Brilinta (ticagrelor) is an oral antiplatelet prescription medication that is usually taken twice a day, in the morning and the evening. It is often prescribed together with aspirin for acute coronary syndrome (severe chest pain or a heart attack) or to help prevent a clot formation in a stent.

• For the above use, the first dose of Brilinta is given as a loading dose which is a higher dose to help achieve therapeutic levels more quickly.
• The manufacturer has shown that Brilinta typically works to inhibit platelets within 30 minutes of taking this loading dose (two 90 mg tablets).

However, one small, open label study demonstrated that despite giving a Brilinta loading dose, it can take from 2 to 11 hours to reach adequate platelet inhibition in patients who have had a heart attack and are receiving a stent.

Responses can be different for different patients, and some patients may need additional antiplatelet therapy when undergoing a stent placement after a heart attack to prevent stent thrombosis.

Brilinta, along with daily aspirin, is also approved (using a lower dose) to reduce the risk of a first heart attack or stroke in patients with coronary artery disease (CAD) at high risk for such events. No loading doses are used for this indication.

Brilinta is also used to help reduce the risk of stroke in patients with acute ischemic stroke or a high-risk transient ischemic attack (TIA). For this use, a loading dose of aspirin and Brilinta is given, followed by maintenance treatment with Brilinta given twice a day along with daily aspirin. Treatment may be continued for up to 30 days. The manufacturer states that the treatment effect accrued early in the course of treatment.

Bottom Line

• The manufacturer of Brilinta, AstraZeneca, has shown that platelet inhibition occurs within 30 minutes of taking a loading dose (two 90 mg tablets). However, effects can be variable and further antiplatelet therapy may be needed in some patients based on therapeutic response.
• Your doctor will decide the most appropriate doses initially and long-term. It is important to follow your doctor’s directions exactly.
• If you stop taking Brilinta too soon, it can increase your risk of a heart attack, stroke or death.

This is not all the information you need to know about Brilinta for safe and effective use. Review the full Brilinta information here, and discuss this information and any questions with your doctor or other health care provider.