Long-term use of ticagrelor, these 5 medication details must be known

For patients with acute coronary syndrome and those after PCI, dual-antibody therapy is the basis of antithrombotic therapy. Among them, aspirin combined with a P2Y12 receptor inhibitor is commonly used in clinical practice. The first P2Y12 receptor inhibitor recommended in the guidelines is ticagrelor. So, for long-term use of ticagrelor, these five medication details must be kept in mind, otherwise it will be in vain.

1. Indications

Used in combination with aspirin, it is used in patients with acute coronary syndrome or a history of myocardial infarction and at least one high-risk factor for atherosclerosis and thrombosis.

2. Usage and Dosage

Food does not affect the absorption of the drug, so it can be taken before or after meals. Swallow the whole tablet. Patients who cannot swallow the whole tablet can crush it and take it, or it can be administered through a nasal cannula.

For patients with acute coronary syndrome, the starting dose is 180 mg and the maintenance dose is 90 mg twice a day for one year; for patients with a history of myocardial infarction, the recommended dose is 60 mg twice a day.

3. Adverse Reactions

Dyspnea is a common adverse reaction, which may be related to the increase in plasma adenosine concentration. Therefore, patients with asthma or COPD should use this drug with caution.

The risk of bleeding with long-term use of Ticagrelor is higher than that with clopidogrel, such as intracranial hemorrhage, gastrointestinal bleeding, hematuria, subcutaneous hemorrhage, nosebleed, etc. In addition, if surgery is required during the use of Ticagrelor, such as tooth extraction, cataracts, etc., it is necessary to inform the doctor in time.

4. Interaction

Ticagrelor is mainly metabolized by CYP3A4, and a small part is metabolized by CYP3A5. Therefore, during use, it should be avoided to use it in combination with CYP3A4 enzyme inducers (such as rifampicin, carbamazepine, phenobarbital, etc.), inhibitors (voriconazole, ketoconazole, clarithromycin, etc.) or substrates (atorvastatin) to avoid fluctuations in drug blood concentrations.

5. Treatment of missed doses

During the treatment, you should try to avoid missing doses. If you accidentally miss a dose, there is no need to make up for it. Just take it normally at the next scheduled time.