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INTRODUCTION
TIKLEEN 90 contains Ticagrelor which belongs to the group of medicines called Antiplatelets. It is used in combination with acetylsalicylic acid (a medicine that prevents blood clot) for adults who had heart attack (blockage of blood flow to the heart muscle characterized by tightness or pain in the chest, neck, back or arms, abnormal heartbeat, and anxiety), unstable angina (chest pain that is caused by inadequate blood supply to heart with the symptom of crushing type of pain in chest with mild physical activity). It also reduces the chances of having another heart attack and stroke from other diseases related to heart or blood vessels. Stroke is defined as the damage to the brain from interruption in its blood supply characterized by paralysis, numbness or weakness in the arm, face, and leg, trouble in speaking or understanding others.
Ticagrelor reduces the clotting of blood and increases the blood flow to vital organs by preventing the clumping of platelets (small blood cells that stops bleeding from cut or damaged blood vessels). Your doctor may check your complete blood count, bleeding time, clotting time at regular intervals along with the treatment.
TIKLEEN 90 is not recommended for use in patients having severe liver problem, bleeding currently, stroke because of bleeding. TIKLEEN 90 should be used in caution with patient having heart disease, lung problems. If you are pregnant or breast-feeding, consult your doctor for advice before taking TIKLEEN 90. TIKLEEN 90 is not recommended for use in children and adolescents up to the age of 18 years. The most common side effects of taking TIKLEEN 90 includes bleeding, bruising, headache, dizziness. Consult your doctor if the symptom worsens.
USES OF TIKLEEN 90
TIKLEEN 90 is used in combination with acetylsalicylic acid (a medicine that prevents blood clot) for adults who have:
- history of a heart attack
- unstable angina (chest pain that is not well controlled)
HOW TIKLEEN 90 WORKS
TIKLEEN 90 reduces the clotting of blood and increases the blood flow to vital oragns by preventing the clumping of platelets (small blood cells that stops bleeding from cut or damaged blood vessels).
DIRECTIONS FOR USE
Take TIKLEEN 90 as advised by your physician. Swallow this medicine, do not crush, or chew the medicine. Your doctor will decide the correct dose and duration for you depending upon your age, body weight and disease condition.
SIDE EFFECTS OF TIKLEEN 90
COMMON
- signs of high uric acid in blood such as intense joint pain, inflammation, redness
- bleeding caused by blood disorders
- bruising (bleeding under the skin due to any injury)
- headache
- dizziness, feeling of spinning (vertigo)
- diarrhoea or indigestion
- feeling sick (nausea)
- constipation
- rash
- itching
- pain and swelling in the joints
- signs of low blood pressure such as dizziness or light-headed, or having blurred visions
- nosebleed
- bleeding after surgery or from cuts (ex. while shaving)
- bleeding from your stomach lining (ulcer)
- bleeding gums
- shortness of breath
UNCOMMON
- signs of allergic reaction such as rash, itching or a swollen face or swollen lips/ tongue
- confusion
- visual problems
- menstrual bleeding heavier than normal
- bleeding in joints and muscles causing painful swelling
- ear bleeding
- internal bleeding that may cause dizziness or light-headedness
RARE
Stop taking TIKLEEN 90 and contact your doctor immediately if you experience any of the following side effects:
- bleeding into the brain may cause signs of a stroke such as sudden numbness or weakness in arm, leg, or face (especially on one side of the body), sudden confusion, difficulty in speaking or understanding, walking or loss of balance or co-ordination, dizziness, severe headache
- signs of bleeding such as severe bleeding that is uncontrollable, unexpected bleeding or bleeding that is of long duration, pink, red or brown urine, vomiting red blood, red or black stools, coughing up or vomiting blood clots
- fainting (syncope) – sudden temporary loss of consciousness
- signs of a Thrombotic Thrombocytopenic Purpura (clotting disease) such as fever and purplish spots (called purpura) on the skin or mouth, with or without yellowing of the skin or eyes (jaundice), unexplained extreme tiredness or confusion
HOW TO MANAGE SIDE EFFECTS
Diarrhea or indigestion:
Drink lots of fluids, such as water or fruit juice to keep yourself hydrated. Do not consume any medicine on your own without consulting your doctor.
Dizziness
When you feel dizzy, lie, or sit down immediately. if you're experiencing a severe episode of vertigo, lie in a dark and quite place with eyes closed. Vehicle driving should be avoided if you experience frequent dizziness without warning. Talk to your doctor if the symptom worsens.
Headache:
Apply hot or cold-water bag on your head. Try taking rest in a quiet and dark room. Massage with mild pressure on scalp or head.
Nausea:
Take this medicine with, or just after meals. Stick to simple meals. Avoid eating oil rich or spicy foods, sugary snacks, and drinks. Avoid drinking too much liquid along with your meals. Talk to your doctor if your symptom is not improving.
Bleeding gums:
Maintain good oral hygiene. Gently brush your teeth twice daily with soft bristled toothbrush and use mouth wash as directed by your physician. Avoid hot and spicy foods as it may irritate the gums. Consult your physician if the symptom worsens.
WARNING & PRECAUTIONS
PREGNANCY
TIKLEEN 90 is not recommended for use in pregnant women or women planning for pregnancy. Women should use appropriate contraceptive measures to avoid pregnancy while taking this medicine. Consult your doctor before taking TIKLEEN 90.
BREASTFEEDING
TIKLEEN 90 should be used during breast-feeding only if clearly considered necessary. Discuss with your doctor before taking TIKLEEN 90.
DRIVING AND USING MACHINES
Do not drive or operate any machines as it may can cause side effects such as confusion and dizziness. Talk to your doctor before taking TIKLEEN 90.
ALCOHOL
Consumption of alcohol is not recommended during treatment with TIKLEEN 90.
LIVER
TIKLEEN 90 should be used with caution in patients having any liver disease or any other disease that affected the liver previously. TIKLEEN 90 is not recommended for use in patients with severe liver disease. Consult your doctor before taking TIKLEEN 90.
ALLERGY
TIKLEEN 90 is not recommended for use if you are allergic to Ticagrelor.
LUNGS
TIKLEEN 90 should be used in caution with patients having asthma, breathing difficulties or other lung problems. Consult your doctor before taking TIKLEEN 90.
HEART DISEASE
TIKLEEN 90 should be taken with caution in patients having low heart rate (having pacemaker). Before taking TIKLEEN 90 consult with your doctor.
OTHERS
TIKLEEN 90 is not recommended for use if you:
- are bleeding currently
- had stroke because of bleeding in brain
Before taking TIKLEEN 90, inform your doctor if you have:
- increased risk of bleeding because of any serious injury recently, recent surgeries (including dental surgeries), bleeding from stomach or gut such as a stomach ulcer or colon polyps
- high levels of uric acid in the blood
Use in pediatrics:
- TIKLEEN 90 is not recommended for use in children and adolescents (under 18 years of age). Consult your physician before taking TIKLEEN 90.
Use in geriatrics:
- TIKLEEN 90 is used with caution in patients above 65 years of age. Consult your doctor before taking TIKLEEN 90.
INTERACTIONS
Before taking TIKLEEN 90, inform your doctor if you are taking any of the following medicine:
- antifungal medicines like ketoconazole used to treat fungal infections
- clarithromycin (medicine used to treat bacterial infections)
- nefazodone (medicine used to treat depression)
- ritonavir and atazanavir (medicine used to treat HIV infection and AIDS)
- medicines like simvastatin or lovastatin used to treat high cholesterol
- rifampicin (medicine used to treat tuberculosis)
- phenytoin, carbamazepine, and phenobarbital (medicines used to control seizures)
- digoxin (a medicine used to treat heart failure)
- cyclosporine (medicine used to lessen your body’s defences)
- quinidine and diltiazem (medicine used to treat abnormal heart rhythms)
- beta blockers like acebutolol, carvedilol and calcium channel blockers like verapamil (medicines used to treat high blood pressure)
- morphine and other opioids (medicines used to treat severe pain)
- warfarin (medicine used to prevent blood clot)
- non-steroidal anti-inflammatory drugs - medicines used to treat pain and inflammation (Ex. aspirin, ibuprofen)
- cisapride (medicine used to treat heartburn)
- medicines like dihydroergotamine, ergotamine which are used to treat migraines and headaches
- selective serotonin reuptake inhibitors (SSRIs) taken as antidepressants such as paroxetine, sertraline and citalopram used to treat depression
- fibrinolytics such as streptokinase or alteplase (medicine used to dissolve clot)
Overdosage:
If you or anyone else accidentally take too much of TIKLEEN 90, consult your doctor immediately or visit the nearby hospital. You may be at a risk of increased risk of bleeding.
SYNOPSIS
| Drug | : | Ticagrelor |
| Pharmacological Category | : | Anticoagulant |
| Therapeutic Indication | : | Prevention of blood clot |
| Dosage Forms | : | Tablet |
MORE INFORMATION
- Keep TIKLEEN 90 out of reach of children
- Store at room temperature
FAQs ABOUT TIKLEEN 90
What are uses of TIKLEEN 90?
Ticagrelor is used alone or in combination with acetylsalicylic acid to lessen the chance of heart attack or stroke in patients with history of heart attack or stroke where the blood flow to the heart and brain is blocked.
What happens if I stop taking TIKLEEN 90?
Do not stop taking TIKLEEN 90 without talking to your doctor first. Stopping this medicine suddenly increase the risk of heart attack or stroke. Your doctor may advice you to stop this medicine for a short time if you are undergoing any surgery.
Can TIKLEEN 90 cause gout?
Yes, TIKLEEN 90 can increase the level of uric acid in blood and cause gout. Talk to your doctor if you get severe pain and swelling in your joints which will be the signs of gout.
Is TIKLEEN 90 safe in children’s and elderly?
TIKLEEN 90 is not recommended for use in children and adolescents (under 18 years of age) and should be used in caution with patients above 65 years of age.
Can TIKLEEN 90 cause shortness of breath?
Higher risk of difficulty in breathing was found in patients treated with TIKLEEN 90 when compared with clopidogrel (antiplatelet drug). Contact your doctor immediately if you feel very difficult to breath.
REFERENCES
1. KD. Tripathi. Anticoagulants. Essentials of medical pharmacology. Eighth edition. 2019. Page – 663-667.
2. RaeAnne Fuller and Benjamin Chavez. Ticagrelor (Brilinta), an Antiplatelet Drug for Acute Coronary Syndrome. NIH National Library of Medicine, National center for biotechnology information. PubMed Central October 2012. [Accessed 14th May 2022] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3474441/
3. Michal J Kubisa, Mateusz P Jezewski, Aleksandra Gasecka, Jolanta M Siller-Matula and Marek Postula. Ticagrelor – toward more efficient platelet inhibition and beyond. NIH National Library of Medicine, National center for biotechnology information. PubMed Central. January 2018. [Accessed 14th May 2022] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5775739/
4. AstraZeneca AB. Electronic Medicines Compendium (EMC). [Revised in February 2022] [Accessed 14h May 2022] https://www.medicines.org.uk/emc/files/pil.5767.pdf
5. AstraZeneca AB. Electronic Medicines Compendium (EMC). [Revised in February 2022] [Accessed 14h May 2022] https://www.medicines.org.uk/emc/files/pil.7606.pdf
6. AstraZeneca AB. U.S. Food & Drug Administration [Revised in September 2016] [Accessed 14h May 2022] https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/022433s020lbl.pdf
USEFUL DIAGNOSTIC TESTS
- Complete blood count
- Bleeding and clotting time
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