Bricor Dosage/Direction for Use

Ticagrelor treatment should be initiated with a single 180 mg loading dose (two tablets of 90 mg) and then continued at 90 mg twice daily.
For oral use. Ticagrelor can be taken with or without food. For patients who are unable to swallow the tablet(s) whole, Ticagrelor tablets (90 mg and 2 x 90 mg) can be crushed to a fine powder and mixed in half a glass of water and drunk immediately. The glass should be rinsed with a further half glass of water and the contents drunk. The mixture can also be administered via a nasogastric tube (CH8 or greater). It is important to flush the nasogastric tube through with water after administration of the mixture.
Patients taking Ticagrelor should also take Acetylsalicylic Acid/Aspirin (ASA) daily unless specifically contraindicated. Following an initial dose of ASA, Ticagrelor should be used with a maintenance dose of ASA of 75-150 mg.
Lapses in therapy should be avoided. A patient who missed a dose of Ticagrelor should take one 90 mg tablet (their next dose) at its scheduled time.
Physicians who desire to switch patients from clopidogrel to Ticagrelor should administer the first 90 mg dose of Ticagrelor 24 hours following the last dose of clopidogrel.
Treatment is recommended for at least 12 months unless discontinuation of Ticagrelor is clinically indicated. In patients with Acute Coronary Syndromes (ACS), premature discontinuation with any antiplatelet therapy, including Ticagrelor, could result in an increased risk of cardiovascular death, or myocardial infarction due to the patient's underlying disease.
Special Populations: Paediatric patients: Safety and efficacy in children below the age of 18 have not been established.
Elderly patients: No dose adjustment is required.
Patients with renal impairment: No dose adjustment is necessary for patients with renal impairment. No information is available concerning treatment of patients on renal dialysis.
Patients with hepatic treatment: No dose adjustment is necessary for patients with mild hepatic impairment. Ticagrelor has not been studied in patients with moderate or severe hepatic impairment.