Most Common Side Effects of Brilinta (Ticagrelor)
The most common side effects of Brilinta (ticagrelor) are dyspnea (breathing difficulty), bleeding complications, and gastrointestinal disturbances. 1
Primary Side Effects
Bleeding-Related Side Effects
- Major bleeding: Increased risk compared to other antiplatelet medications
- Non-CABG (Coronary Artery Bypass Graft) related bleeding: Higher incidence than with clopidogrel
- Minor bleeding: More common than with placebo
Respiratory Side Effects
- Dyspnea (shortness of breath): Occurs in up to 15% of patients
- Usually mild to moderate in severity
- Often appears early in treatment
- May be related to ticagrelor's ability to inhibit adenosine reuptake 1
Cardiovascular Side Effects
- Bradycardia: Slowed heart rate
- Ventricular pauses: Usually asymptomatic but can be detected on monitoring
- Elevated heart rate: Can occur in some patients
Gastrointestinal Side Effects
- Nausea
- Diarrhea
- Abdominal discomfort
Other Notable Side Effects
- Elevated uric acid levels: Mechanism may be related to adenosine effects 1
- Headache
- Dizziness
Special Considerations
Timing of Side Effects
- Many side effects, particularly dyspnea, occur early in treatment
- Respiratory symptoms typically appear within the first few weeks
Medication Interactions
- Increased bleeding risk when combined with other anticoagulants
- Potential for reduced effectiveness when combined with high-dose aspirin (>100mg) 2
Discontinuation Timing
- Must be discontinued at least 5 days before any planned surgery to minimize bleeding risk 2
Patient Education Points
- Emphasize the importance of twice-daily dosing
- Missing doses significantly increases thrombotic risk
- If dyspnea occurs, patients should report it but understand it's usually not severe
- Patients should be aware of bleeding signs and when to seek medical attention
- If a dose is missed and remembered within 12 hours, take immediately; if more than 12 hours have passed, skip the dose 2
Monitoring Recommendations
- Regular assessment for bleeding complications
- Monitor for dyspnea, especially in the initial treatment period
- Be alert for bradycardia or cardiac rhythm changes
- Consider uric acid level monitoring in at-risk patients
Understanding these common side effects helps in proper patient selection, education, and management when using Brilinta for its antiplatelet effects in conditions like acute coronary syndrome.