60 mg: Prevention of thrombotic events (CV death, MI, stroke) in patients w/ history of MI (MI occurred at least 1 yr ago) & a high risk of developing a thrombotic event. 90 mg: Co-administered w/ ASA (75-100 mg) for prevention of thrombotic events (CV death, MI & stroke) in patients w/ acute coronary syndromes (ACS) [unstable angina, non-ST elevation myocardial infarction (NSTEMI) or ST elevation myocardial infarction (STEMI)] including patients managed w/ percutaneous coronary intervention (PCI) or CABG. Co-administered w/ ASA to reduce the risk of stroke in patient w/ acute ischaemic stroke (NIH Stroke Scale score ≤5) or high-risk transient ischaemic attack (TIA) (ABCD2 score ≥6).
Acute coronary syndromes Initially, 180 mg loading dose (2 tab of 90 mg) followed by 90 mg twice daily w/ low maintenance dose of ASA 75-100 mg daily unless specifically contraindicated. History of MI (occurred at least 1 yr ago) 60 mg twice daily when an extended treatment is required w/ low maintenance dose of ASA 75-100 mg unless specifically contraindicated. Acute ischaemic stroke or TIA Initially, 180 mg loading dose (2 tab of 90 mg), continued w/ 90 mg twice daily for 30 days.
View Brilinta overdosage for action to be taken in the event of an overdose.
Administration
May be taken with or without food: For patients w/ swallowing difficulties, crush tab to a fine powd & mix in a ½ glass of water then drink immediately. Rinse the glass w/ another ½ glass of water & drink. Mixt may also be administered via nasogastric tube.
Contraindications
Hypersensitivity (eg, angioedema). History of intracranial haemorrhage. Active pathological bleeding eg, peptic ulcer or intracranial hemorrhage. Co-administration w/ strong CYP3A4 inhibitors (eg, ketoconazole, clarithromycin, nefazodone, ritonavir, atazanavir). Severe hepatic impairment.
History of bleeding disorders, undergone percutaneous invasive procedures, recent coronary angiography, PCI, CABG & other surgical procedures. Patients at risk for bradycardic events, dyspnea, central sleep apnoea. Should be discontinued 5 days prior to surgery. Treatment >1 yr is not recommended in patients w/ history of MI w/ prior ischaemic stroke. Concomitant administration of aspirin (>100 mg), chronic intake of NSAIDs, oral anticoagulants & fibrinolytics, high maintenance dose of ASA (>300 mg) is not recommended. Avoid use w/ strong CYP3A inhibitors & potent CYP3A inducers. May increase creatinine levels. History of hyperuricaemia or gouty arthritis. Avoid abrupt or premature discontinuation. May give false -ve result in platelet function test. Moderate hepatic impairment. Pregnancy & lactation. Childn. Elderly.
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