From the Guidelines
Ticagrelor causes muscle weakness primarily through its effect on cellular energy metabolism in muscle cells, potentially by interfering with mitochondrial function and adenosine-mediated effects that lead to decreased muscle contractility. The exact mechanism of ticagrelor-induced muscle weakness is not fully understood, but it is thought to be related to its inhibition of the P2Y12 receptor, which plays a role in regulating cellular energy metabolism 1. Ticagrelor's inhibition of ADP-mediated receptor activation in a noncompetitive fashion, likely through an allosteric mechanism, may also contribute to its effects on muscle cells 1. Additionally, ticagrelor's interaction with statins may increase the risk of myopathy and muscle weakness 1.
Some key points to consider when evaluating the mechanism of ticagrelor-induced muscle weakness include:
- Ticagrelor's rapid onset of action and potent inhibition of ADP-induced platelet aggregation 1
- The drug's ability to achieve a level of inhibition of ADP-induced platelet exceeding that obtained with clopidogrel 1
- The potential for ticagrelor to interfere with mitochondrial function and disrupt normal muscle energy production 1
- The possible interaction between ticagrelor and statins, which may increase the risk of myopathy and muscle weakness 1
It is essential to note that muscle weakness is a rare side effect of ticagrelor, and patients experiencing this symptom should seek medical attention promptly 1. The typical dose of ticagrelor is 90 mg twice daily, and muscle symptoms typically resolve after stopping the medication 1. Overall, the mechanism of ticagrelor-induced muscle weakness is complex and multifactorial, and further research is needed to fully understand its effects on muscle cells.
From the Research
Mechanism of Ticagrelor-Induced Muscle Weakness
- The exact mechanism by which ticagrelor causes muscle weakness is not clearly understood, as there is limited research directly addressing this topic 2, 3, 4.
- However, it is known that ticagrelor works by inhibiting platelet aggregation via blocking the ADP receptors of the subtype P2Y12 2.
- Some studies suggest that muscle weakness may be a side effect of antiplatelet therapy, but these studies primarily focus on statins rather than ticagrelor 5, 6.
- The available evidence on ticagrelor does not provide a clear explanation for the mechanism of muscle weakness, and more research is needed to fully understand this potential side effect 3, 4.
Comparison to Other Antiplatelet Therapies
- Studies comparing ticagrelor to other antiplatelet therapies, such as clopidogrel, do not provide insight into the mechanism of muscle weakness 3, 4.
- These studies primarily focus on the efficacy and safety of ticagrelor in preventing cardiovascular events, rather than its potential side effects 3, 4.
- Further research is needed to determine the mechanisms by which ticagrelor may cause muscle weakness, and to compare its side effect profile to other antiplatelet therapies 2, 3, 4.