Request Samples
Request Samples
Sample Closet

 

Request samples for your practice

BRILINTA® (ticagrelor) Dosing Card
BRILINTA® (ticagrelor) Dosing Card
BRILINTA Dosing Card for Patients With Acute Coronary Syndrome (ACS) or Prior Myocardial Infarction (MI)

 

Download a Dosing Card for BRILINTA in ACS/Prior MI>

Clinical trial reprints

The following links to journals are provided as an educational service by AstraZeneca Pharmaceuticals LP. The articles linked herein may include some information for AstraZeneca products that is not contained in or is inconsistent with the FDA-approved Prescribing Information. Some authors may have a financial interest in AstraZeneca and/or may have received compensation from AstraZeneca. AstraZeneca recommends use of its products only in accordance with the approved Prescribing Information. Prescription drugs used outside of an approved indication may not be eligible for reimbursement by third-party payors, including Medicare or Medicaid.

BRILINTA in ACS

PLATO
PLATO

Wallentin L et al. Ticagrelor versus clopidogrel in patients with acute coronary syndromes

READ THE FULL ARTICLE

NSTE-ACS in PLATO
NSTE-ACS IN PLATO

Lindholm D et al. Ticagrelor vs clopidogrel in patients with non-ST-elevation acute coronary syndrome with or without revascularization: results from the PLATO trial

READ THE FULL ARTICLE

PLATO Safety
PLATO safety

Becker RC et al. Bleeding complications with the P2Y12 receptor antagonists clopidogrel and ticagrelor in the PLATelet inhibition and patient Outcomes (PLATO) trial

READ THE FULL ARTICLE

Post Hoc Analysis in CKD PLATO
Post hoc analysis CKD in PLATO

James S et al. Ticagrelor versus clopidogrel in acute coronary syndromes in relation to renal function: results from the Platelet Inhibition and Patient Outcomes (PLATO) trial

READ THE FULL ARTICLE

SWEDEHEART Real-World Evidence
SWEDEHEART Real-world evidence

Sahlén A et al. Outcomes in patients treated with ticagrelor or clopidogrel after acute myocardial infarction: experiences from SWEDEHEART registry

READ THE FULL ARTICLE

BRILINTA in prior MI

PEGASUS
PEGASUS

Bonaca MP et al. Long-term use of ticagrelor in patients with prior myocardial infarction

READ THE FULL ARTICLE

BRILINTA in high-risk CAD without history of MI or stroke

THEMIS
THEMIS

Steg PG et al. Ticagrelor in patients with stable coronary disease and diabetes

READ THE FULL ARTICLE

THEMIS-PCI
THEMIS-PCI

Bhatt DL et al. Ticagrelor in patients with diabetes and stable coronary artery disease with a history of previous percutaneous coronary intervention (THEMIS-PCI): a phase 3, placebo-controlled, randomized trial

READ THE ABSTRACT

BRILINTA in acute ischemic stroke or high-risk TIA

THALES
THALES

Johnston SC et al. Ticagrelor and aspirin or aspirin alone in acute ischemic stroke or TIA

READ THE ABSTRACT

THALES IPSILATERAL ATHEROSCLEROTIC STENOSIS SUBGROUP
THALES IPSILATERAL ATHEROSCLEROTIC STENOSIS SUBGROUP

Amarenco P et al. Ticagrelor added to aspirin in acute nonsevere ischemic stroke or transient ischemic attack of atherosclerotic origin

READ THE FULL ARTICLE

THALES subsequent disabling stroke prespecified analysis
THALES subsequent disabling stroke prespecified analysis

Amarenco P et al. Ticagrelor added to aspirin in acute ischemic stroke or transient ischemic attack in prevention of disabling stroke

READ THE FULL ARTICLE

Pharmacokinetics/Pharmacodynamics of BRILINTA

It is not known how pharmacology or chemical class correlates to clinical efficacy or safety results.

PLATO Genetic Sub Study
PLATO genetic substudy

Wallentin L et al. Effect of CYP2C19 and ABCB1 single nucleotide polymorphisms on outcomes of treatment with ticagrelor versus clopidogrel for acute coronary syndromes: a genetic substudy of the PLATO trial

READ THE ABSTRACT

Onset and Offset of BRILINTA® (ticagrelor)
Onset and offset of BRILINTA

Gurbel PA et al. Randomized Double-Blind Assessment of the ONSET and OFFSET of the Antiplatelet Effects of Ticagrelor in Patients With Stable Coronary Artery Disease

READ THE FULL ARTICLE

Request Samples

Want to help your patients get started on BRILINTA?

REQUEST SAMPLES

ACS=acute coronary syndrome; CAD=coronary artery disease; MI=myocardial infarction; NSTE-ACS=non–ST-elevation acute coronary syndrome; PEGASUS=Prevention of Cardiovascular Events in Patients with Prior Heart Attack Using Ticagrelor Compared to Placebo on a Background of Aspirin; PLATO=PLATelet inhibition and patient Outcomes; RRR=relative risk reduction; STEMI=ST-elevation MI; THALES=Acute STroke or Transient IscHemic Attack Treated with TicAgreLor and Aspirin for PrEvention of Stroke and Death; THEMIS=Effect of Ticagrelor on Health Outcomes in DiabEtes Mellitus Patients Intervention Study; TIA=transient ischemic attack; T2D=type 2 diabetes.

Read More

IMPORTANT SAFETY INFORMATION FOR BRILINTA® (ticagrelor) 60-MG AND 90-MG TABLETS

WARNING: BLEEDING RISK

  • BRILINTA, like other antiplatelet agents, can cause significant, sometimes fatal bleeding
  • Do not use BRILINTA in patients with active pathological bleeding or a history of intracranial hemorrhage
  • Do not start BRILINTA in patients undergoing urgent coronary artery bypass graft surgery
  • If possible, manage bleeding without discontinuing BRILINTA. Stopping BRILINTA increases the risk of subsequent cardiovascular events

CONTRAINDICATIONS

  • BRILINTA is contraindicated in patients with a history of intracranial hemorrhage or active pathological bleeding such as peptic ulcer or intracranial hemorrhage. BRILINTA is also contraindicated in patients with hypersensitivity (eg, angioedema) to ticagrelor or any component of the product

WARNINGS AND PRECAUTIONS

  • Dyspnea was reported more frequently with BRILINTA than in patients treated with control agents. Dyspnea from BRILINTA is often self-limiting
  • In patients being treated for coronary artery disease, discontinuation of BRILINTA will increase the risk of MI, stroke, and death. When possible, interrupt therapy with BRILINTA for 5 days prior to surgery that has a major risk of bleeding. If BRILINTA must be temporarily discontinued, restart as soon as possible
  • Ticagrelor can cause ventricular pauses. Bradyarrhythmias including AV block have been reported in the post-marketing setting. Clinical trials excluded patients at increased risk of bradyarrhythmias not protected by a pacemaker, and they may be at increased risk of developing bradyarrhythmias
  • Avoid use of BRILINTA in patients with severe hepatic impairment. Severe hepatic impairment is likely to increase serum concentration of ticagrelor and there are no studies of BRILINTA in these patients
  • Central sleep apnea (CSA) including Cheyne-Stokes respiration (CSR) has been reported in the post-marketing setting in patients taking ticagrelor, including recurrence or worsening of CSA/CSR following rechallenge
  • In patients with Heparin Induced Thrombocytopenia (HIT): False-negative results for HIT-related platelet functional tests, including the heparin-induced platelet aggregation (HIPA) assay, have been reported with BRILINTA. BRILINTA is not expected to impact PF4 antibody testing for HIT

ADVERSE REACTIONS

  • The most common adverse reactions (>5%) associated with the use of BRILINTA included bleeding and dyspnea

DRUG INTERACTIONS

  • Avoid use with strong CYP3A inhibitors and strong CYP3A inducers. BRILINTA is metabolized by CYP3A4/5. Strong inhibitors substantially increase ticagrelor exposure and so increase the risk of adverse events. Strong inducers substantially reduce ticagrelor exposure and so decrease the efficacy of ticagrelor
  • As with other oral P2Y12 inhibitors, co-administration of opioid agonists delays and reduces the absorption of ticagrelor. Consider the use of a parenteral anti-platelet in ACS patients requiring co-administration
  • Patients receiving more than 40 mg per day of simvastatin or lovastatin may be at increased risk of statin-related adverse events
  • Rosuvastatin plasma concentrations may increase because rosuvastatin is a breast cancer resistance protein (BCRP) substrate. Monitor for statin-related adverse effects
  • Monitor digoxin levels with initiation of, or change in, BRILINTA therapy

SPECIAL POPULATIONS

  • Lactation: Breastfeeding is not recommended

INDICATIONS

BRILINTA is indicated to reduce the risk of cardiovascular death, myocardial infarction (MI), and stroke in patients with acute coronary syndrome (ACS) or a history of myocardial infarction. For at least the first 12 months following ACS, it is superior to clopidogrel. BRILINTA also reduces the risk of stent thrombosis in patients who have been stented for the treatment of ACS.

BRILINTA is indicated to reduce the risk of a first MI or stroke in patients with coronary artery disease (CAD) at high risk for such events. While use is not limited to this setting, the efficacy of ticagrelor was established in a population with type 2 diabetes.

BRILINTA is indicated to reduce the risk of stroke in patients with acute ischemic stroke (NIH Stroke Scale Score ≤5) or high-risk transient ischemic attack (TIA).

DOSING

In the management of ACS, initiate BRILINTA treatment with a 180-mg loading dose. Administer 90 mg twice daily during the first year after an ACS event. After one year administer 60 mg twice daily. Use BRILINTA with a daily maintenance dose of aspirin of 75-100 mg. However, in patients who have undergone PCI, consider single antiplatelet therapy with BRILINTA based on the evolving risk for thrombotic versus bleeding events.

In patients with CAD but no prior stroke or MI, administer 60 mg twice daily. Generally, use BRILINTA with a daily maintenance dose of aspirin of 75 mg to 100 mg.

In patients with acute ischemic stroke or high-risk TIA, initiate treatment with a 180-mg loading dose of BRILINTA and then continue with 90 mg twice daily for up to 30 days. Use BRILINTA with a loading dose of aspirin (300 mg to 325 mg) and a daily maintenance dose of aspirin of 75 mg to 100 mg.

Please read full Prescribing Information, including Boxed WARNING, and Medication Guide.

You may report side effects related to AstraZeneca products.

 

Read More