Ticagrelor is indicated in-

• Unstable angina
• Stroke
• Non ST-elevation Myocardial infarction
• Patients with ST-elevation myocardial infarction (STEMI) when managed with either primary or delayed PCI

Angina

Myocardial Infarction

Stroke

Initiate treatment with 180 mg oral loading dose following an acute coronary syndrome (ACS) event. Continue treatment with 90 mg twice daily during the first year after an ACS event. After one year, administer 60 mg twice daily. 

Use Ticagrelor with a daily maintenance dose of aspirin of 75-100 mg.

Side effects of clopidogrel include-

• Bleeding, including life-threatening and fatal bleeding
• Thrombotic thrombocytopenic purpura
• Shortness of breath

Bleeding

Purpura

Shortness of Breath

• Ticagrelor, like other antiplatelet agents, can cause significant, sometimes fatal bleeding.
• Do not use Ticagrelor in patients with active pathological bleeding or a history of intracranial hemorrhage.
• Do not start Ticagrelor in patients undergoing urgent coronary artery bypass graft surgery (CABG). 
• If possible, manage bleeding without discontinuing Ticagrelor. Stopping Ticagrelor increases the risk of subsequent cardiovascular events. 
• Maintenance doses of aspirin above 100 mg reduce the effectiveness of Ticagrelor and should be avoided.
• Dyspnea was reported more frequently with Ticagrelor than with control agents in clinical trials. Dyspnea resulting from Ticagrelor is self-limiting.
• Severe Hepatic Impairment: Likely increase in exposure to ticagrelor.