Gretor 90

Prevention of thrombotic events (CV death, MI, & stroke) in patients w/ acute coronary syndrome (ACS) unstable angina, non-ST elevation MI (NSTEMI) or ST elevation MI (STEMI), including patients managed medically, & w/ percutaneous coronary intervention (PCI) or CABG; history of MI (MI occurred at least 1 yr ago) & high risk of developing thrombotic event.

ACS Initially 180 mg loading dose. Administer 90 mg bid during the 1st yr after an ACS event, then 60 mg bid after 1 yr. Use w/ daily maintenance dose of aspirin 75-100 mg.

May be taken with or without food: For patients unable to swallow whole tab, crush & mix w/ water & drink.

Hypersensitivity. Active pathological bleeding eg, peptic ulcer or intracranial hemorrhage. History of intracranial hemorrhage. Severe hepatic impairment.

Increased risk for bleeding in patients w/ a propensity to bleed (eg, due to recent trauma, recent surgery, active or recent GI bleeding, or moderate hepatic impairment); concomitant use of drugs that may increase risk of bleeding (eg, NSAIDs, oral anticoagulants &/or fibrinolytics w/in 24 hr of ticagrelor). Discontinue therapy 5 days prior surgery if patient undergoes elective surgery. Caution in treatment >1 yr in ACS patients w/ prior ischemic stroke. Increased risk of bradycardic events (eg, patients w/o pacemaker w/ sick sinus syndrome, 2nd- or 3rd-degree AV block or bradycardic-related syncope). Consider another antiplatelet agent in case of intolerable dyspnea requiring discontinuation of ticagrelor. TTP. False -ve results in platelet function test for heparin-induced thrombocytopenia. Discontinuation will increase risk of MI, stroke, & death. May affect ability to drive or operate machinery. Patients w/ moderate hepatic impairment. Should be used during pregnancy only if the potential benefit to the mother justifies any potential risks to the fetus. Not recommended during lactation.

Blood disorder bleedings; hyperuricemia; dyspnea. Gout; dizziness, syncope; vertigo; hypotension; resp system bleedings; GI hemorrhage, diarrhea, nausea; SC or dermal bleeding, pruritus; urinary tract bleeding; increased blood creatinine; post procedural hemorrhage, traumatic bleedings.

Increased exposure & risk of dyspnea, bleeding, & other adverse events w/ strong CYP3A4 inhibitors (eg, ketoconazole, itraconazole, voriconazole, clarithromycin, nefazodone, ritonavir, saquinavir, nelfinavir, indinavir, atazanavir & telithromycin). Reduced exposure & efficacy w/ strong CYP3A inducers (eg, rifampin, phenytoin, carbamazepine & phenobarb). Delayed & reduced absorption w/ opioid agonists. Increased serum conc of simvastatin, lovastatin, & atorvastatin. Inhibits P-gp transporter; monitor digoxin levels w/ initiation of or change in ticagrelor therapy. Increased exposure of ethinyl estradiol.

Anticoagulants, Antiplatelets & Fibrinolytics (Thrombolytics)

B01AC24 - ticagrelor ; Belongs to the class of platelet aggregation inhibitors excluding heparin. Used in the treatment of thrombosis.

Rx