Reduce rate of CV death, MI, & stroke in patients w/ acute coronary syndrome (ACS) or history of MI; stent thrombosis in patients who have been stented for treatment of ACS.
ACS management Loading dose: 180 mg. Administer 90 mg bid during the 1st yr after an ACS event, then 60 mg bid after 1 yr. Use w/ a daily maintenance aspirin dose of 75-100 mg.
View Ticalor overdosage for action to be taken in the event of an overdose.
Administration
May be taken with or without food: For patients unable to swallow tab whole, tab can be crushed, mixed w/ water & drunk. Mixt can also be administered via nasogastric tube.
Contraindications
Hypersensitivity. Patients w/ history of intracranial hemorrhage. Active pathological bleeding eg, peptic ulcer or intracranial hemorrhage.
Do not administer w/ another oral P2Y12 platelet inhibitor. Increased risk of bleeding; can cause significant, sometimes fatal bleeding. Stopping therapy increases the risk of subsequent CV events; manage bleeding w/o discontinuation if possible. Dyspnea. Patients w/ a history of sick sinus syndrome, 2nd or 3rd degree AV block or bradycardia-related syncope not protected by a pacemaker may be at increased risk of developing bradyarrhythmias. Interrupt therapy for 5 days prior to surgery that has major risk of bleeding; resume as soon as hemostasis is achieved. Do not start therapy in patients undergoing urgent CABG. Avoid use in patients w/ severe hepatic impairment. Not recommended during lactation. Safety & effectiveness in ped patients have not been established.
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