Bleeding Risk; Aspirin and Brilinta Effectiveness
- Ticagrelor, like other antiplatelet agents, can cause significant, sometimes fatal, bleeding.
- Do not use ticagrelor in patients with active pathological bleeding or a history of intracranial hemorrhage.
- Do not start ticagrelor in patients planned to undergo urgent coronary artery bypass graft surgery (CABG). When possible, discontinue ticagrelor at least 5 days prior to any surgery.
- Suspect bleeding in any patient who is hypotensive and has recently undergone coronary angiography, percutaneous coronary intervention (PCI), CABG, or other surgical procedures in the setting of ticagrelor.
- If possible, manage bleeding without discontinuing ticagrelor. Stopping ticagrelor increases the risk of subsequent cardiovascular events.
Aspirin Dose and Reduced Ticagrelor Effectiveness
- Maintenance doses of aspirin above 100 mg reduce the effectiveness of ticagrelor and should be avoided. After any initial dose, use with aspirin 75 to 100 mg per day.
Patient Counseling Information
Updated January 2018