Brilinta (Ticagrelor) - Oral

Warning:

Brilinta can cause significant bleeding that can sometimes lead to death. People with active bleeding or a history of intracranial hemorrhage (brain bleeds) should not take Brilinta. Do not start Brilinta prior to undergoing urgent coronary artery bypass graft (CABG) surgery. This medication may not be appropriate for people who underwent a recent and urgent CABG or fibrinolytic therapy.

In the event of a bleed, it is recommended to manage the bleeding without stopping Brilinta, as stopping Brilinta increases the risk of heart attack or stroke. After the initial aspirin dose, people should avoid taking more than 100 milligrams (mg) of aspirin per day because daily doses over 100 milligrams can interfere with how well Brilinta works.

What Is Brilinta?

Brilinta (ticagrelor) is an oral prescription drug used to prevent serious or life-threatening heart attack, stroke, or death in people who have had a heart attack or have a condition called acute coronary syndrome (ACS).

Brilinta can also help:

  • Prevent blood clots in people who have a stent to treat ACS
  • Lower the risk of a first heart attack or stroke in people with heart disease
  • Lower the risk of a more serious stroke in people who are having a transient ischemic attack (ministroke) or a mild to moderate stroke

Brilinta is in a drug class called antiplatelet medications. It works by preventing blood cells called platelets from making clots that could cause a heart attack or stroke.

Drug Facts

Generic Name: Ticagrelor

Brand Name(s): Brilinta

Drug Availability: Prescription

Therapeutic Classification: Antiplatelet drug

Available Generically: No

Controlled Substance: No

Administration Route: Oral

Active Ingredient: Ticagrelor

Dosage Form(s): Tablet

What Is Brilinta Used For?

The Food and Drug Administration (FDA) approved Brilinta to:

  • Lower the risk of cardiovascular (heart) death, heart attack (myocardial infarction, or MI), or stroke, in people with ACS (a sudden blockage of blood flow to the heart) or who have had a heart attack
  • Lower the risk of clotting in people who have had a stent to treat ACS
  • Lower the risk of a first heart attack or stroke in people with heart disease who are at high risk (such as people with type 2 diabetes)
  • Lower the risk of a more severe stroke in people with a transient ischemic attack (ministroke) or a stroke that is considered mild to moderate (five or less on the NIH Stroke Scale).

Brilinta is usually taken with a 75 milligram (mg) to 100 milligrams daily dose of aspirin (not to exceed 100 milligrams of aspirin per day).

How to Take Brilinta

Once you receive your Brilinta prescription, read the prescription label and the information leaflet that comes with it. Consult your healthcare provider if you have any questions. Use Brilinta exactly as directed, and do not skip doses. Your healthcare provider will tell you how much Brilinta to take and when to take it.

When taking Brilinta, remember to:

  • Take your dose at about the same time each day.
  • Take with or without food, but avoid drinking alcohol while using Brilinta and aspirin.
  • Take Brilinta with aspirin at the dose recommended by your healthcare provider. Do not take more aspirin than recommended. Too much aspirin can make Brilinta less effective.
  • Tell your healthcare providers that you take Brilinta. You may need to stop taking Brilinta for a few days before a surgery or a medical or dental procedure.

If you have trouble swallowing the tablet, you can crush the tablet. Mix with water, and drink all of the water immediately. Fill the glass with water again, stir, and drink all of it.

Brilinta makes you more likely to bleed. Contact your healthcare provider right away or get emergency medical help if you have bleeding that won't stop. Do not stop taking Brilinta unless your healthcare provider tells you to stop. Stopping Brilinta can increase your chance of having a heart attack or stroke.

Storage

Store at room temperature, away from heat, direct light, and moisture. Keep this medication out of reach and out of sight of children and pets. Keep the bottle tightly closed when not in use.

How Long Does Brilinta Take to Work?

Brilinta starts working after a few hours, but you have to keep taking it as directed so that it can keep working. Your healthcare provider will tell you how long to take Brilinta. Do not stop taking it unless instructed by your provider. Stopping Brilinta too soon can increase the risk of heart attack or stroke.

What Are the Side Effects of Brilinta?

This is not a complete list of side effects and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or a healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 1-800-FDA-1088.

Common Side Effects

The most common side effects of Brilinta are:

  • Bleeding
  • Shortness of breath
  • Dizziness
  • Nausea and diarrhea
  • Increased levels of creatinine (a measure of kidney function)

Severe Side Effects

Call your healthcare provider right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Severe bleeding: Call your healthcare provider right away if you have nosebleeds, bleeding that does not stop, unusual bleeding, easy bruising, black/blood/tarry stools, red or pink urine, coughing up blood, or if you have vomit that looks like coffee grounds.
  • Hypersensitivity reaction or anaphylaxis: Symptoms can include rash, hives, swelling around the lips, tongue, and face, difficulty breathing, and require emergency medical attention. 
  • Fainting: Notify your healthcare provider if you feel lightheaded, dizzy, feel like you will faint, or faint.
  • AV block/bradyarrhythmia (the heart beats slowly or skips beats; symptoms include tiredness, dizziness, fainting, and shortness of breath)
  • Thrombotic thrombocytopenic purpura (TTP, a rare and life-threatening blood disorder): Symptoms include red or purple spots under the skin, tiredness, fever, shortness of breath, stomach problems like nausea, vomiting, and diarrhea. Some people may experience confusion, seizures, coma, or a stroke.
  • Sleep apnea: Tell your healthcare provider if you have irregular breathing when sleeping or if someone tells you that you are snoring or gasping for air while sleeping.

Long-Term Side Effects

While many people tolerate Brilinta well, long-term or delayed side effects are possible. Some long-term side effects can be mild, such as:


Moderate long-term side effects can include: 


Severe long-term side effects may include: 

Report Side Effects

Brilinta may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your healthcare provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much Brilinta Should I Take?

Drug Content Provided and Reviewed by IBM Micromedex®

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (tablets):
    • For prevention of heart attack or stroke in patients with acute coronary syndrome (ACS) or a history of heart attack:
      • Adults—At first, 180 milligrams (mg) taken as a single dose. Followed by, 90 mg two times a day during the first year after an ACS event. Then, 60 mg two times a day after 1 year. Your doctor may also give you a maintenance dose of aspirin 75 to 100 mg once a day to be taken together with this medicine. Do not take more than 100 mg of aspirin per day.
      • Children—Use and dose must be determined by your doctor.
    • For prevention of first heart attack or stroke in patients with coronary artery disease (CAD):
      • Adults—60 milligrams (mg) two times a day. Your doctor may also give you a maintenance dose of aspirin 75 to 100 mg once a day to be taken together with this medicine. Do not take more than 100 mg of aspirin per day.
      • Children—Use and dose must be determined by your doctor.
    • For prevention of stroke in patients with transient ischemic attack (TIA):
      • Adults—At first, 180 milligrams (mg) taken as a single dose. Followed by, 90 mg two times a day for up to 30 days. Your doctor may also give you a loading dose of aspirin 300 to 325 mg and a maintenance dose of aspirin 75 to 100 mg once a day to be taken together with this medicine. Do not take more than 100 mg of aspirin per day.
      • Children—Use and dose must be determined by your doctor.

Modifications

Brilinta is an oral medication that comes in tablet form. Some people have trouble swallowing pills and may need to modify how they take them. If you have difficulty swallowing Brilinta, you can crush the tablet. Mix with water, and drink all of the water immediately. Fill the glass with water again, stir, and drink all of it.

Impaired liver function can increase the risk for bleeding and other side effects because the liver processes the medication. For this reason, people with severe liver problems should not use Brilinta. However, people with mild liver problems can take Brilinta with caution. Discuss the risks vs benefits with your healthcare provider. Generally, it is OK for people with kidney problems to take Brilinta, but consult your healthcare provider for more information.

People who are pregnant or planning to become pregnant should consult their healthcare provider. You should not breastfeed while taking Brilinta because the drug is expected to be present in milk.

Missed Dose

If you miss a dose of Brilinta, skip the missed dose and take the next dose at the regular time. Do not take two doses together at the same time.

Overdose: What Happens If I Take Too Much Brilinta?

Taking too much Brilinta can cause bleeding, stomach problems (e.g., nausea, vomiting, diarrhea), or heart rate problems.

What Happens If I Overdose on Brilinta?

If you think you or someone else may have overdosed on Brilinta, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking Brilinta, call 911 immediately.

Precautions

Drug Content Provided and Reviewed by IBM Micromedex®

It is very important that your doctor check your progress at regular visits. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to take it. Blood tests may be needed to check for unwanted effects.

Tell all medical doctors, dentists, nurses, and pharmacists you go to that you are taking this medicine. Ticagrelor may increase the risk of serious bleeding during a surgery, other medical procedures (eg, coronary artery bypass graft or CABG), or some kinds of dental work. You may need to stop using this medicine at least 5 days before a surgery, medical procedure, or dental work. The results of some medical tests may also be affected by this medicine.

Do not change your dose or stop taking this medicine without checking first with your doctor. To do so may increase the chance of having a heart attack, blood clotting problems, or other serious conditions.

While you are using this medicine, if you have any kind of bleeding, it may take longer than usual to stop, especially if you hurt yourself. Stay away from rough sports or other situations where you could be bruised, cut, or injured. Be careful when using sharp objects, including razors and fingernail clippers.

This medicine may increase your chance of bleeding or bruising. Check with your doctor right away if you notice any unusual bleeding or bruising, black, tarry stools, blood in the urine or stools, or pinpoint red spots on your skin. Avoid picking your nose. If you need to blow your nose, blow it gently.

Tell your doctor right away if you have chest tightness, or difficult or trouble breathing when asleep or awake. These could be symptoms of a serious lung or breathing problem (eg, central sleep apnea, Cheyne-Stokes respiration).

This medicine may cause heart rhythm problems (eg, bradyarrhythmia). Check with your doctor right away if you have chest pain or discomfort, lightheadedness, dizziness, or fainting, trouble breathing, slow or irregular heartbeat, or unusual tiredness.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

What Are Reasons I Shouldn't Take Brilinta?

Brilinta is not appropriate for everyone. You should not take this medication if you are allergic to ticagrelor or any of the inactive ingredients in Brilinta. 

You also should not take Brilinta:

  • If you have active bleeding
  • If you have a history of intracranial hemorrhage
  • Prior to undergoing urgent CABG surgery
  • If you have severe liver problems
  • Post fibrinolytic therapy: Brilinta may not be appropriate for people who have undergone recent fibrinolytic therapy as their reperfusion therapy as the recommended treatment is Plavix (clopidogrel).

This medication may also not be appropriate for people who underwent a recent and urgent CABG. In this case, your healthcare provider will weigh the risks versus benefits and may monitor Brilinta's use.

Brilinta may be prescribed with caution in some people only if the healthcare provider determines it is safe. This includes:

  • People with moderate liver problems
  • Older adults (65 years and older)
  • People at risk of bleeding
  • People undergoing an elective surgery within five days
  • People without a pacemaker who have sick sinus syndrome (a condition where the heart's normal pacemaker cannot generate a normal heartbeat) or second or third-degree AV block

What Other Medications May Interact With Brilinta?

Tell your healthcare provider about all of your medicines, including prescription and over-the-counter (OTC) medicines and vitamins or supplements. The following drugs may interact with Brilinta.

Strong CYP3A Inhibitors

Brilinta interacts with drugs known as strong CYP3A inhibitors. These drugs interfere with how the body processes Brilinta, resulting in higher Brilinta levels. This can increase the risk of side effects like bleeding and shortness of breath. Examples of these drugs include:

  • Biaxin (clarithromycin)
  • Erythromycin
  • Nizoral (ketoconazole)
  • Norvir (ritonavir) and other drugs that contain ritonavir

Strong CYP3A Inducers

Brilinta also interacts with drugs known as strong CYP3A inducers. These drugs have the opposite effect. They decrease Brilinta levels, making Brilinta less effective. Examples of these drugs include:

Aspirin

Although aspirin is taken along with Brilinta, aspirin doses of 100 milligrams or more per day can decrease the effectiveness of Brilinta and should be avoided. If you take any other OTC medicines for pain or cold and cough, make sure they do not contain aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs). Ask your pharmacist if you need help with the ingredients.

Alcohol

Avoid drinking alcohol if you take Brilinta with aspirin. Alcohol taken with aspirin can increase the risk of stomach bleeding.

Opioid Pain Medications

Opioid pain medications can decrease the effectiveness of Brilinta. Examples of opioids include:

  • Oxycontin (oxycodone)
  • Percocet (oxycodone and acetaminophen)
  • Vicodin (hydrocodone and acetaminophen)

Certain Cholesterol Medications

Zocor (simvastatin) and Mevacor (lovastatin) interact with Brilinta. Brilinta increases levels of these cholesterol medications, which will require a dosage adjustment of the cholesterol medicine.

Lanoxin (Digoxin)

People who take digoxin will require close monitoring of digoxin levels while taking Brilinta.

Other drug interactions may occur with Brilinta. Consult your healthcare provider for a complete list of drug interactions.

What Medications Are Similar?

Brilinta is a blood thinner. There are two types of blood thinners: antiplatelets and anticoagulants. Brilinta is an antiplatelet drug.

Other antiplatelet medications include:

  • Aggrastat (tirofiban) injection
  • Aspirin
  • Effient (prasugrel)
  • Integrilin (eptifibatide) injection
  • Persantine (dipyridamole)
  • Plavix (clopidogrel)
  • Pletal (cilostazol)
  • Zontivity (vorapaxar)

Anticoagulants include:

  • Arixtra (fondaparinux) injection
  • Coumadin (warfarin)
  • Eliquis (apixaban)
  • Fragmin (dalteparin) injection
  • Heparin injection
  • Lovenox (enoxaparin)
  • Pradaxa (dabigatran)
  • Savaysa (edoxaban)
  • Xarelto (rivaroxaban)

Frequently Asked Questions

  • What is Brilinta used for?

    Brilinta is used, along with a daily low dose of aspirin (75 to 100 milligrams but not more than 100 milligrams) to:

    • Reduce the risk of cardiovascular death, heart attack, or stroke in people with ACS or who have had a heart attack
    • Reduce clotting risk in people who have had a stent to treat ACS
    • Reduce the risk of a first stroke or heart attack in people with heart disease who are at high risk
    • Reduce the risk of a more severe stroke in people who are having a ministroke or a stroke that is considered mild to moderate
  • How does Brilinta work?

    Brilinta works by preventing platelets (a type of blood cell) from making clots that can cause a stroke or heart attack.

  • What drugs should not be taken with Brilinta?

    Brilinta interacts with various drugs, including certain antibiotics, heart medications, and cholesterol medications. Before taking Brilinta, tell your healthcare provider about all of the medications you take, including prescription and OTC medicines, vitamins, and supplements.

  • How long does it take for Brilinta to work?

    Brilinta starts working within a few hours. However, you have to keep taking the medication as directed so that it can keep working. Your healthcare provider will tell you how long to take Brilinta. Stopping Brilinta too early may increase the risk of a stroke or heart attack, so do not stop taking the medication unless instructed by your healthcare provider.

  • What are the side effects of Brilinta?

    The most common side effects of Brilinta are bleeding, shortness of breath, dizziness, nausea, and diarrhea. Before taking Brilinta, talk with your healthcare provider about what side effects to expect and what to do if you experience them.

  • How do I stop taking Brilinta?

    Your healthcare provider will tell you how long to take Brilinta. Do not stop taking this medication without guidance from your healthcare provider. Stopping Brilinta too soon can increase the risk of having a heart attack or stroke.

How Can I Stay Healthy While Taking Brilinta?

Before taking Brilinta, discuss your medical history and all medications you take with your healthcare provider. 

When taking Brilinta, follow your healthcare provider’s instructions for use. Read the patient information leaflet that comes with your prescription and ask your healthcare provider if you have any questions.

When you take a blood thinner, you are more prone to bleeding, and bleeding can take longer to stop. Here are some tips to help you stay as safe as possible:

  • When shaving, use an electric razor to avoid cuts and scrapes.
  • Use extra caution when using sharp objects like knives and scissors.
  • File your nails with an emery board instead of using a nail clipper.
  • Use a soft-bristle toothbrush to avoid bleeding gums. Avoid toothpicks.
  • Use a vaporizer or humidifier to keep the air moist, especially in the winter. This can help avoid nosebleeds.
  • Blow your nose gently.
  • Avoid activities where you can get injured. Ask your healthcare provider what kind of exercise would be appropriate for you.
  • Always wear a helmet if you ride a bike.
  • Wear a medical alert so emergency responders know you take a blood thinner.
  • Get emergency medical care if you fall or hit your head. Even if you are not visibly bleeding, you may have bleeding under the skin or in the skull. 
  • When inside the house, wear shoes or non-slip slippers.
  • Always wear shoes outside of the house.
  • If you work outside, for example, gardening, wear appropriate gloves for using sharp tools or for working in the yard.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

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7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. MedlinePlus. Ticagrelor.

  2. DailyMed. Label: Brilinta-ticagrelor tablet.

  3. Epocrates. Brilinta.

  4. Prescribers’ Digital Reference. Ticagrelor - drug summary.

  5. Epocrates. Brilinta.

  6. Berwanger O, Lopes RD, Moia DDF, et al. Ticagrelor versus clopidogrel in patients with STEMI treated with fibrinolysis: TREAT trial. J Am Coll Cardiol. 2019;73(22):2819-2828. doi:10.1016/j.jacc.2019.03.011

  7. Lawton JS, Tamis-Holland JE, Bangalore S, et al. 2021 ACC/AHA/SCAI guideline for coronary artery revascularization: a report of the American College of Cardiology/American Heart Association Joint Committee on clinical practice guidelines. J Am Coll Cardiol. 2022;79(2) e21-e129. doi:10.1016/j.jacc.2021.09.006