Ticagrelor 90 mg tablets What is Ticagrelor used for: Ticagrelor is used to treat patients who have had a heart attack or severe chest pain that occurred due to lack of oxygen delivered to their heart. This medicine is used to decrease the chance of developing heart attacks or dying from stroke or a heart attack. It is used with aspirin to decrease your chance of having another serious heart or blood vessels problem (e.g. stroke, heart attack, or blood clots in your stent) which may be fatal. Do not use Ticagrelor: If you are allergic to Ticagrelor, or any of the ingredients in this medicine. Tell your doctor about the allergy and what signs you had. If you have previously experienced bleeding in the brain. If you are currently bleeding. Warnings and Precautions: Stop the medication right away and talk to your doctor or pharmacist if you develop allergic reactions such as shortness of breath, skin rash, swelling of the face or neck, decreased blood pressure and dizziness. This medicine may cause dyspnea (difficulty breathing). Talk to your doctor if this happens. Talk to your doctor if you have liver problems before you start/continue taking this medicine. Your doctor may recommend another alternative depending on the severity of your liver damage if needed. You may have an increased risk of bleeding when taking this medicine if you have severe liver damage. This medicine may increase the risk of bleeding which may be serious and sometimes may be fatal. You may need blood transfusion or surgery if you experience serious bleeding (e.g. internal bleeding). You may be at higher risk of experiencing bleeding signs like easy bruising and bleeding, nose bleeds, delayed wound healing and delayed blood clotting. Contact your doctor immediately if you experience any of the following serious bleeding signs; severe bleeding, bleeding that you cannot control, pink, brown or red urine, coughing up blood or blood clots, vomiting blood or vomit that looks like “coffee grounds”, black or red stools or stools that look like tar. This medicine is usually taken with aspirin. Ask your doctor about the dose of aspirin that you should take. Do not take more than 100 mg of aspirin per day in order not to affect the efficacy of ticagrelor. Take your aspirin dose exactly as prescribed by your doctor, do not take higher than prescribed doses. Talk to your doctor if you are taking other medications that contain aspirin, and make sure not to take new over-the-counter medicines (do not require a prescription) that contain aspirin. Talk to your doctor before starting this medicine if you have a history of bleeding problems. Talk to your doctor before starting this medicine if you have a history of stomach ulcers (sore in your stomach) or colon polyps. Talk to your doctor before starting this medicine if you have recently had any serious injury or surgery or if you have a planned dental procedure or a surgery. Talk to your doctor before starting this medicine if you have lung problems (e.g. COPD or asthma). Talk to your doctor before starting this medicine if you have a history of stroke. Make sure to tell your doctors and dentists that you are taking this medicine. They should also inform the doctor who prescribed your medicine about any planned surgical procedures that you have. Possible side effects: Possible side effects include allergic reactions; signs of serious bleeding, like severe bleeding, bleeding that you cannot control, pink, brown or red urine Coughing up blood or blood clots, vomiting blood or vomit that looks like “coffee grounds”, black or red stools or stools that look like tar and new or unexpected shortness of breath at night, at rest, or during any activity. Most common side effects include bleeding (e.g. easy bruising and bleeding, nose bleeds, delayed wound healing and delayed blood clotting) and dyspnea (difficulty breathing). Other medicines and Ticagrelor: Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medications including prescription medicines, over the counter medicines, herbals, vitamins and supplements. If you are taking Digoxin (used to treat some heart problems). If you are taking medicine used to decrease high blood cholesterol levels (e.g. lovastatin or simvastatin). If you are taking an HIV-AIDS medicine. If you are taking medicines used for heart conditions or high blood pressure. If you are taking an oral anti-fungal medicine. If you are taking a medicine that is used to treat seizures. If you are taking a blood thinner medicine. If you are taking rifampin (antibiotic). How to take Ticagrelor: The usual recommended initial dose is 180 mg orally given as a loading dose (an initial higher dose that may be given at the start of a course of therapy before decreasing the dose down to a maintenance dose) following an acute coronary syndrome (ACS) event (conditions associated with sudden, reduced blood flow to the heart like heart attack). It is usually recommended that you continue treatment with 90 mg twice daily during the first year after an ACS event, followed by 60 mg twice daily after 1 year. This medicine is usually given with a daily maintenance dose of aspirin of 75-100 mg. Take this medicine exactly as prescribed by your doctor. Ask your doctor if you are not sure. It is not known if this medicine is safe and effective in children yet. How To Use: Take this medicine exactly as prescribed by your doctor. Your doctor will determine how many tablets you need to take and when to take them. Take with or without food. Take your doses at the same time every day. If you are unable to swallow the tablet, you may crush it and mix it with water. Make sure to drink the entire cup, then rinse the cup with water and drink all the water again. How to store Ticagrelor: Keep out of the reach of children and pets Store medication at 20 to 25°C Do not use beyond the expiry date mentioned on the box Keep medication in its original pack to protect it from moisture and light Do not use damaged tablets Do not dispose medication in the wastewater or household waste A valid prescription should be available upon delivery

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