Type:10 Tablets
Generic Name:Ticagrelor
Manufacturer:Ziska Pharmaceuticals Ltd.
Price:৳480.00
Prevention of thrombotic events, [cardiovascular death (CV), myocardial infarction (MI) and stroke] in patients with acute coronary syndromes (ACS) [unstable angina, non-ST elevation myocardial infarction (NSTEMI) or ST elevation myocardial infarction (STEMI)]; including patients managed with percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG).
May be taken with or without food.
Oral Acute coronary syndrome Adult: Loading dose (following ACS event): 180 mg PO (two 90 mg tablets) Maintenance dose (for first year following ACS event): 90 mg PO BID Maintenance dose (after 1 year with history of MI): 60 mg PO BID Administer with aspirin: Initial aspirin loading dose of 325 mg, then maintenance dose of aspirin of 75-100 mg/day; DO NOT exceed aspirin dose of 100 mg/day. Hepatic Impairment Moderate to severe: Contraindicated.
Renal impairment No dosage adjustment needed
History of Intracranial Hemorrhage: Ticagrelor is not recommended in patients with a history of intracranial hemorrhage (ICH) due to a high risk of recurrent ICH in this population. Active Bleeding: Patients with active pathological bleeding eg, peptic ulcer or intracranial hemorrhage. Severe Hepatic Impairment: Patients with severe hepatic impairment because of a probable increase in exposure, and it has not been studied in these patients. Severe hepatic impairment increases the risk of bleeding because of reduced synthesis of coagulation proteins. Hypersensitivity (eg, angioedema) to ticagrelor or to any of the components.
Ticagrelor and its major metabolite reversibly interact with the platelet P2Y12 ADP-receptor to prevent signal transduction and platelet activation. Ticagrelor and its active metabolite are approximately equipotent.
Patients w/ increased risk of bleeding (e.g. patients who are likely to undergo surgery or invasive procedures). Patients at risk of bradycardic events; w/ history of asthma or COPD, hyperuricaemia or gouty arthritis. Pregnancy and lactation. Lactation: Unknown whether distributed in human breast milk; potential for serious adverse reactions in breastfed infants, a decision should be made whether to discontinue nursing or to discontinue drug, taking into account the importance of the drug to the mother
>10% Dyspnea (13.8%),Bleeding 1-10% Headache (6.5%),Cough (4.9%),Dizziness (4.5%),Nausea (4.3%),Atrial fibrillation (4.2%),Hypertension (3.8%),Noncardiac chest pain (3.7%),Diarrhea (3.7%),Back pain (3.6%),Hypotension (3.2%),Fatigue (3.2%),Chest pain (3.1%),Syncope (1.7%) <1% Dyspena (0.9%) Bleeding Non-CABG related bleeds Total bleeds (major + minor) (8.7%) Major bleeds (4.5%) Fatal/life-threatening (2.1%) Fatal (0.2%) Intracranial (fatal/life-threatening) (0.3%) CABG related bleeds Total major bleeds (85.8%) Major bleeds when antiplatelet therapy stopped 5 days before CABG (75%) Fatal/life-threatening (48.1%) Fatal (0.9%)
Aminocaproic acid or tranexamic acid &/or recombinant clotting factor VIIa may augment haemostatis. NSAIDs, oral anticoagulants &/or fibrinolytics, ketoconazole, clarithromycin, nefazodone, ritonavir, atazanavir, rifampin, dexamethasone, phenytoin, carbamazepine, phenobarb, simvastatin >40 mg, digoxin. Increased Cmax & AUC w/ cyclosporine.
