Ticagrelor

Question 1

What is ticagrelor?

Answer 1

Ticagrelor (90mg tab/ODT) is an antiplatelet medication that is a reversibly binding, direct-acting adenosine diphosphate receptor antagonist that inhibits platelet activation & aggregation.

Hepatic metabolism.

Onset: 30 min
Duration: 7 days
Half-life: 7 hours

Question 2

Indications for ticagrelor?

Answer 2

1. Patients with STEMI (as identified by the relevant QAS coronary artery reperfusion checklist) who have been accepted for pPCI (as an adjunct medication to aspirin and heparin) and the receiving cardiologist is requesting ticagrelor administration.

Question 3

Contraindications for ticagrelor?

Answer 3

1. Allergy/ADR
2. Patient currently taking ticagrelor or clopidogrel
3. Patient under 18 years
4. Active bleeding (excluding menses)
5. Prior intracranial haemorrhage
6. History of hepatic impairment

Question 4

Precautions for ticagrelor?

Answer 4

1. Concurrent medication known to induce bradycardia (e.g. B-blockers, calcium channel blocker, digoxin)
2. Symptomatic bradycardia (HR less than 60)

Question 5

Side effects of ticagrelor?

Answer 5

1. Haemorrhage

2. Bradycardia

Question 6

What is the dose of ticagrelor for an adult?

Answer 6

> 18 years - 180 mg PO