Tiga 90mg Tablet 14pcs

Indications

Ticagrelor is indicated to reduce the rate of thrombotic cardiovascular events in patients with acute coronary syndrome (ACS) (unstable angina, non-ST elevation myocardial infarction, or ST elevation myocardial infarction). It has been shown to reduce the rate of cardiovascular death, myocardial infarction or stroke compared to clopidogrel. In patients treated with PCI, it also reduces the rate of stent thrombosis.

Pharmacology

Ticagrelor is a selective adenosine diphosphate (ADP) receptor antagonist acting on the P2Y12 ADP-receptor that can prevent ADP-mediated platelet activation and aggregation. Ticagrelor reversibly interacts with the platelet P2Y12 ADP-receptor.Ticagrelor does not interact with the ADP binding site itself, but interacts with platelet P2Y12 ADP-receptor to prevent signal transduction.Thus it prevents platelet activation & aggregation.

Dosage & Administration

Initiate Ticagrelor treatment with a 180mg (two 90mg tablets) loading dose and continue treatment with 90mg twice daily. After the initial loading dose of aspirin (usually 325mg) use Ticagrelor with a daily maintenance dose of aspirin of 75-100mg. It can be administered with or without food. A patient who misses a dose of Ticagrelor should take one 90mg tablet (their next dose) at its scheduled time. Or, as directed by the registered physician.

Interaction

CYP3A inhibitors: Avoid use of strong inhibitors of CYP3A (e.g., ketoconazole, itraconazole, voriconazole, clarithromycin, nefazodone, ritonavir, saquinavir, nelfinavir, indinavir, atazanavir and telithromycin).

CYP3A inducers: Avoid use with potent inducers of CYP3A (e.g., rifampin, dexamethasone, phenytoin,carbamazepine and phenobarbital).

Aspirin: Use of Ticagrelor with aspirin maintenance doses above 100 mg reduced the effectiveness ofTicagrelor.

Simvastatin, Lovastatin: Ticagrelor will result in higher serum concentrations of simvastatin and lovastatin because these drugs are metabolized by CYP3A4. Avoid simvastatin and lovastatin doses greater than 40 mg.

Digoxin: Because of inhibition of the P-glycoprotein transporter, monitor digoxin levels with initiation of or any change in ticagrelor therapy.

Other Concomitant Therapy: Ticagrelor can be administered with unfractionated or low-molecular-weight heparin, GPIIb/llla inhibitors, proton pump inhibitors, beta-blockers, angiotensin converting enzyme inhibitors, and angiotensin receptor blockers.

Contraindications

Ticagrelor is contraindicated in patients with active pathological bleeding such as peptic ulcer or intracranial hemorrhage. It is also contraindicated in patients with hypersensitivity to Ticagrelor or any component of the product

Side Effects

Bleeding is the most commonly reported adverse reaction. Others adverse effects include hypertension, fatigue, headache, back pain, dizziness, nausea etc.

Pregnancy & Lactation

Ticagrelor Hydrochloride should be used during pregnancy & lactation only if the potential benefit to the mother justifies the potential risk to the fetus.

Precautions & Warnings

Ticagrelor increased the overall risk of bleeding (major & minor) to a somewhat greater extent than did clopidogrel. The increase was seen for non-CABG-related bleeding

Storage Conditions

Protect from light & moisture. Store below 25° C. Keep out of reach of children.