Ticagrelor Warnings and Precautions

If you have certain allergies or a bleeding disorder, you may not be able to safely use ticagrelor. Other precautions and warnings with this drug apply to people with liver disease and women who are pregnant or breastfeeding. In addition, you will need to be watchful for signs of bleeding, such as easy bruising, during treatment.

What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to taking ticagrelor (Brilinta™) if you have:
 
  • A bleeding disorder
  • Intestinal or stomach ulcers or bleeding
  • Bleeding in the brain
  • An aneurysm
  • Liver disease, such as liver failure or cirrhosis
  • Any allergies, including to food, dyes, or preservatives.
     
Also, let your healthcare provider know if you are:
 
  • Planning an upcoming surgery
  • Pregnant or thinking of becoming pregnant
  • Breastfeeding.
     
Make sure to tell your healthcare provider about any other medications you are taking, including prescription and nonprescription medicines, vitamins, and herbal supplements.
 

Specific Warnings and Precautions With Ticagrelor

Warnings and precautions to be aware of prior to taking this drug include the following:
 
  • One of the most serious ticagrelor side effects is bleeding, including potentially fatal internal bleeding. This risk is higher for certain people, such as those who:
     
    • Have a bleeding disorder
    • Are taking other medications that increase the risk of bleeding
    • Are about to undergo an invasive procedure or surgery.
Ticagrelor should not be given to any individual with active bleeding.
  • Let your healthcare provider know if you develop any signs of bleeding, such as:
     
    • Easy bruising
    • Cuts or scrapes that are slow to stop bleeding
    • Black, tarry stools; bright-red blood in the stool; or vomiting of blood (signs of gastrointestinal bleeding)
    • Signs of bleeding in the brain, such as vision or speech changes, weakness or numbness in an arm or leg, or a severe headache.
 
  • This medication has not been studied in people with liver disease. Liver disease probably will increase the risk of dangerous ticagrelor side effects, especially bleeding.
     
  • Ticagrelor should not be given to people who are likely to need heart bypass surgery. If a person already taking the drug needs to have a bypass, the procedure should be postponed for five days, if possible, in order to decrease the risk of life-threatening bleeding.
     
  • This medicine may need to be stopped ahead of time for any elective surgery. Ask your healthcare provider when you should stop and restart it.
     
  • Ticagrelor often causes shortness of breath. This is not a particularly dangerous side effect. However, report any shortness of breath (or worsening of shortness of breath) to your healthcare provider, since it could be caused by something more serious.
     
  • Ticagrelor may react with several different medications (see Ticagrelor Drug Interactions).
     
  • At this time, it is not entirely clear how long people should continue to take this medicine, and different healthcare providers may have different opinions on this matter. Your healthcare provider will take into account your particular situation when recommending how long you should take ticagrelor. Stopping it too soon may increase your risk of heart attacks, blood clots in your stent, and death.
     
  • This product is a pregnancy Category C medication, meaning that it may not be safe for use during pregnancy, although the full risks are currently unknown (see Brilinta and Pregnancy for more information).
     
  • At this time, it is unknown if ticagrelor passes through breast milk in humans. If you are breastfeeding or plan to start, discuss this with your healthcare provider prior to taking the drug (see Brilinta and Breastfeeding for more information).
     
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