Is Brilinta a blood thinner or antiplatelet?

Brilinta (generic name: ticagrelor) is an oral antiplatelet prescription tablet for adults that is usually taken twice a day, in the morning and the evening. It is classified as a P2Y₁₂ inhibitor and works by making your platelets less sticky to help prevent blood clots from forming.

Blood clots are formed from red and white blood cells, platelets, and fibrin. Both anticoagulants (for example, drugs like warfarin) and antiplatelet drugs (such as aspirin or Brilinta) keep these components from clumping together and forming a blood clot.

Like blood thinners, Brilinta also has a risk of serious or possibly fatal bleeding, and carries a Boxed Warning for this effect.

What did the FDA approve Brilinta for?

Brilinta is approved by the FDA to:

1. Decrease your risk of death, heart attack, and stroke in people with a blockage of blood flow to the heart (called acute coronary syndrome or ACS) or a history of a heart attack.

• ACS can result in severe chest pain (angina) or a heart attack (myocardial infarction). This could happen because your heart is not getting enough oxygen.
• For at least the first 12 months following ACS, it is superior to clopidogrel (brand name: Plavix) for this use.
• Brilinta can also decrease your risk of blood clots in your stent if you have received stents for the treatment of ACS. Further blockage of your stent could lead to a heart attack or even death.

2. Decrease your risk of a first heart attack or stroke if you have a condition where the blood flow to the heart is decreased (called coronary artery disease or CAD) and are at high risk for having a heart attack or stroke.

• While use is not limited to this setting, the effectiveness for CAD was established in people with type 2 diabetes.

3. Decrease your risk of stroke if you are having a stroke (acute ischemic stroke) or mini-stroke (transient ischemic attack or TIA).

If you stop taking Brilinta too soon, it may increase your risk of a heart attack, stroke or death.

If you are having surgery, your doctor may instruct you to stop taking Brilinta 5 days before your procedure. This will help to lower the chance of bleeding during surgery or your procedure.

Follow your doctor’s directions on when to stop and start taking Brilinta again. Do not stop treatment on your own.

Is aspirin used with Brilinta?

Your doctor may prescribe a daily dose of aspirin with Brilinta to help reduce the chance of a blood clot forming. Your doctor will tell what dose of aspirin to take. Using Brilinta and aspirin together is called “dual antiplatelet therapy”.

Tell your healthcare provider if you take any other medicines that contain aspirin, and do not take new over-the-counter medicines with aspirin in them.

Table 1. Examples of Antiplatelet and Anticoagulant Drugs

Related questions

• How long do I have to take Brilinta after a stent or heart attack?
• What foods should I eat or avoid when taking Brilinta?
• Can you drink alcohol while taking Brilinta?

Does Brilinta have a Boxed Warning about bleeding?

Yes, Brilinta carries a Boxed Warning on its label, the most stringent safety warning from the FDA, about bleeding risks. It states:

• Brilinta, like other antiplatelet agents, can cause significant bleeding which my lead to death.
• Do not use Brilinta if you are bleeding now or have a history of bleeding in the brain.
• Do not use Brilinta if you are undergoing an urgent coronary artery bypass graft surgery (CABG).
• If possible, your doctor will manage bleeding without discontinuing Brilinta. Stopping Brilinta increases the risk of a heart attack, stroke or death in people with coronary artery disease (CAD).

Do not use Brilinta if you are allergic to the active ingredient ticagrelor or any other component in the medicine.

The most common side effects with Brilinta are bleeding and shortness of breath.

Bottom Line

• Brilinta (generic name: ticagrelor) is an oral antiplatelet prescription tablet that is usually taken twice a day, in the morning and the evening.
• It is often prescribed together with a daily dose of aspirin to help reduce the chance of a blood clot forming. Your doctor will tell what dose of aspirin to take. Using Brilinta and aspirin together is called “dual antiplatelet therapy”.
• If you stop taking Brilinta too soon, it can increase your risk of a heart attack, stroke or death. However, Brilinta can also increase the risk of severe bleeding that might lead to death. Ask your doctor how long you’ll need to take these drugs and do not stop taking them without talking to your heart doctor first.

This is not all the information you need to know about Brilinta (generic name: ticagrelor) for safe and effective use and does not take the place of your health care provider's directions. Review the full product information and discuss this information with your doctor or other health care provider.