Ticagrelor

About ticagrelor

Ticagrelor is an antiplatelet medicine. It makes your blood flow through your veins more easily. This means your blood will be less likely to make a dangerous blood clot.

Taking ticagrelor can help prevent blood clots if you have an increased risk of having them.

Your risk is higher if you have:

Ticagrelor is only available on prescription. It comes as tablets or melt in the mouth tablets.

Key facts

Who can and cannot take ticagrelor

Ticagrelor can be taken by adults aged 18 and over.

Ticagrelor is not suitable for some people. To make sure this medicine is safe for you, tell your doctor if you:

How and when to take ticagrelor

Dosage

Always follow your doctor's instructions when taking ticagrelor.

Ticagrelor comes as 90mg tablets. It's also available as 60mg tablets for people who need a lower dose.

On your first day of treatment, your pharmacist will give you two 90mg tablets to take at the same time. After this, the usual dose is 90mg twice a day for 12 months.

If you have had a heart attack, your doctor may advise you to keep on taking ticagrelor after you've finished the 12-month course of treatment. You'll usually take a lower dose of 60mg, twice a day, for up to 3 years.

How and when to take ticagrelor

When you start taking ticagrelor, you'll take 1 dose on your first day.

After this, most people take ticagrelor twice a day, usually once in the morning and once in the evening.

You can take ticagrelor with or without food.

If you're taking melt in the mouth tablets, put the tablet on your tongue and let it dissolve. You can then swallow it with or without water.

What if I forget to take it?

If you forget to take ticagrelor, take it as soon as you remember. If it's nearly time for your next dose, skip the missed dose and take your next dose at the usual time.

Do not take a double dose to make up for a forgotten dose.

If you often forget doses, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.

What if I take too much?

Taking 1 or 2 extra tablets is unlikely to harm you.

But the amount of ticagrelor that can lead to overdose is different for everyone.

Contact your doctor if you have taken some extra tablets and notice any signs of bleeding.

Side effects

Common side effects

Like all medicines, ticagrelor can cause side effects, although not everyone gets them.

These common side effects happen in more than 1 in 100 people.

Talk to your doctor or pharmacist if these side effects bother you or do not go away:

Serious side effects

Serious side effects are rare and happen in less than 1 in 1,000 people.

Tell a doctor as soon as possible if you are coughing up blood, or there's blood in your pee, poo or vomit. This needs to be checked out as these are signs of internal bleeding.

Call 999 or go to A&E now if:

  • you have weakness on one side of your body, trouble speaking or thinking, loss of balance or blurred eyesight – these can be signs of a stroke

Serious allergic reaction

In rare cases, ticagrelor can cause a serious allergic reaction (anaphylaxis).

These are not all the side effects of ticagrelor. For a full list, see the leaflet inside your medicines packet.

How to cope with side effects of ticagrelor

What to do about:

Pregnancy and breastfeeding

Ticagrelor and pregnancy

Ticagrelor is not recommended during pregnancy or if you're trying to get pregnant.

It's important to use contraception while you're taking ticagrelor to avoid becoming pregnant.

Talk to your doctor if you take ticagrelor and are trying to get pregnant. They may be able to recommend a more suitable medicine for you.

Ticagrelor and breastfeeding

Only take ticagrelor while breastfeeding if your doctor advises you to.

It's not known how much ticagrelor gets into breast milk, but it's likely to be a small amount, and your baby will not absorb a lot into their body from the breast milk.

If your doctor says it's OK for you to keep taking ticagrelor, then monitor your baby for any possible side effects, such as bruises or bleeding more easily than usual. However, it is unlikely that ticagrelor will cause any side effects in your baby.

Talk to your doctor, pharmacist, midwife or health visitor if you have any concerns about your baby while you're breastfeeding.

Cautions with other medicines

Taking ticagrelor with everyday painkillers

Some medicines affect the way ticagrelor works.

Tell your doctor if you're taking any of these medicines before you start taking ticagrelor:

Your doctor may prescribe low-dose aspirin (75mg tablets) to take together with ticagrelor.

Do not take aspirin for pain relief (300mg tablets) or ibuprofen while you're taking ticagrelor, unless a doctor has said it's OK. They increase the chance of bleeding.

You can take paracetamol together with ticagrelor.

Mixing ticagrelor with herbal remedies and supplements

There might be a problem with taking some herbal remedies and supplements with ticagrelor, especially ones that can affect your blood (for example, ginkgo).

St John's wort (used for depression) can reduce the levels of ticagrelor in your blood. This may stop ticagrelor from working properly and increase your chances of getting a blood clot.

Common questions about ticagrelor

How does ticagrelor work? How long does it take to work? When will I feel better? How long will I take it for? Is it safe to take it for a long time? What will happen if I stop taking it? Are there any other similar medicines to prevent blood clots? How does ticagrelor compare with other antiplatelet medicines like clopidogrel? Can I drink alcohol with it? Is there any food or drink I need to avoid? Can I take indigestion medicines at the same time? Will I need to stop ticagrelor before having surgery or dental treatment? Can I have vaccinations? Will it affect my contraception? Will it affect my fertility? Will it affect my sex life? Will it affect my periods? Can I drive or ride a bike? Can lifestyle changes help?