Experiences with
TicagrelorTicagrelor is not suitable for some people. For example, check with your doctor if you have asthma or an abnormal heart rate.
Ticagrelor comes as tablets that take twice a day. Follow the instructions that come with your medicine.
Common side effects of ticagrelor include shortness of breath, headaches and joint pain. More serious side effects can happen but are not common.
Ticagrelor is not usually recommended during pregnancy. Check with a pharmacist or doctor before taking it.
Who can take ticagrelor
Most adults aged 18 or over can take ticagrelor.
Who may not be able to take ticagrelor
Ticagrelor is not suitable for some people. To make sure it's safe for you, tell your doctor if you:
- have ever had an allergic reaction to ticagrelor or any other medicine
- have recently had surgery or have any injuries that are currently bleeding a lot, such as a wound
- have ever had a stomach ulcer
- have breathing difficulties, such as asthma or chronic obstructive pulmonary disease (COPD)
- have an abnormal heart rate (arrhythmia)
- have had bleeding in your brain (a brain haemorrhage) or a stroke caused by bleeding in the brain (haemorrhagic stroke)
- have gout or high levels of a chemical called uric acid in your body
- have liver problems
- are trying to get pregnant, are already pregnant or breastfeeding
Dosage and how to take ticagrelor
Ticagrelor tablets come in strengths of 60mg or 90mg.
It comes as standard tablets that you usually swallow whole or tablets that melt in your mouth.
Dose if you've had a heart attack
On your first day of treatment, you'll take a single dose of 180mg. This will usually be two 90mg tablets taken at the same time.
After this, the usual dose is 90mg twice a day for 12 months.
Your doctor may advise you to keep on taking ticagrelor after you've finished the 12-month course of treatment. In this case, you'll usually take a lower dose of 60mg twice a day. You'll take this dose for up to 3 years.
Dose if you have unstable angina
On the first day of treatment, you'll take a single dose of 180mg. This will usually be two 90mg tablets taken at the same time.
After this, the usual dose is 90mg twice a day for 12 months.
Dose if you've had a minor stroke or a transient ischaemic attack (mini-stroke)
Ticagrelor may be prescribed by a specialist if you've had a minor stroke or a transient ischaemic attack.
On your first day of treatment, you'll take a single dose of 180mg. This will usually be two 90mg tablets taken at the same time.
After this, the usual dose is 90mg twice a day. You'll take this dose combined with aspirin for the first 30 days.
How to take it
When you start taking ticagrelor, you'll take 1 dose on your first day.
After this, most people take ticagrelor twice a day, usually once in the morning and once in the evening.
You can take ticagrelor with or without food.
How to take standard tablets
You'll usually swallow standard tablets whole with a drink of water. If you have trouble swallowing tablets, you can crush them and mix them with water.
How to take tablets that melt in your mouth
Put the tablet on your tongue and let it dissolve. You can then swallow it with or without water.
Common side effects of ticagrelor
These common side effects of ticagrelor happen in more than 1 in 100 people. There are things you can do to help cope with them:
Ticagrelor can cause bleeding problems such as nosebleeds, heavier periods, bruising more easily or bleeding that takes longer to stop.
Be careful when doing activities that might cause an injury or a cut.
Always wear a helmet when cycling. Wear protective gloves when you use sharp objects like scissors, knives, and gardening tools. Use an electric razor instead of wet shaving. Speak to a dentist for advice on how to clean your teeth.
See a doctor if you're worried about any bleeding.
You might sometimes feel short of breath in the first few weeks of taking ticagrelor. This side effect is usually mild. Your breathing will usually return to normal within a few weeks of starting the medicine.
Try breathing in slowly through your nose and out through your mouth. Sitting on a chair and leaning your chest slightly forward may also help.
Tell your doctor if your symptoms do not improve or they get worse. Shortness of breath can also be a sign of an ongoing or worsening heart problem.
These can be signs of gout. This is because ticagrelor can lead to high levels of uric acid in your blood.
If you get sudden severe pain in a joint or hot, swollen skin over a joint, talk to your doctor. You may need a blood test to check what might be causing it.
Make sure you rest and drink plenty of fluids. Do not drink too much alcohol. Ask your pharmacist to recommend a painkiller.
If your headaches are severe or do not go away, talk to your doctor.
If ticagrelor makes you feel dizzy when you stand up, try getting up very slowly or stay sitting down until you feel better.
If you begin to feel dizzy, lie down so that you do not faint, then sit until you feel better.
Do not drive, cycle or use any tools or machinery if you feel dizzy, have muscle cramps or muscle pain.
Try taking your tablets with, or shortly after, food. It may also help if you avoid eating rich or spicy food.
If it doesn't go away, tell your doctor.
If you have indigestion that does not go away, it could be a sign that you have a stomach ulcer. Talk to your doctor, as they may prescribe something to protect your stomach or switch you to a different medicine.
Drink lots of fluids, such as water or squash, to avoid dehydration. Speak to a pharmacist if you have signs of dehydration, such as peeing less than usual or having dark, strong-smelling pee. Do not take any other medicines to treat diarrhoea without speaking to a pharmacist or doctor.
If you take the combined contraceptive pill or progestogen-only pill and you have severe diarrhoea for more than 24 hours, your contraception may not protect you from pregnancy. Check the pill packet for advice.
Get more fibre into your diet, such as fresh fruit, vegetables and cereals, and drink plenty of water. Try to exercise more regularly, for example by going for a daily walk or run. If this does not help, talk to your pharmacist or doctor.
It may help to take an antihistamine, which you can buy from a pharmacy. Check with the pharmacist to see what type is suitable for you while you are on this medicine.
Speak to a doctor or pharmacist if the advice on how to cope does not help and a side effect is still bothering you or does not go away.
Ticagrelor and pregnancy
Ticagrelor is not usually recommended during pregnancy or if you're trying to get pregnant. This is because there’s very little safety information.
Talk to your doctor if you take ticagrelor and are planning a pregnancy or find out that you are pregnant. They may be able to recommend other medicines that may be more suitable during pregnancy.
Ticagrelor and breastfeeding
If your baby is healthy, you may be able to take ticagrelor if you need to while you're breastfeeding. Talk to your doctor or pharmacist first, and they'll help you to decide.
It's not known how much ticagrelor gets into breast milk, but it's likely to be low levels, and your baby will not be able to absorb a lot into their body from the breast milk. It's unlikely to cause any side effects in your baby.
It's very rare for breastfed babies to have side effects from medicines you're taking. But it's important to keep monitoring your baby if you're taking any medicine while breastfeeding.
Contact your healthcare professional or call 111 if you notice that your baby:
- is not feeding as well as usual
- is bruising or bleeding easily
- has diarrhoea or constipation
- is being irritable
- is getting a rash
If your baby has any symptoms that are not listed, or if you're worried about them, you can also call 111 or contact any healthcare professional.
Carry on taking the medicine and keep breastfeeding as usual until you've got advice about your baby’s symptoms.
Related links
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