Brilinta Dosage/Direction for Use

Ticagrelor (BRILINTA) 90 mg: In patients with Acute Coronary Syndromes, Ticagrelor (BRILINTA) treatment should be initiated with a single 180 mg loading dose (two tablets of 90 mg) and then continued at 90 mg twice daily. Treatment is recommended for at least 12 months unless discontinuation of Ticagrelor (BRILINTA) is clinically indicated (see Pharmacology: Pharmacodynamics under Actions). After one year, patients initiated on 90 mg twice daily may continue treatment with 60 mg twice daily without interruption.
In patients with Acute Ischaemic Stroke or Transient Ischaemic Attack, initiate Ticagrelor (BRILINTA) with a single 180 mg loading dose (two tablets of 90 mg) and then continue with 90 mg twice daily for 30 days (see Pharmacology: Pharmacodynamics under Actions).
Patients taking Ticagrelor (BRILINTA) should also take a daily low maintenance dose of acetylsalicylic acid (ASA) of 75-150 mg, unless specifically contraindicated. An initial loading dose of ASA is recommended for patients with ACS, acute ischaemic stroke or TIA (see Pharmacology: Pharmacodynamics under Actions).
Ticagrelor (BRILINTA) 90 mg: Missed dose: Lapses in therapy should be avoided. A patient who misses a dose of Ticagrelor (BRILINTA) should take their next dose at its scheduled time.
Premature discontinuation: Premature discontinuation with any antiplatelet therapy, including Ticagrelor (BRILINTA), could result in an increased risk of cardiovascular (CV) death, MI, or stroke due to the patient's underlying disease (see Precautions).
Switching: In patients having an ACS event, the loading dose of 180 mg should be given as soon as possible regardless of any previous antiplatelet treatment.
Physicians who desire to switch patients, with a prior ACS event to Ticagrelor (BRILINTA), should administer the first dose of Ticagrelor (BRILINTA) 24 hours following the last dose of the other antiplatelet medication.
Special Populations: Paediatric patients: Safety and efficacy in children below the age of 18 have not been established (see Pharmacology: Pharmacodynamics under Actions).
Elderly patients: No dose adjustment is required.
Patients with renal impairment: No dose adjustment is necessary for patients with renal impairment (see Pharmacology: Pharmacokinetics under Actions).
Patients with hepatic impairment: No dose adjustment is necessary for patients with mild hepatic impairment. Ticagrelor (BRILINTA) has not been studied in patients with severe hepatic impairment and there is limited information on treatment of patients with moderate hepatic impairment (see Contraindications, Precautions and Pharmacology: Pharmacokinetics under Actions).
Administration: For oral use. Ticagrelor (BRILINTA) can be taken with or without food.
For patients who are unable to swallow the tablet(s) whole, Ticagrelor (BRILINTA) tablets can be crushed to a fine powder and mixed in half a glass of water and drunk immediately. The glass should be rinsed with a further half glass of water and the contents drunk. The mixture can also be administered via a nasogastric tube (CH8 or greater). It is important to flush the nasogastric tube through with water after administration of the mixture.