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Brilinta

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Brilinta (Ticagrelor) is a platelett aggregation inhibitor used to prevent heart attacks and strokes in patients with a history of heart disease or surgery. It works by preventing platelets from sticking together to form dangerous blood clots. Brilinta is an essential therapy for long-term cardiovascular protection.


Ingredient
Availability
In Stock
Delivery Time
Airmail (14-21 days) | EMS trackable (5-9 days)
Product is shipped in a fully discreet envelope with no content disclosure, including all required documentation inside

Product Sheet

Active Ingredient(s)
Ticagrelor
Reference Brand
Brilique
Manufacturer
AstraZeneca
Product Form
Tablets
Regulatory Classification
Rx
Primary Category
Blood Thinner
Product Category
Blood and Blood Forming Organs, Antithrombotic agents, Platelet aggregation inhibitors
Pharmacological Class
P2Y12 Platelet Inhibitor
Manufacturer Description
A specialized antiplatelet medicine used to prevent serious cardiovascular events in patients who have had a heart attack.
Mechanism of Action
Ticagrelor prevents platelets (a type of blood cell) from sticking together and forming harmful blood clots. This keeps blood flowing smoothly to the heart and brain, reducing the risk of a repeat heart attack or stroke.
Route of Administration
Oral
Onset Time
30 to 90 minutes
Duration
12 hours (requires twice daily dosing)
Contraindications
Active bleeding, History of intracranial haemorrhage, Severe liver disease
Severe Adverse Events
Severe internal bleeding, Stroke-like symptoms, Passing blood in urine or stools
Common Side Effects
Easy bruising, Minor nosebleeds
Uncommon Side Effects
Shortness of breath (dyspnoea), Gastrointestinal bleeding, Bleeding from wounds
Drug Interactions
Aspirin (high dose), Warfarin, Ketoconazole, Clarithromycin, Simvastatin
Pregnancy Safety Warnings
Not recommended during pregnancy.
Age Restrictions
Approved for adults 18 and over
Storage Guidelines
Store at room temperature.
Related Products
Clopidogrel, Prasugrel

Brilinta FAQ

Can I travel internationally with Brilinta?

Yes, Brilinta can be taken while traveling, but you should carry the medication in its original packaging with the prescription label. It is advisable to bring a copy of the prescribing information in case border or security checks request documentation.

Does Brilinta have any effect on cholesterol levels?

No, ticagrelor specifically targets platelet aggregation and does not influence lipid metabolism. Patients requiring cholesterol management should discuss separate statin or lipid-lowering therapy with their clinician.

What do the imprint codes on Brilinta tablets look like?

In the UK, the 60 mg tablet is commonly imprinted with “AZ 60” and the 90 mg tablet with “AZ 90,” identifying the manufacturer and strength. Imprint details may vary slightly between batches.

How does Brilinta compare with clopidogrel?

Both are P2Y12 inhibitors, but ticagrelor provides faster and more consistent platelet inhibition than clopidogrel, which requires metabolic activation. Clinical guidelines often prefer ticagrelor for ACS when no contraindications exist.

Is Brilinta detectable in drug-testing for athletes?

Ticagrelor is not listed as a prohibited substance by major sports anti-doping agencies. However, athletes should disclose all medications to their anti-doping authority to avoid inadvertent violations.

Can I store Brilinta in a fridge to extend its shelf life?

Routine refrigeration is unnecessary and not recommended. Keeping the tablets at room temperature away from humidity and direct sunlight preserves their stability until the expiry date.

What is the typical cost difference between the 60 mg and 90 mg tablets?

Both strengths are priced similarly per tablet, but total therapy cost depends on the prescribed dose frequency. Generic versions may become available after patent expiry, potentially reducing overall expense.

Do I need to stop Brilinta before a surgical procedure?

Yes, clinicians usually advise discontinuing ticagrelor 5-7 days before elective surgery to reduce bleeding risk. The exact timing should be individualized based on the procedure’s bleeding risk and the patient’s cardiovascular status.

Is Brilinta covered by the NHS for all patients?

Eligibility for NHS reimbursement depends on clinical indication, such as an acute coronary syndrome event or post-MI secondary prevention, and adherence to NICE guidelines. Your prescribing physician can confirm coverage based on your specific circumstances.

Can I take Brilinta with over-the-counter NSAIDs?

Concurrent use of NSAIDs (e.g., ibuprofen) may increase gastrointestinal bleeding risk when combined with dual antiplatelet therapy. If NSAID therapy is necessary, it should be discussed with a healthcare professional to weigh risks and consider gastro-protective strategies.

What is Brilinta?

Brilinta is a prescription medication that contains the active ingredient ticagrelor. It belongs to the class of antiplatelet agents used to reduce the risk of clot-related cardiovascular events. Brilinta is supplied as a pill in two strengths-60 mg and 90 mg-and is regulated in the United Kingdom by the Medicines and Healthcare products Regulatory Agency (MHRA). The product is marketed by AstraZeneca and is indicated for use in patients with acute coronary syndrome (ACS) and for secondary prevention after myocardial infarction (MI) when used together with low-dose aspirin.

How Brilinta Works in the Body

Ticagrelor is a reversible antagonist of the platelet P2Y12 adenosine diphosphate (ADP) receptor. By binding to this receptor, ticagrelor blocks ADP-mediated activation of the glycoprotein IIb/IIIa complex, which is essential for platelets to aggregate and form a thrombus. The drug achieves rapid platelet inhibition within 30 minutes of oral administration, and its effect is maintained as long as the medication is taken twice daily. Because the inhibition is reversible, platelet function can recover more quickly after discontinuation compared with irreversible agents such as clopidogrel.

Conditions Treated by Brilinta

  • Acute coronary syndrome (ACS) - including unstable angina, non-ST-segment elevation myocardial infarction (NSTEMI) and ST-segment elevation myocardial infarction (STEMI). The drug is used as part of dual antiplatelet therapy (DAPT) with low-dose aspirin to lower the risk of cardiovascular death, MI, and stroke.
  • Secondary prevention after myocardial infarction - patients who have survived a MI and are at high risk of a recurrent event may be prescribed the 60 mg twice-daily dose together with aspirin.
  • Post-percutaneous coronary intervention (PCI) - when a coronary stent has been placed, Brilinta helps prevent stent thrombosis, a potentially life-threatening clot within the stent.

These indications are approved by the MHRA and endorsed in UK clinical guidelines such as those from NICE.

Evaluating Brilinta for Your Health Profile

Who May Benefit

  • Adults with a recent ACS event who are candidates for DAPT.
  • Patients who have experienced a myocardial infarction and have additional risk factors (e.g., diabetes, prior stent placement) that warrant intensified antiplatelet therapy.
  • Individuals undergoing PCI who require a potent antiplatelet agent to protect the stented segment.

Absolute Contraindications

  • Active pathological bleeding (e.g., gastrointestinal hemorrhage, intracranial bleed).
  • History of intracranial hemorrhage or subarachnoid hemorrhage.
  • Known hypersensitivity to ticagrelor, any component of the tablet, or other P2Y12 inhibitors.
  • Severe hepatic impairment (Child-Pugh class C).

Relative Contraindications and Cautions

  • Moderate hepatic impairment (Child-Pugh class A or B) - dose adjustment may be required.
  • Renal impairment (creatinine clearance < 30 mL/min) - monitor for bleeding; no formal dose reduction but use caution.
  • History of bleeding disorders, recent major surgery, or trauma.
  • Pregnancy or breastfeeding - use only if the potential benefit outweighs the risk to the fetus or infant; ticagrelor crosses the placenta.

Special populations such as the elderly may be more susceptible to bleeding and should be monitored closely.

Safety Profile and Interactions

Common Side Effects

  • Dyspnoea - described as a sensation of shortness of breath, reported in a minority of patients.
  • Bleeding - including bruising, nosebleeds, gum bleeding, or more serious gastrointestinal bleeding.
  • Gastro-intestinal discomfort - nausea, dyspepsia, or abdominal pain.
  • Headache and dizziness - generally mild and transient.

Most of these events are mild to moderate in intensity and resolve with continued therapy or simple symptomatic measures.

Serious Adverse Events

  • Life-threatening bleeding - such as intracranial hemorrhage or massive gastrointestinal bleed requiring urgent medical attention.
  • Severe allergic reactions - anaphylaxis or angioedema, which mandate immediate emergency care.
  • Elevation of serum uric acid - may precipitate gout in susceptible individuals.

Patients experiencing any of these events should seek prompt medical evaluation.

Drug Interactions

  • Strong CYP3A4 inhibitors (e.g., ketoconazole, clarithromycin, HIV protease inhibitors) increase ticagrelor plasma concentrations, potentially heightening bleeding risk. Dose reduction to 60 mg twice daily is recommended when co-administered with such agents.
  • Strong CYP3A4 inducers (e.g., rifampicin, carbamazepine, phenytoin) lower ticagrelor levels, reducing antiplatelet efficacy; alternative antiplatelet therapy should be considered.
  • Concomitant anticoagulants (warfarin, direct oral anticoagulants) or other antiplatelet agents (aspirin, clopidogrel) increase the risk of hemorrhage and require careful clinical judgment.
  • Caffeine may modestly increase ticagrelor exposure; routine restriction is not required but patients should be aware.

Food and Lifestyle Interactions

  • Alcohol - moderate consumption does not appear to affect ticagrelor pharmacokinetics, but heavy drinking can exacerbate bleeding risk.
  • Smoking - does not significantly alter ticagrelor metabolism, though smoking is an independent cardiovascular risk factor.
  • Driving and machinery - mild dyspnoea or dizziness may impair performance; patients should assess their own tolerance before operating vehicles.

How to Take Brilinta

  • Standard dosing for ACS - 90 mg taken twice daily (approximately 12 hours apart) together with low-dose aspirin (75-100 mg once daily). Therapy typically continues for at least 12 months, followed by a reassessment of the need for continued DAPT.
  • Secondary prevention after MI - 60 mg taken twice daily with low-dose aspirin when a reduced bleeding risk is desired or when the patient has tolerated DAPT for the initial 12-month period.
  • Administration - swallow the tablet whole with a glass of water. Food does not significantly affect absorption, so the pill may be taken with or without meals.
  • Missed dose - take the missed tablet as soon as remembered unless it is close to the time of the next scheduled dose; do not double up.
  • Overdose - symptoms may include severe bleeding, dizziness, or respiratory distress. Seek emergency medical care; there is no specific antidote, but supportive measures and platelet transfusion may be employed.
  • Discontinuation - the drug should be stopped under medical supervision. Because platelet inhibition wanes within 3-5 days after the last dose, clinicians may advise a short wash-out period before elective surgery.

Dosing adjustments based on hepatic function are advised when strong CYP3A4 inhibitors are co-administered. No routine renal dose modification is required, but clinicians should monitor for bleeding in patients with severe renal impairment.

Monitoring and Follow-Up

  • Bleeding assessment - patients should be evaluated at each clinic visit for signs of overt or occult bleeding. Laboratory tests such as haemoglobin, haematocrit, and stool guaiac may be ordered if bleeding is suspected.
  • Renal and hepatic function - baseline liver enzymes and serum creatinine should be measured, with periodic re-evaluation in patients with known impairment.
  • Platelet function testing - not required routinely, but may be considered in research settings or when therapeutic failure is suspected.
  • Clinical review - after the initial 12-month DAPT period, a cardiology specialist should reassess the balance between ischemic protection and bleeding risk to decide on continuation, dose reduction, or cessation.

Storage and Handling

  • Store Brilinta tablets at room temperature (20-25 °C), protected from moisture and light.
  • Keep the container tightly closed and out of reach of children.
  • Do not use tablets that are past the expiry date printed on the packaging.
  • For disposal, follow local pharmacy or NHS guidelines for safe medication waste.

Medication-Specific Glossary

P2Y12 receptor
A platelet surface receptor that binds ADP; antagonism prevents platelet activation and aggregation.
Antiplatelet agent
A drug that reduces platelet clotting ability, thereby lowering the risk of arterial thrombotic events.
Dual antiplatelet therapy (DAPT)
The combined use of two antiplatelet medications-commonly ticagrelor (or clopidogrel) plus low-dose aspirin-to provide enhanced protection against clot formation.
Platelet aggregation
The process by which platelets clump together, forming the primary component of a thrombus.
Pharmacokinetics
The study of how a drug is absorbed, distributed, metabolised, and eliminated by the body.
Bioavailability
The proportion of an administered dose that reaches systemic circulation in an active form; ticagrelor has high oral bioavailability.

Medical Disclaimer

This article provides educational information about Brilinta and is not a substitute for professional medical advice. Treatment decisions, including use for unapproved indications, must be made under the guidance of a qualified healthcare provider. The content is intended for informational purposes and does not constitute medical recommendations. Always consult a physician before starting, stopping, or changing any medication regimen.

Information for Brilinta is sourced from established medical standards and updated frequently. It is provided for general guidance and should be confirmed with a healthcare professional before use.
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