Brilinta is a brand-name prescription drug that’s used in certain adults to lower the risk of:

  • Serious cardiovascular events. These events include heart attack, stroke, and death caused by heart problems. For this use, Brilinta is prescribed for people with acute coronary syndrome (ACS) or for people who’ve had a heart attack in the past. (With ACS, you have certain conditions that reduce blood flow to your heart.)
  • Blood clots. For this use, Brilinta is prescribed for people with ACS who’ve had a stent placed in one or more blood vessels in their heart. (Stents are small metal devices that keep your blood vessels open, allowing blood to flow through them.)
  • Heart attack and stroke. For this use, Brilinta is prescribed for people with coronary artery disease (CAD) who have an increased risk for heart attack or stroke. But these people haven’t had a heart attack or stroke in the past. (With CAD, the blood vessels in your heart muscle are narrowed.)
  • Stroke. For this use, Brilinta is prescribed for people who are having either a stroke caused by a blocked blood vessel or a transient ischemic attack (TIA). (With a TIA, you have temporary, stroke-like symptoms.)

Drug class and form

Brilinta contains the active drug ticagrelor. It belongs to a class of drugs called antiplatelets.

Brilinta comes as a tablet that’s taken by mouth twice a day. It’s available in two strengths: 60 mg and 90 mg. And it should be used in combination with aspirin.

Effectiveness

Brilinta has been found effective in preventing heart attack, stroke, and death caused by heart problems in certain people. For information about Brilinta’s effectiveness, see the “Brilinta uses” section below.

Brilinta is available only as a brand-name medication. A generic form of the drug has been approved, but it may not be available at pharmacies yet.

A generic drug is an exact copy of the active drug in a brand-name medication. The generic is considered to be as safe and effective as the original drug.

Brilinta contains the active drug ticagrelor.

Brilinta can cause mild or serious side effects. The following lists contain some of the key side effects that were seen in clinical studies of people taking Brilinta. (Most of the people who took Brilinta were also taking aspirin). These lists do not include all possible side effects.

For more information on the possible side effects of Brilinta, talk with your doctor or pharmacist. They can give you tips on how to deal with any side effects that may be bothersome.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs they have approved. If you would like to report to the FDA a side effect you’ve had with Brilinta, you can do so through MedWatch.

More common side effects

The more common side effects of Brilinta can include:

These side effects may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk with your doctor or pharmacist.

Serious side effects

Serious side effects from Brilinta aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency.

Serious side effects and their symptoms can include the following:

  • Major bleeding, which may require medical treatment.* Symptoms can include:
    • urine that looks red, pink, or brown in color
    • stool that looks red or black in color
    • bleeding that you can’t stop, from anywhere in your body
  • Abnormal bradycardia (slow heart rate).†
  • Severe allergic reaction.†

* Brilinta has a boxed warning from the FDA regarding the risk of major bleeding. A boxed warning is the strongest warning the FDA requires. It alerts doctors and patients about drug effects that may be dangerous. For more information on Brilinta’s boxed warning, see the “FDA warnings” section at the beginning of this article.
† For more information about this side effect, see the “Side effect details” section below.

Side effect details

You may wonder how often certain side effects occur with this drug, or whether certain side effects pertain to it. Here’s some detail on several of the side effects this drug may or may not cause.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Brilinta.

Severe allergic reactions have been reported in clinical studies of Brilinta. However, it’s not known for sure how many people taking Brilinta have had an allergic reaction to the drug.

Symptoms of a mild allergic reaction can include:

  • skin rash
  • itchiness
  • flushing (warmth and redness in your skin)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your tongue, mouth, or throat
  • trouble breathing or speaking

Call your doctor right away if you have a severe allergic reaction to Brilinta. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency.

Shortness of breath

Shortness of breath is one of the most common side effects of Brilinta. In clinical studies, about 14% to 21% of people who took Brilinta had shortness of breath. In comparison, this side effect happened in 8% of people taking clopidogrel. (Most of the people who took either Brilinta or clopidogrel were also taking aspirin.) Of people who took aspirin alone, 6% had shortness of breath.

In these studies, people’s shortness of breath was generally mild.

However, some people stopped taking Brilinta because their shortness of breath was bothersome. In separate clinical studies, the percentage of people who stopped treatment due to this side effect was:

  • 0.9% of people using Brilinta, compared with 0.1% of people taking clopidogrel
  • 1.0% of people using Brilinta, compared with 0.2% of people taking aspirin alone
  • 6.9% of people using Brilinta, compared with 0.8% of people taking aspirin alone

Additionally, one clinical study tested people’s lung function for long-term problems caused by Brilinta treatment. The study found no long-term lung problems related to Brilinta use, regardless of whether people had shortness of breath during treatment.

There have also been reports of central sleep apnea (CSA) with Brilinta use. CSA is a condition that causes shortness of breath and other breathing problems during sleep. This side effect wasn’t reported in clinical studies of Brilinta. But it has been reported since the drug was approved for use.

Shortness of breath typically goes away after you’ve been taking Brilinta for a while. However, if you have trouble breathing while you’re taking Brilinta, including trouble breathing while sleeping, talk with your doctor. They’ll check to see what’s causing your breathing problems. They can also determine if you should stop Brilinta treatment.

If you have severe shortness of breath, or you think you’re having a medical emergency, call 911 right away. In some cases, shortness of breath can indicate serious problems with your heart or lungs.

If you need to stop taking Brilinta because of shortness of breath, your doctor will likely prescribe a different antiplatelet drug for you to take.

Rash

During clinical studies, rash wasn’t reported as a side effect of Brilinta. However, rash has been noted in post-marketing reports of Brilinta.

With post-marketing reports, healthcare professionals or people taking a drug report side effects to either the drug’s manufacturer or to the FDA. These reports are voluntary. Because of this, it’s not possible to know how common the side effect is or whether the drug caused the side effect.

In some cases, rash may be a symptom of an allergic reaction to Brilinta. If you have a rash along with other serious symptoms of an allergic reaction (such as trouble breathing), or you feel like you’re having a medical emergency, call 911 right away.

If you have a mild rash while taking Brilinta, tell your doctor. They’ll check to see what’s causing your rash, and if needed they’ll recommend ways to treat it.

Bruising

Bruising may occur during Brilinta treatment. This is because Brilinta stops your blood from forming clots as it usually does. Since your blood doesn’t form clots like usual, bleeding and bruising (which is bleeding that happens underneath your skin) occur more easily during treatment.

If you have more bruising or bleeding than usual, tell your doctor. If you have bruising with bleeding that doesn’t stop, call your doctor right away or call 911. Your doctor will determine if it’s safe for you to continue taking Brilinta.

Diarrhea

Diarrhea wasn’t a common side effect of Brilinta during clinical trials. However, in one clinical study of people who took Brilinta with aspirin, 3.3% of people had diarrhea. In comparison, 2.5% of people who took aspirin alone had diarrhea.

If you have diarrhea while you’re taking Brilinta, tell your doctor. They’ll check to see what’s causing your diarrhea and recommend if you need any treatment.

If you have diarrhea that looks red or black in color, or has any blood in it, tell your doctor right away. If you have bleeding in your stool that seems like a medical emergency, call 911.

Abnormal bradycardia

Bradycardia (slow heart rate) has occurred in people taking Brilinta. In some cases, slow heart rates caused fainting or heartbeat skipping or stoppage.

In a clinical trial, 6% of people taking Brilinta had bradycardia within the first few days of treatment. In comparison, 3.5% of people taking clopidogrel had the same result. (Most of the people who took either Brilinta or clopidogrel were also taking aspirin.)

However, the percentage of people who still had bradycardia after 1 month of treatment decreased. After 1 month, 2.2% of people who took Brilinta had bradycardia, compared to 1.6% of people who took clopidogrel.

Symptoms of bradycardia include:

If you have symptoms of bradycardia while you’re taking Brilinta, tell your doctor. They’ll determine if you have bradycardia. They’ll also recommend if it’s safe for you to take Brilinta.

Cough (not a side effect)

Cough wasn’t reported as a side effect during clinical studies of Brilinta.

But if you have a cough while you’re taking Brilinta, tell your doctor. They can check to see what’s causing your cough and recommend ways to relieve it.

In rare cases, a cough may be related to bleeding in your stomach. If you’re coughing up blood or phlegm that looks like coffee grounds, tell your doctor right away.

Other drugs are available that can reduce your risk of developing blood clots or having cardiovascular events, such as heart attack or stroke.

If you’re interested in finding an alternative to Brilinta, talk with your doctor. They can tell you about other medications that may work well for you.

Other drugs that are used to reduce your risk of developing blood clots or having cardiovascular events include:

  • clopidogrel (Plavix)
  • prasugrel (Effient)
  • dipyridamole (Persantine)
  • dipyridamole/aspirin (Aggrenox)
  • ticlopidine
  • eptifibatide
  • warfarin (Jantoven)
  • heparin
  • rivaroxaban (Xarelto)
  • apixaban (Eliquis)
  • dabigatran (Pradaxa)
  • edoxaban (Savaysa)
  • enoxaparin (Lovenox)
  • fondaparinux (Arixtra)

Note: Some of the drugs listed above are used off-label to treat these specific conditions. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.

You may wonder how Brilinta compares to other medications that are prescribed for similar uses. Here we look at how Brilinta and Plavix are alike and different.

Ingredients

Brilinta contains the drug ticagrelor, while Plavix contains the drug clopidogrel. Both medications belong to a class of drugs called antiplatelets.

Uses

Brilinta and Plavix are each approved by the Food and Drug Administration (FDA) to reduce the risk of cardiovascular events, such as heart attack and stroke. For this use, Brilinta and Plavix are given to people with acute coronary syndrome (ACS) or people who’ve had a heart attack in the past. (ACS includes certain conditions that reduce blood flow to your heart.)

Brilinta is also used to prevent:

  • Blood clots in people with ACS who’ve had a stent placed in one or more blood vessels in their heart. (Stents are small metal devices that keep your blood vessels open, allowing blood to flow through them.)
  • Heart attack and stroke in people with coronary artery disease (CAD) who have an increased risk for heart attack or stroke. But these people haven’t had a heart attack or stroke in the past. (With CAD, the blood vessels in your heart muscle are narrowed.)
  • Stroke in people who are having either a stroke caused by a blocked blood vessel or a transient ischemic attack (TIA). (With a TIA, you have temporary, stroke-like symptoms.)

Plavix is also approved to prevent cardiovascular events in people who either have had a stroke or have peripheral arterial disease (PAD).

Drug forms and administration

Brilinta and Plavix each come as tablets that are taken by mouth. Brilinta is taken twice daily, while Plavix is taken once daily.

Both medications should be taken in combination with aspirin each day.

Side effects and risks

Brilinta and Plavix both contain antiplatelets. Therefore, both medications can cause very similar side effects. Below are examples of these side effects.

More common side effects

These lists contain examples of more common side effects that can occur with Brilinta, with Plavix, or with both drugs (when taken individually).

  • Can occur with Brilinta:
  • Can occur with Plavix:
    • few unique common side effects
  • Can occur with both Brilinta and Plavix:
    • bleeding or bruising more often than usual

Serious side effects

These lists contain examples of serious side effects that can occur with Brilinta, with Plavix, or with both drugs (when taken individually).

  • Can occur with Brilinta:
  • Can occur with Plavix:
  • Can occur with both Brilinta and Plavix:
    • major bleeding, which may require medical treatment*
    • severe allergic reaction

* Brilinta has a boxed warning from the FDA regarding the risk of major bleeding. A boxed warning is the strongest warning the FDA requires. It alerts doctors and patients about drug effects that may be dangerous. For more information on Brilinta’s boxed warning, see the “FDA warnings” section at the beginning of this article.

Effectiveness

Brilinta and Plavix are each used to reduce the risk of cardiovascular events, such as heart attack and stroke. These medications are prescribed for people with acute coronary syndrome (ACS) or those who’ve had a heart attack in the past.

The use of Brilinta and Plavix for this purpose has been directly compared in several clinical studies.

One clinical study looked at people with ACS who’d had symptoms of a heart attack within the past 24 hours. The people took aspirin with either Brilinta or clopidogrel (Plavix). Over the course of 1 year, people taking the Brilinta combination had a 16% lower risk of heart attack, stroke, and death caused by heart problems than did people taking the clopidogrel combination.

However, a pooled analysis of several clinical studies found that Brilinta and Plavix were similarly effective for reducing the risk of cardiovascular events, such as heart attack and stroke. This analysis also found that the risk of bleeding was similar for both of these drugs.

Costs

Brilinta and Plavix are both brand-name drugs. A generic form of Brilinta has been approved, but it may not be available at pharmacies yet. A generic form of Plavix is available, which is called clopidogrel. Generic medications usually cost less than brand-name medications.

Brilinta may cost more than Plavix. The generic form of Plavix costs less than either brand-name drug. The actual price you’ll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.

Here are answers to some frequently asked questions about Brilinta.

Is Brilinta a blood thinner or anticoagulant?

Yes, Brilinta is considered a blood thinner. It’s an antiplatelet drug that works by stopping your platelets from being activated. Platelets are cells that stick together and form clots. So, by stopping the cells from being activated, Brilinta helps keep your blood thin and free of clots.

Brilinta isn’t classified as an anticoagulant. Anticoagulants work differently from antiplatelets. Instead of working on platelets, anticoagulants affect certain proteins that help blood clot. Different anticoagulants affect different proteins in the blood. By doing this, anticoagulants increase the amount of time it takes for blood to clot.

If you’d like to know more about how Brilinta works, see the “How Brilinta works” section below.

Does caffeine help relieve shortness of breath that’s caused by Brilinta?

It’s not known for sure if caffeine will help relieve shortness of breath caused by Brilinta. One clinical study found that consuming caffeine had no effect on shortness of breath in people taking Brilinta. However, the study did find that consuming caffeine was safe for most people taking Brilinta.

If you’re having shortness of breath while you’re taking Brilinta, talk with your doctor. They can recommend ways to help reduce this side effect.

Do I need to avoid certain foods while I’m taking Brilinta?

Yes, eating grapefruit or drinking grapefruit juice while using Brilinta may increase your risk for side effects of Brilinta, such as bleeding. This is because grapefruit prevents the breakdown of Brilinta in your body, which leads to increased levels of Brilinta in your blood.

On the other hand, the effectiveness of Brilinta isn’t affected by your diet. Brilinta is an antiplatelet drug, which is different than an anticoagulant drug, such as warfarin.

The effectiveness of anticoagulant drugs can be affected by eating foods that are high in vitamin K. This can include foods such as leafy greens. But that’s not the case for antiplatelet drugs including Brilinta.

For information about maintaining a healthy diet while you’re taking Brilinta, talk with your doctor.

I’m going to have surgery, do I need to stop taking Brilinta?

Possibly, but it depends on the type of surgery you’re going to have.

If you’re going to have a surgery that has a major risk of bleeding (such as surgery in your stomach), you’ll likely need to stop taking Brilinta for 5 days before your surgery. This allows your platelets to start working as they did without Brilinta treatment. Your platelets will work to control bleeding and help prevent serious bleeds during and after your surgery. After the surgery, your doctor will advise when it’s safe for you to start taking Brilinta again.

If you’re going to have surgery that doesn’t have a major risk for bleeding, you may be able to keep taking Brilinta without a break.

Be sure that all members of your healthcare team know that you’re taking Brilinta if you’re going to have surgery. Your healthcare professionals will recommend the appropriate length of time to stop the drug, if needed.

If you’d like to know more about taking Brilinta around the time of surgery, talk with your doctor.

Can I take Tylenol with Brilinta?

Most people can take Tylenol (acetaminophen) with Brilinta. However, if you need to take an over-the-counter pain medication, such as Tylenol, talk with your doctor or pharmacist. They can let you know whether it’s safe for you to take the medication.

If I stop taking Brilinta, will I have withdrawal symptoms?

There aren’t any known withdrawal symptoms linked to Brilinta use.

After you stop taking Brilinta, it takes several days for your platelets to begin working like they did prior to treatment. (Platelets are blood cells that help your blood clot.) However, there aren’t any symptoms related to this process.

It’s important that you don’t stop taking Brilinta until your doctor tells you it’s safe to stop. Doing so can increase your risk of heart attack, stroke, or blood clots. Your exact risk depends on the reason you’re taking the drug. In some cases, your doctor may suggest stopping after 1 year. But they’ll tell you how long you should take Brilinta.

If you have any unusual symptoms after stopping Brilinta, tell your doctor. They’ll check to see what’s causing your symptoms and recommend treatment if needed.

Can I take a drug like omeprazole for acid reflux while I’m using Brilinta?

Yes, probably. Omeprazole (Prilosec OTC), which belongs to a class of drugs called proton pump inhibitors, is used to treat acid reflux.

It’s safe to take omeprazole for acid reflux treatment while you’re using Brilinta. In fact, there aren’t any known interactions between Brilinta and any proton pump inhibitors.

If you have acid reflux, talk with your doctor. They’ll recommend the best treatment option for you.

The Brilinta dosage your doctor prescribes will depend on how long you’ve been taking Brilinta.

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to suit your needs.

Drug forms and strengths: 60 mg and 90 mg

Brilinta contains the active drug ticagrelor. It comes as 60-milligram (mg) and 90-mg tablets that are taken by mouth.

Dosage for preventing cardiovascular events

The usual dosage of Brilinta for preventing cardiovascular events in people who have either acute coronary syndrome (ACS) or history of heart attack is as follows:

  • On the first day of treatment, you’ll take a one-time loading dose of 180 mg. (A loading dose is a higher-than-usual dose that’s given so that there’s enough medication in your body to start working right away.)
  • Then, you’ll take 90 mg twice daily for 1 year.
  • Starting in the second year of treatment, you’ll take 60 mg twice each day. You’ll continue to take this dosage for as long as your doctor recommends.

Brilinta should be taken in combination with aspirin each day. The recommended daily dosage of aspirin for this use is 75 mg to 100 mg.

Dosage for preventing blood clots following stent placement

The usual dosage of Brilinta for preventing blood clots in people with ACS who’ve had a stent placed is as follows:

  • On the first day of treatment, you’ll take a one-time loading dose of 180 mg. (A loading dose is a higher-than-usual dose that’s given so that there’s enough medication in your body to start working right away.)
  • Then, you’ll take 90 mg twice daily for 1 year.
  • Starting in the second year, you’ll take 60 mg twice each day. You’ll continue to take this dosage for as long as your doctor recommends.

Brilinta should be taken in combination with aspirin each day. The recommended daily dosage of aspirin for this use is 75 mg to 100 mg.

Dosage for preventing heart attack and stroke

The usual dosage of Brilinta for preventing heart attack and stroke in people with coronary artery disease (CAD) who have an increased risk for heart attack or stroke but haven’t had one in the past is as follows:

  • You’ll take 60 mg of Brilinta twice a day for as long as your doctor recommends.

Brilinta should be taken in combination with aspirin each day. The recommended daily dosage of aspirin for this use is 75 mg to 100 mg.

Note: If you have ACS, which is a specific type of CAD, see the dosage section above called “Dosage for preventing cardiovascular events.”

Dosage for preventing stroke

The usual dosage of Brilinta for preventing stroke in people who are having either a stroke caused by a blocked blood vessel or a transient ischemic attack (TIA) is as follows:

  • On the first day of treatment, you’ll take a one-time loading dose of 180 mg. (A loading dose is a higher-than-usual dose that’s given so that there’s enough medication in your body to start working right away.)
  • Then, you’ll take 90 mg twice daily for up to 30 days.

Brilinta should be taken in combination with aspirin each day. The recommended loading dose of aspirin for this use is 300 mg to 325 mg. Then, you’ll take a daily dosage of 75 mg to 100 mg of aspirin going forward.

What if I miss a dose?

If you miss a dose of Brilinta, just wait and take your next scheduled dose at the usual time. Don’t take an extra dose to make up for your missed dose. Doing this will increase your risk of serious bleeding.

To help make sure that you don’t miss a dose, try setting a reminder on your phone. A medication timer may be useful, too.

Will I need to use this drug long term?

Brilinta is meant to be used as a long-term treatment. Current treatment guidelines recommend that most people who take Brilinta should be on the drug for at least 6 to 12 months.

If you and your doctor determine that Brilinta is safe and effective for you, you’ll likely take it long term.

The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

Financial and insurance assistance

If you need financial support to pay for Brilinta, or if you need help understanding your insurance coverage, help is available.

AstraZeneca, the manufacturer of Brilinta, offers a savings card that may help lower the cost of the drug. For more information and to find out if you’re eligible for support, call 800-422-5604 or visit the program website.

The Food and Drug Administration (FDA) approves prescription drugs such as Brilinta to treat certain conditions.

Brilinta for preventing cardiovascular events

Brilinta is FDA-approved to lower the risk of serious cardiovascular events, such as heart attack, stroke, and death caused by heart problems. For this use, it’s prescribed for adults with acute coronary syndrome (ACS) and for adults who’ve had a heart attack in the past. (ACS includes certain conditions that reduce blood flow to your heart.)

For this purpose, Brilinta should be used in combination with aspirin each day.

Effectiveness for preventing cardiovascular events

One clinical study looked at people with ACS who’d had symptoms of a heart attack within the past 24 hours. The people took aspirin with either Brilinta or clopidogrel (Plavix). Over the course of 1 year, people taking the Brilinta combination had a 16% lower risk of heart attack, stroke, and death caused by heart problems than did people taking the clopidogrel combination.

Another clinical study looked at people with risk factors for cardiovascular events. These risk factors included being over the age of 65 years, having certain problems with kidney function, or having diabetes that requires treatment with medication.

The people included in this study had had a heart attack 1 to 3 years before the start of the study. They took either Brilinta with aspirin or aspirin alone. Over the course of 1 year, people who took Brilinta with aspirin had a 17% lower risk of heart attack, stroke, or death caused by heart problems than did people who were taking aspirin alone.

Brilinta for preventing blood clots after stent placement

Brilinta is also FDA-approved to lower the risk of blood clots in adults with ACS who’ve had a stent placed in one or more of the blood vessels in their heart. (Stents are small metal devices that keep the blood vessels open, to allow blood to flow through.)

For this purpose, Brilinta should be used in combination with aspirin each day.

Effectiveness for preventing blood clots

In one clinical study, people with ACS and a stent took aspirin with either Brilinta or clopidogrel. Over the course of 1 year, people who took the Brilinta combination had a 33% lower risk of blood clots forming on their stents than did people who took the clopidogrel combination.

Brilinta for preventing heart attack and stroke

Brilinta is also FDA-approved to lower the risk of heart attack and stroke in people with coronary artery disease (CAD) who have an increased risk for heart attack or stroke. But these people haven’t had a heart attack or stroke in the past. (With CAD, the blood vessels in your heart muscle are narrowed.)

For this purpose, Brilinta should be used in combination with aspirin each day.

Effectiveness for preventing heart attack and stroke

One clinical study looked at people with CAD and diabetes who had an increased risk for heart attack and stroke. But they hadn’t had a heart attack or stroke in the past. Some people took Brilinta, while other people took a placebo (treatment with no active drug). Both groups of people also took daily aspirin.

This study reported people’s risk for stroke, heart attack, or death related cardiovascular issues. Half of the people in the study took treatment for at least 33 months. The longest anyone in the study took treatment was 58 months.

People taking Brilinta had a 10% lower risk for stroke, heart attack, or cardiovascular-related death than people who took a placebo.

Brilinta for preventing stroke

Brilinta is also FDA-approved to lower the risk of stroke in people who are having either a stroke caused by a blocked blood vessel or a transient ischemic attack (TIA). (With a TIA, you have temporary, stroke-like symptoms.)

For this purpose, Brilinta should be used in combination with aspirin each day.

Effectiveness for preventing stroke

A clinical study looked at people with a TIA or stroke caused by a blocked blood vessel. Some people took Brilinta, while other people took a placebo (treatment with no active drug). Everyone also took aspirin. Treatment was started within 24 hours of a person’s TIA or stroke.

People taking Brilinta had a 17% lower risk for stroke or death than people who took a placebo.

You should avoid drinking excessive amounts of alcohol while you’re taking Brilinta. This is because Brilinta and alcohol can each increase your risk of bleeding when used on their own. If you use them together, you may be at greater risk of serious bleeding.

Talk with your doctor about how much alcohol is safe for you to consume during Brilinta treatment.

You may wonder how Brilinta compares to other medications that are prescribed for similar uses. Here we look at how Brilinta and Effient are alike and different.

Ingredients

Brilinta contains the drug ticagrelor, while Effient contains the drug prasugrel. Both drugs belong to the class of drugs called antiplatelets.

Uses

Brilinta and Effient are each approved by the Food and Drug Administration (FDA) to reduce the risk of serious cardiovascular events in people with acute coronary syndrome (ACS). (ACS includes certain conditions that reduce blood flow to your heart.) These cardiovascular events include heart attack and stroke.

For this use, Brilinta and Effient are prescribed in somewhat different situations:

  • Brilinta is prescribed for people with ACS or people who’ve had a heart attack in the past. It can be used in people with or without a stent placed in their heart. (Stents are small metal devices that keep your blood vessels open, allowing blood to flow through them.)
  • Effient is prescribed for people with ACS who will be having or have had a stent placed in their heart.

Brilinta is also approved to lower the risk of:

Drug forms and administration

Brilinta comes as tablets that are taken twice a day, while Effient comes as tablets that are taken once a day.

Both Brilinta and Effient should each be taken with daily aspirin.

Side effects and risks

Brilinta and Effient both contain antiplatelet drugs. Therefore, both medications can cause very similar side effects. Below are examples of these side effects.

More common side effects

These lists contain examples of more common side effects that can occur with Brilinta, with Effient, or with both drugs (when taken individually).

  • Can occur with Brilinta:
    • few unique common side effects
  • Can occur with Effient:
    • changes in blood pressure
    • headache
  • Can occur with both Brilinta and Effient:

Serious side effects

These lists contain examples of serious side effects that can occur with Brilinta, with Effient, or with both drugs (when taken individually).

  • Can occur with Brilinta:
  • Can occur with Effient:
  • Can occur with both Brilinta and Effient:
    • major bleeding, which may require medical treatment*
    • severe allergic reaction

* Brilinta and Effient each have a boxed warning from the FDA regarding the risk of major bleeding. A boxed warning is the strongest warning the FDA requires. It alerts doctors and patients about drug effects that may be dangerous. For more information on Brilinta’s boxed warning, see the “FDA warnings” section at the beginning of this article.

Effectiveness

Brilinta and Effient are each used to prevent cardiovascular events in people with ACS. While Brilinta can be used in people with or without stents, Effient is used in people who have or will have a stent placed.

The use of Brilinta and Effient for this purpose has been directly compared in several clinical studies.

A pooled analysis of several studies found that Brilinta and Effient were each similarly effective for preventing cardiovascular events, such as heart attack and stroke. This analysis also found that the risk of bleeding was similar for both of these drugs.

Costs

Brilinta and Effient are both brand-name drugs. A generic form of Brilinta has been approved, but it may not be available at pharmacies yet. A generic form of Effient is available, which is called prasugrel. Generic medications usually cost less than brand-name medications.

The brand-name forms of Brilinta and Effient generally cost about the same. The generic form of Effient costs less than either brand-name drug.

The actual price you’ll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.

Brilinta should be used in combination with aspirin to prevent:

  • certain events, such as heart attack or stroke, that are caused by heart or blood vessel problems
  • blood clots in people who have stents

When used for these purposes, the recommended dosage of aspirin is 75 mg to 100 mg taken once each day. But for some uses, your doctor may have you start by taking a loading dose of aspirin. A loading dose is a higher-than-usual dose that’s given so that there’s enough medication in your body to start working right away.

Brilinta can interact with several other medications. It can also interact with certain foods.

Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase side effects or make them more severe.

Brilinta and other medications

Below are lists of medications that can interact with Brilinta. These lists do not contain all the drugs that may interact with Brilinta.

Before taking Brilinta, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Brilinta and ibuprofen

Taking Brilinta with ibuprofen (Advil, Motrin) can increase your risk of bleeding, especially in your stomach. This is because ibuprofen can cause stomach bleeding when used on its own, and Brilinta also increases your risk for bleeding in general.

Talk with your doctor to see if it’s safe for you to take ibuprofen during Brilinta treatment.

Brilinta and digoxin

Taking Brilinta with digoxin (Lanoxin), a heart rhythm drug, can increase your risk of serious side effects from digoxin. This is because Brilinta prevents your body from breaking down digoxin, which increases the level of digoxin in your blood.

If you need to take digoxin with Brilinta, your doctor will closely monitor your digoxin level on blood tests. This will help your doctor to determine the safest dosage of digoxin for you.

Brilinta and certain antifungal drugs

Taking Brilinta with certain antifungal drugs (drugs used to treat fungus infections) can increase your risk of side effects of Brilinta, such as bleeding. This is because certain antifungal drugs prevent your body’s breakdown of Brilinta, which increases the level of Brilinta in your blood.

Examples of antifungal drugs that can increase your risk for side effects if taken with Brilinta include:

  • itraconazole (Sporanox, Tolsura)
  • ketoconazole
  • posaconazole (Noxafil)
  • voriconazole (Vfend)

If you need to take an antifungal drug with Brilinta, your doctor will monitor you closely for signs and symptoms of bleeding. Your doctor may recommend that you take a reduced dosage of either Brilinta or the antifungal drug.

Brilinta and certain antiviral drugs

Taking Brilinta with certain antiviral medications (drugs used to treat viral infections) can increase your risk of side effects of Brilinta, such as bleeding. This is because certain antivirals prevent your body’s breakdown of Brilinta, which increases the level of Brilinta in your blood.

Examples of antiviral drugs that can increase your risk for side effects if taken with Brilinta include:

  • ritonavir (Norvir)
  • nefazodone
  • saquinavir (Invirase)
  • nelfinavir (Viracept)
  • atazanavir (Reyataz)

Many of these drugs are part of combination medications (medications made from more than one drug). Be sure to tell your doctor or pharmacist about all of the antiviral medications you’re taking. Doing this will help you to avoid dangerous side effects.

If you need to take one of these antiviral drugs with Brilinta, your doctor will closely monitor you for increased bleeding.

Brilinta and certain seizure drugs

Taking Brilinta with certain drugs used to treat seizures can reduce the effectiveness of Brilinta. This is because certain seizure drugs cause your body to break down Brilinta more quickly than usual. This reduces the level of Brilinta in your blood.

Examples of seizure drugs that can reduce Brilinta’s effectiveness if taken together include:

  • carbamazepine (Carbatrol, Equetro, Tegretol)
  • phenytoin (Dilantin, Phenytek)
  • phenobarbital

If you need to take a seizure medication, your doctor may prescribe a seizure drug other than those listed above. Switching medications will help you to avoid this drug interaction.

Brilinta and certain cholesterol drugs

Taking Brilinta with certain cholesterol drugs, such as simvastatin (Zocor) and lovastatin (Altoprev), can increase your risk of serious side effects from the cholesterol drug. This is because Brilinta prevents your body’s breakdown of simvastatin and lovastatin, which leads to increased levels of these drugs in your blood.

If you need to take simvastatin or lovastatin while you’re taking Brilinta, your doctor will prescribe a dosage of simvastatin or lovastatin that’s no greater than 40 mg daily.

Brilinta and opioid pain relievers

Taking Brilinta with opioids (strong pain relievers) can slow down and reduce the absorption of Brilinta from your stomach into your blood stream. This can make Brilinta less effective for you.

Examples of opioids that can make Brilinta less effective include:

  • morphine (MS Contin)
  • hydrocodone (Hysingla ER)
  • oxycodone (Roxicodone, Xtampza ER)
  • hydromorphone (Dilaudid)
  • codeine
  • fentanyl (Actiq, Fentora)
  • methadone (Methadose)
  • oxymorphone

If you need to take an opioid with Brilinta, your doctor may recommend a form of opioid that’s injected into your body rather than taken by mouth. Your doctor will also recommend that you take the opioid for the shortest amount of time necessary for treatment.

Brilinta and herbs and supplements

There aren’t any herbs or supplements that have been specifically reported to interact with Brilinta. However, you should still check with your doctor or pharmacist before using any of these products while taking Brilinta.

Brilinta and grapefruit

Eating grapefruit or drinking grapefruit juice while you’re using Brilinta may increase your risk of side effects of Brilinta, such as bleeding. This is because grapefruit prevents the breakdown of Brilinta in your body, which leads to increased levels of Brilinta in your blood.

Talk with your doctor about whether it’s safe for you to eat grapefruit or drink grapefruit juice during Brilinta treatment.

Using more than the recommended dosage of Brilinta can lead to serious side effects.

Overdose symptoms

Symptoms of an overdose can include:

  • severe bleeding that doesn’t stop
  • nausea
  • vomiting
  • diarrhea
  • abnormal bradycardia (slow heart rate)

What to do in case of overdose

If you think you’ve taken too much of this drug, call your doctor. You can also call the American Association of Poison Control Centers at 800-222-1222 or use their online tool. But if your symptoms are severe, call 911 or go to the nearest emergency room right away.

You should take Brilinta according to your doctor’s or another healthcare professional’s instructions.

When to take

You should take Brilinta twice each day, about 12 hours apart.

To help make sure that you don’t miss a dose, try setting a reminder on your phone. A medication timer may be useful, too.

Taking Brilinta with food

You can take Brilinta with or without food.

Can Brilinta be crushed, split, or chewed?

Yes. If you have trouble swallowing Brilinta tablets, you can crush them and mix the powder in water. You should drink the water right away. Then refill the glass with water, stir it well, and drink the second glass of water. This will help make sure that you get your full dose of Brilinta.

Brilinta is used to lower the risk of:

  • certain events, such as heart attack and stroke, that are caused by heart or blood vessel problems
  • blood clots in people who have stents

For more information about Brilinta’s approved uses, see the “Brilinta uses” section above.

What happens with heart attack, stroke, and blood clots?

Heart attack, stroke, and blood clots can occur when plaque builds up on the inside of your blood vessels. Plaque is made up of cholesterol, fat, and other substances that stick to the lining of your blood vessels. Plaque can also build up on the walls of stents (small metal devices that are placed in blood vessels to allow blood to flow through the vessels).

Plaque buildup can block the flow of blood through your blood vessels or stents, which prevents the blood from reaching your heart muscle. Plaques can also cause inflammation in and around the area of the plaque. This inflammation attracts a certain type of blood cell called platelets.

Platelets stick together and form clots. They normally form clots when there is damage inside your blood vessels. This activity is necessary to help heal damaged vessels and prevent bleeding.

However, platelets can also form clots in ways that are harmful to your body. For example, some clots can form and break off from your blood vessel walls. Then they may travel to other parts of your body and lodge in other blood vessels. This can lead to serious conditions such as heart attack or stroke.

What does Brilinta do?

Brilinta contains the drug ticagrelor. It belongs to a class of drugs called antiplatelets, which are drugs that block the activity of platelets.

Brilinta attaches to a protein (called the P2Y12 ADP-receptor) on the surface of platelets. When it attaches to this receptor, it keeps the platelets from being activated. This prevents your platelets from sticking together with other platelets, which lowers your risk of a clot. This can also lower your risk of serious cardiovascular events, such as heart attacks and strokes.

How long does it take to work?

Brilinta starts preventing clot formation on the first day of treatment. However, it may be difficult to tell when Brilinta starts working since it’s used to prevent serious events from occurring. This may not cause a noticeable change.

In one clinical study, Brilinta was compared to clopidogrel. This study found that, starting in the first month of treatment, Brilinta reduced the risk of cardiovascular events more than clopidogrel did.

It’s not known exactly how safe Brilinta is when it’s used during pregnancy. In animal studies, harm to fetuses was seen when pregnant females were given Brilinta. However, animal studies don’t always predict what will happen in humans.

If you’re pregnant or considering becoming pregnant, talk with your doctor before starting Brilinta. They’ll discuss the risks and benefits of treatment with you.

It’s not known if Brilinta is safe to use during pregnancy. If you or your sexual partner can become pregnant, talk with your doctor about your birth control needs while you’re using Brilinta.

Breastfeeding isn’t recommended during Brilinta treatment. Animal studies have shown that Brilinta passes into the breast milk of lactating females. But keep in mind that animal studies don’t always predict what will happen in people.

If you’re breastfeeding, talk with your doctor before taking Brilinta. They’ll recommend safe and healthy ways to feed your child.

This drug comes with several precautions.

FDA warnings

This drug has boxed warnings. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). It alerts doctors and patients about drug effects that may be dangerous.

  • Risk of bleeding. Brilinta can cause serious bleeding, which may sometimes be fatal. Brilinta shouldn’t be used by people with a serious active bleed in their body or a history of bleeding in their head. Brilinta should also not be started in people who will be having emergency coronary artery bypass graft (CABG) surgery. If you have bleeding while you’re taking Brilinta, the bleeding should be treated without stopping Brilinta therapy. Stopping Brilinta therapy increases your risk of future heart-related problems.
  • Use of aspirin with Brilinta. Daily doses of aspirin greater than 100 mg should be avoided in people taking Brilinta. Daily doses of aspirin that are greater than 100 mg will reduce the effectiveness of Brilinta.

Other precautions

Before taking Brilinta, talk with your doctor about your health history. Brilinta may not be right for you if you have certain medical conditions or other factors affecting your health. These include:

  • History of bleeding inside your head. You shouldn’t take Brilinta if you’ve had bleeding inside your head in the past. This is because Brilinta can increase your risk of having another bleed. Talk with your doctor to determine if Brilinta is safe for you.
  • Active bleed. You shouldn’t take Brilinta if you have a serious active bleed, such as bleeding from an ulcer or bleeding inside your head. Brilinta will prevent the bleed from stopping. Talk with your doctor to determine if you have an active bleed that would make Brilinta unsafe for you.
  • Severe allergic reaction. You shouldn’t take Brilinta if you’ve had a severe allergic reaction to Brilinta in the past. Talk with your doctor if you’re unsure if you’ve had a severe allergic reaction to Brilinta.
  • Slow heart rate or other heart rate problems. Brilinta can cause a slow heart rate, which may lead to other problems, such as fainting. If you have a heart condition that causes heart rate problems, Brilinta may worsen your heart rate. Talk with your doctor to determine if Brilinta is safe for you.
  • Severe liver problems. Brilinta is not recommended for people with severe liver problems. Having severe liver problems can increase your risk for serious side effects of Brilinta, such as bleeding. If you have liver problems, talk with your doctor to determine if Brilinta is safe for you.
  • Breathing problems. Brilinta can cause shortness of breath and trouble breathing for some people. If you have breathing problems such as chronic obstructive pulmonary disease (COPD) or asthma, this side effect may be worse for you. Talk with your doctor to determine if Brilinta is safe for you.
  • Pregnancy. It’s not known how safe Brilinta is when it’s used during pregnancy. For more information, please see the “Brilinta and pregnancy” section above.
  • Breastfeeding. Breastfeeding is not recommended during Brilinta treatment. For more information, please see the “Brilinta and breastfeeding” section above.

Note: For more information about the potential negative effects of Brilinta, see the “Brilinta side effects” section above.

When you get Brilinta from the pharmacy, the pharmacist will add an expiration date to the label on the bottle. This date is typically 1 year from the date they dispensed the medication.

The expiration date helps guarantee the effectiveness of the medication during this time. The current stance of the Food and Drug Administration (FDA) is to avoid using expired medications. If you have unused medication that has gone past the expiration date, talk to your pharmacist about whether you might still be able to use it.

Storage

How long a medication remains good can depend on many factors, including how and where you store the medication.

Brilinta tablets should be stored at room temperature (59°F to 86°F/15°C to 30°C) in a tightly sealed container away from light. Avoid storing this medication in areas where it could get damp or wet, such as in bathrooms.

Disposal

If you no longer need to take Brilinta and have leftover medication, it’s important to dispose of it safely. This helps prevent others, including children and pets, from taking the drug by accident. It also helps keep the drug from harming the environment.

The FDA website provides several useful tips on medication disposal. You can also ask your pharmacist for information on how to dispose of your medication.

The following information is provided for clinicians and other healthcare professionals.

Indications

Brilinta (ticagrelor) is approved by the Food and Drug Administration (FDA) to reduce the rate of:

  • stroke, myocardial infarction (MI), and cardiovascular death in people with acute coronary syndrome (ACS) or a history of MI
  • stent thrombosis in people who have had a stent implanted for ACS
  • first heart attack or stroke in people with a high risk for these conditions and who have coronary artery disease
  • stroke in people with transient ischemic attack or acute ischemic stroke

Mechanism of action

Brilinta inhibits platelet activation by binding to the P2Y12 ADP-receptor on platelets. This prevents signal transduction and platelet activation, which are necessary for clot formation.

Pharmacokinetics and metabolism

Absolute bioavailability of Brilinta is approximately 36%, and it reaches maximum concentration in 1.5 hours. Brilinta and its active metabolite are 99% bound to plasma proteins.

Metabolism occurs primarily via CYP3A4. Half-life is approximately 7 hours for the parent drug and 9 hours for the active metabolite. Elimination occurs primarily through hepatic metabolism and biliary excretion.

Contraindications

Brilinta is contraindicated for the following:

  • people with a history of intracranial hemorrhage (ICH)
  • active pathological bleeding, such as peptic ulcer or ICH
  • hypersensitivity to any component of Brilinta

Storage

Brilinta tablets should be stored at room temperature (59°F to 86°F/15°C to 30°C).

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.