LOTAC 90/MG FC TAB 60/FC TAB

Indications

Approved Uses

Reduction of thrombotic cardiovascular events (CV death, MI, stroke) in adults with acute coronary syndrome (ACS: unstable angina, NSTEMI, STEMI), including those managed medically or with PCI/CABG, when used with aspirin; and reduction of thrombotic events in patients with a history of MI (extended secondary prevention-typically with 60 mg twice daily after 12 months).

Off-Label Uses

No distinct off-label use is necessary to state: prevention of stent thrombosis after PCI is encompassed within ACS/PCI indications when ticagrelor is used as part of DAPT.

Dosage & Administration

Dosing by Condition

ACS: 180 mg loading dose once, then 90 mg orally twice daily with aspirin 75-100 mg/day for up to 12 months; Post-MI extended therapy (beyond 12 months after MI): 60 mg twice daily (requires 60 mg strength product, not this 90 mg pack).

Initial Dose

180 mg as a single loading dose for Acute Coronary Syndrome or Acute Ischemic Stroke/TIA.

Maintenance Dose

90 mg twice daily for up to 1 year post-ACS, then 60 mg twice daily.

Maximum Dose

180 mg per day (as 90 mg twice daily).

Children's Dosage

Not approved for children.

How to Take

Swallow tablet whole with water, with or without food. Can be crushed and mixed with water for patients unable to swallow tablets (e.g., via nasogastric tube). Take doses approximately 12 hours apart.

Safety & Warnings

Contraindications

Contraindications: Active pathological bleeding; history of intracranial hemorrhage; severe hepatic impairment; hypersensitivity to ticagrelor/excipients; concomitant use with strong CYP3A4 inhibitors (e.g., ketoconazole, itraconazole, clarithromycin, ritonavir).

Drug Interactions

Food Interaction

No restriction.

Special Populations

Children

Not approved for children.

Elderly

Standard adult dosing; no dose adjustment required, but monitor closely for bleeding risk as elderly patients may have increased susceptibility

Kidney Impairment

No dose adjustment in renal impairment, including severe impairment and dialysis; use caution/monitor in severe renal dysfunction due to higher overall bleeding risk.

Storage & Patient Advice

Missed Dose

If a dose is missed, take the next dose at the usual scheduled time; do not take two doses at once to make up for a missed dose.

Overdose

Overdose: expect bleeding and possible bradyarrhythmias/ventricular pauses and GI symptoms; management is supportive (hold drug, treat bleeding, monitor ECG/vitals). No specific antidote; dialysis is ineffective; platelet transfusion may have limited benefit.

Patient Counseling

Do not stop ticagrelor without prescriber advice; take 90 mg twice daily about 12 hours apart with or without food; take with low-dose aspirin 75-100 mg/day (avoid >100 mg/day); expect easier bruising/bleeding and seek urgent care for severe/prolonged bleeding or signs of intracranial/GI bleeding; report new/worsening shortness of breath; inform all clinicians/dentists before procedures; avoid strong CYP3A4 inhibitors/inducers and discuss OTC NSAIDs/herbals due to bleeding risk.

Pharmacology

Onset of Action

After a 180 mg loading dose, onset of platelet inhibition begins within ~30 minutes with near-maximal/peak inhibition typically within ~2-4 hours.

Half-Life

Ticagrelor terminal half-life ~7 hours; active metabolite (AR-C124910XX) ~8-9 hours.

Excretion

Elimination is primarily via hepatic metabolism with excretion mainly in feces; renal excretion is a minor route (unchanged drug in urine is minimal).

Product Information

Available Dosage Forms

Film-coated tablet.

Composition per Dose

Each film-coated tablet: Ticagrelor 90mg

Generic Availability

Yes

OTC Alternatives

No OTC alternative

Cv Drug Class

Antiplatelet

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