Brililina Astrazeneca medicine reduces the risk of heart attack, stroke (6 blisters x 10 tablets)

Dosage form Box of 6 blisters x 10 tablets
Specifications Ticagrelor
Ingredient Astra

Ingredient

Composition information	Content
Ticagrelor	90mg

Uses

Indications

Brililinta drugs are indicated in case of prevention of thrombosis due to atherosclerosis In patients with adults with acute coronary syndrome (unstable angina, myocardial infarction without ST difference (NSTEME) or steering myocardial infarction (stemid) including patients with medical treatment or patients with surgical patients or surgical patients or surgical patients Coraic bridge.

The drug reduces the risk of another heart attack, a stroke or death from heart disease or blood vessels.

Pharmacokology

Brilinta contains ticagrelo, a component of the chemical group of cyclopentyltriazology (CPTP), a oral medicine, with direct impact, selective P2YG receptor antagonism and reversible interaction, preventing the process of activity and collection of P2YG -dependent plasma Diphosphate. Tiagrelor does not prevent the cohesion with ADP, but when attached to P2Y12 receptor will prevent the transmission of many ADP induction. Micro platelets are involved in the process of onset and/or develop blood complications when atherosclerosis, inhibiting platelet function has been shown to reduce the risk of cardiovascular complications such as death, myocardial infarction or stroke.

ticagrelor, also increases the level of endogenous adenosin levels by inhibiting nucleoside -1 balancing shipping. Ticagrelor has been recognized as increasing the following adenosin touch effects in healthy people and ACS patients: vasodilation (determined by increasing coronary blood flow in healthy volunteers and ACS patients; headache), inhibiting platelet function (total blood of people when observing in laboratory) and shortness of breath. However, the relationship between cases of adenosin increases and clinical results (for example, the incidence of disease-death) has not been clearly clarified.

pharmacokinetic

ticagrelor shows linear pharmacokinetic. The concentration and time of contact with Ticagrelor and the active metabolites (AR-C124910XX) ratio in the dose ratio up to about 1260 mg.

absorption

Ticagrelor absorbs fast with an average TMAX about 1.5 hours. The main metabolites of the AR-C124910xx blood (also active) from Ticagrelor are created quickly with an average TMAX about 2.5 hours. After taking 90mg Ticagrelor at hunger, the cmax peak concentration reaches 529 ng/ml and the area under the AUC curve is 3,451 ng*h/ml. The metabolic ratio is 0.28 for CMAX peak concentration and 0.42 for the area below the AUC curve.

Ticagrelor's absolute average bioavailability estimates about 36%. Consumption of a fat -rich meal increases 21% under the AUC curve of Ticagrelor and reducing 22% of the cmax peak concentration of the active metabolic but does not affect the cmax peak concentration of Ticagrelor or the area under the AUC curve of the active metabolic. These small changes are considered less clinical significance, so Ticagrelor can be used with or not with food. Ticagrelor as well as active metabolites are the substrates of P-GP.

ticagrelor in the form of pellets are crushed and dispersed in water, taken or used through gastric catheter, bioavailability can be compared to the original tablet of the AUC and CMAX indicators of ticagrelor and active metabolites. The starting concentration (0.5 hours after the tablet is crushed and dispersed in the water higher than the intact tablet, with the data about the concentration almost the same as later (after 2 - 48 hours).

Distribution

The volume of distribution in the constant state of Ticagrelor is 87.5 L. Ticagrelor and metabolites have high activity associated with plasma proteins (> 99.0%).

Metabolism

CYP3A4 is the main enzyme responsible for the metabolism of ticagrelor and forming the metabolic substance that has the activity and interaction with other substrates of the CYP3A enzyme that can go from activation to inhibition.

The main metabolites of Ticagrelor are AR-C124910XX, which also has the activity when studying in vitro in association with the P2Y12 ADP receptor of platelets. Time and concentration of exposure to metabolites with flowers are about 30-40% of time and concentration of contact with ticagrelor.

Elimination

The main elimination line of Ticagrelor through the liver metabolism. When taking Ticagrelor, the radioactive radioactive activity is about 84% (57.8% in the part, 26.5% in the urine). Ticagrelor and metabolites that are active in urine are 1% lower than the dose. The main elimination line of metabolites is very active through the biliary tract. T1/2 on average is about 7 hours for tagrelo and 8.5 hours for active metabolites.

Before taking Brililina Astrazeneca medicine reduces the risk of heart attack, stroke (6 blisters x 10 tablets)

How to use

always use the medication as directed by the doctor. Ask the doctor or pharmacist if the patient is not sure.

Can take the same or not with the meal. There is a sun shape (to drink in the morning) and the moon image (to drink in the evening). Based on that, the patient can determine whether or not he has taken medicine.

Crush the pill into fine powder. 180mg). This dose is always used during patients in the hospital.

After this starting dose, the usual dose is 1 tablet 90mg 2 times daily for up to 12 months, unless otherwise instructed by a doctor.

Take the medicine at the same time every day (for example 1 morning tablet, 1 tablet in the evening).

Doctors usually prescribe Brilinta with acetylsalicylic acid. This is the active ingredient in many drugs to prevent blood clots. The doctor will guide the dosage for patients (usually from 75 - 100mg per day).

Note: The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.

What to do when overdose?

immediately notify the doctor or hospitalized. Carry a box/blister box.

What to do when forgetting 1 dose?

Do not take double the dose (2 tablets at the same time) to make up for the forgotten dose.

Side Effects

When using Brililinta, you may experience unwanted effects (ADR).

Brilninto acts on blood clots, so the most unwanted effect is related to bleeding. Some event bleeding events are often encountered such as bruises and nose bleeding. Less serious bleeding, but if there is life -threatening:

Bleeding in the brain or in the skull is unwanted effects and may be a sign of a stroke such as:

The patient suddenly has numbness or weak arms, legs or face, especially if only occurs on one side of the body.

suddenly find it difficult to walk or lose balance or coordinate movement.

suddenly felt dizzy or suddenly severe headache without the cause.

Signs of bleeding such as:

intense or uncontrolled bleeding.

vomit blood or vomit like coffee grounds.

red or black stool (looks like black).

cough or vomit blood clots.

Fainting (fainting): Losing temporary consciousness due to a sudden reduction in blood flow to the brain (common).

Discuss with a doctor if the patient encountered any of the following problems: Feeling folding - this is very common. It may be due to available heart disease or other causes, or may be due to unwanted effects of Brilinta. Difficulty breathing related to normal brililina and is characterized by sudden, feeling of lack of external air, usually occurs at rest and can appear in the first week when treatment and in most cases will be over. If the patient feels the worse, the worse and lasts for a long time, notify the doctor. The doctor will decide whether or not to be investigated or investigated.

Other undesirable effects:

Very common, ADR> 1/10

Increasing uric acid levels (recorded in subclinical tests).

Bleeding due to blood disorders.

Common, ADR> 1/100

bruises. Headache. Feeling dizzy or feeling like the room is rotating.

Diarrhea or indigestion . Feeling disease (nausea). Constipation.

floating. Itchy.

Painful and joint swelling - These are signs of gout .

Feeling dizziness or light head, or blurred vision - this is a sign of hypotension.

Nose bleeding. Bleeding after surgery or cutting (for example, shaving) and the wound is worse than usual. Stomach bleeding (ulcer). Bleeding in the gums.

Allergic reaction - rash, itching, or swelling of the face or swelling of the lips/tongue may be a sign of allergic reactions. Confusion.

vaginal bleeding that occurs worse, or occurs at other times, compared to bleeding during the normal menstrual cycle.

Internal hemorrhage, which can cause dizziness or light head.

Instructions on how to handle ADR

immediately see a doctor if the patient has the following unwanted effects because the patient may need emergency medical care.

Warnings

Before using the drug you need to read the instructions carefully and refer to the information below.

Contraindicated

Brililinta drugs are contraindicated in the following cases:

Patients with allergies to ticagrelor or with any ingredients of the drug.

Patients with bleeding. nefazodon , ritonavir, atanavir .

Be cautious when using

Notice to a doctor or pharmacist before taking Brilinta if:

Patients increasing the risk of bleeding for the following reasons:

Recently has serious injuries.

Recently surgery (including dental surgery, ask the dentist about this information).

has recently bleeding in the stomach or intestines (such as stomach ulcers or "polyps" in the intestine).

Patients with surgery (including dental surgery) at any time during the use of Brilinta. This is due to increased risk of bleeding. The doctor may ask to stop this medicine 7 days before surgery.

abnormal bradycardia

Patients with asthma or other lung diseases or shortness of breath.

Patients with liver disease or previously suffered from diseases that affect liver function.

If the patient encounters any of the above (or uncertainty), inform the doctor or pharmacist before taking this medication.

There is no encouragement to use Brilinta for adolescents and adolescents under 18 years old.

The ability to drive and operate machinery

Brilinta is not likely to affect the ability to drive and operate machinery. If the patient feels dizzy or confused while taking this medication, be careful while driving and operating machines.

Pregnancy

No encouragement to use Brilinta if the patient is pregnant or may be pregnant. Women should apply contraceptive measures while using Brililina. If the patient is pregnant or think that may be pregnant or intended to get pregnant, consult a doctor or pharmacist before taking this medication.

Breastfeeding period

Notice to the doctor if the patient is breastfeeding before taking Brilinta. If the patient is breastfeeding, consult a doctor or pharmacist before taking this medication.

Medicinal interaction

Notice to a doctor or pharmacist if the patient is taking, recently used or may use any other drug. This is because Brililina can affect the mechanism of impact of some drugs and some other drugs may also affect Brilinta.

Notify the doctor or pharmacist if the patient is taking any of the following drugs:

Use more than 40 mg daily Simvastatin or lovastatin (medication to treat hypertonic blood cholesterol), rifampicin (antibiotic).

phenytoin , carbamazepine and phenobarbital (epilepsy drugs).

Digoxin (Heart failure medication).

Cyclosporin (drugs that reduce the body's resistance).

quinidine and diltiazem (abnormal heart rate treatment).

Specifically notify the doctor or pharmacist if the patient is taking any drug increases the risk of bleeding such as:

Oral anticoagulants are often called "blood thinning drugs" including warfarin.

Non-steroid anti-inflammatory drugs (abbreviated as NSAIDs) are often used to reduce pain such as ibuprofen and Naproxen.

Select Serotonin Rehabilitation Inhibitors (abbreviated as SSRIs), used to prevent depression such as paroxetin , sertralin and citalopram.

Other drugs such as ketoconazole (fungal infections), Clarithromycin (infectious drugs), nefazodon (antidepressants), Ritonavir and Atazanavir (HIV and AIDS medications), Cisaprid (Heart Certificate Treatment Heart ), Alkaloid vascular medicine (headache medicine and headache).

It is necessary to notify the doctor because the patient is taking Brilinta drug, so there is a risk of increased bleeding if the doctor prescribes additional medication as a fiber fiber solving, often called "medication that dissolves blood clots" such as Streptokinase or Alteplase.

Storage

Store at temperatures not exceeding 30 ° C.

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