Ticagrelor is used to lower your risk of heart attack, stroke, or death due to a blocked artery or a prior heart attack.

Ticagrelor is also used to lower your risk of blood clots if you have coronary artery disease (decreased blood flow to the heart) and have been treated with stents to open clogged arteries.

Ticagrelor is also used to lower your risk of a first heart attack or stroke if you have decreased blood flow to the heart.

Ticagrelor is also used to lower the risk of stroke and death in adults with a blockage or decreased blood flow in an artery that supplies blood to the brain.

Ticagrelor is usually given together with low-dose aspirin. Carefully follow your doctor's dosing instructions. Using too much aspirin can make ticagrelor less effective.

Ticagrelor may also be used for purposes not listed in this medication guide.

You should not use ticagrelor if you have any active bleeding or a history of bleeding in the brain. Do not use ticagrelor just before heart bypass surgery.

Ticagrelor may cause you to bleed more easily, which can be severe or life-threatening. Call your doctor or seek emergency medical attention if you have bleeding that will not stop, black or bloody stools, red or pink urine, or if you cough up blood or vomit that looks like coffee grounds.

Tell your doctor about all your current medicines and any you start or stop using. Many drugs can interact with ticagrelor.

Do not stop taking ticagrelor without first talking to your doctor, even if you have signs of bleeding. Stopping ticagrelor may increase your risk of a heart attack or stroke.

Ticagrelor comes as a tablet to take by mouth. It is usually taken with or without food two times a day. Take ticagrelor at around the same times every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take ticagrelor exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

If you are unable to swallow ticagrelor tablets, you may crush the tablet and mix it with water. Drink the mixture immediately, then refill the glass with water and stir and again drink the mixture immediately. If you have a nasogastric (NG) tube, your doctor or pharmacist will explain how to prepare ticagrelor to give through an NG tube.

Ticagrelor will help prevent serious problems with your heart and blood vessels only as long as you take the medication. Continue to take ticagrelor even if you feel well. Do not stop taking ticagrelor without talking to your doctor. If you stop taking ticagrelor, there is a higher risk that you may have a heart attack or stroke. If you have a stent, there is also a higher risk that you could develop a blood clot in the stent if you stop taking ticagrelor too soon.

Follow all directions on your prescription label and read all medication guides or instruction sheets. Ticagrelor is taken together with aspirin. Use these medicines exactly as directed.

Do not take more aspirin than your doctor has prescribed. Taking too much aspirin can make ticagrelor less effective.

Take ticagrelor at the same times each day, with or without food.

If you cannot swallow a tablet whole, crush the pill and mix it with water. Stir and drink this mixture right away. Add more water to the glass, stir, and drink right away.

Ticagrelor keeps your blood from coagulating (clotting) and can make it easier for you to bleed, even from a minor injury. Contact your doctor or seek emergency medical attention if you have any bleeding that will not stop.

To prevent excessive bleeding, you may need to stop using ticagrelor for a short time before a surgery, medical procedure, or dental work. Any healthcare provider who treats you should know that you are taking ticagrelor.

Do not stop taking ticagrelor without first talking to your doctor, even if you have signs of bleeding. Stopping the medicine could increase your risk of a heart attack or stroke.

ticagrelor may affect medical testing for platelets in your blood and you may have false results. Tell the laboratory staff that you use ticagrelor.

Store at room temperature away from moisture and heat.

You should not use ticagrelor if you are allergic to it, or if you have:

• any active bleeding; or

• a history of bleeding in the brain (such as from a head injury).

Tell your doctor if you have ever had:

• a stroke;

• heart problems;

• a surgery or bleeding injury;

• bleeding problems;

• a stomach ulcer or colon polyps;

• liver disease; or

• asthma, COPD (chronic obstructive pulmonary disorder) or other breathing problem.

It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

You should not breastfeed while using ticagrelor.

Skip the missed dose and use your next dose at the regular time. Do not use two doses at one time.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Overdose can cause excessive bleeding.

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

Unless your doctor tells you otherwise, continue your normal diet.

Drinking alcohol while taking aspirin can increase your risk of stomach bleeding.

Avoid activities that may increase your risk of bleeding or injury. Use extra care to prevent bleeding while shaving or brushing your teeth.

While taking ticagrelor with aspirin, avoid using medicines for pain, fever, swelling, or cold/flu symptoms. They may contain ingredients similar to aspirin (such as salicylates, ibuprofen, ketoprofen, or naproxen). Taking certain products together can cause you to get too much aspirin which can increase your risk of bleeding.

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Ticagrelor may cause serious side effects. Call your doctor at once if you have:

• slow heartbeats;

• nosebleeds, or any bleeding that will not stop;

• shortness of breath even with mild exertion or while lying down;

• easy bruising, unusual bleeding, purple or red spots under your skin;

• red, pink, or brown urine;

• black, bloody, or tarry stools; or

• coughing up blood or vomit that looks like coffee grounds.

Common side effects of ticagrelor may include:

• bleeding; or

• shortness of breath.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Sometimes it is not safe to use certain medications at the same time. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective.

Tell your doctor about all your current medicines. Many drugs can affect ticagrelor, especially:

• antifungal medicine;

• antiviral medicine to treat HIV or AIDS;

• a blood thinner;

• cholesterol medication;

• heart or blood pressure medication;

• opioid medication;

• seizure medicine; or

• tuberculosis medicine.

This list is not complete and many other drugs may affect ticagrelor. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Keep all appointments with your doctor and the laboratory. Your doctor may order certain lab tests to check your body's response to ticagrelor.

Before having any laboratory test, tell your doctor and the laboratory personnel that you are taking ticagrelor.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.