a regular basis. There are no safety and efficacy data for children under 18 years old. Avoid premature termination of treatment (since it may increase the risk of cardiovascular death or myocardial infarction).
Haemorrhages due to blood disorders, hyperuricemia, gout/gouty arthritis, dizziness, syncope, headache, dizziness, hypotension, dyspnoea, hemorrhages in the respiratory system, gastrointestinal hemorrhage, diarrhea, nausea, dyspepsia, constipation, subcutaneous or dermal hemorrhages, pruritus, urinary tract hemorrhage, increased serum creatinine, bleeding after the procedure, traumatic bleeding.
- Brilique ®
Gene or region studied