Nice | Ticagrelor for the treatment of acute coronary syndrome ACS

Ticagrelor is a PO drug which inhibits platelet aggregation. In combination with aspirin it is more effective than clopidogrel + aspirin at reducing the endpoint of MI or death from vascular events.

It will be started by secondary care and continued by cardiologists, so we shouldn’t really have to initiate it.

It will be started in patients who’ve had a STEMI where primary percutaneous coronary intervention (PCI) is considered and also in patients with a NSTEMI who have certain other risk factors.

Generally the side-effects are mainly easy bleeding, but dyspnoea is also an important side-effect, though it is normally just short episodes which are tolerated well.

You can’t use ketoconazole or clarithromycin with it, nor should it be used in moderate to severe hepatic failure.

Read the NICE guidance here.

Louise Hudman

I'm a freelance GP locum in Winchester & Southampton.

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1 Response

  1. Pallavi Chaudhary
    I have also seen quite a few patients on Prasugrel. It is started with aspirin and only in secondary care setting in certain cases(pt who require immediate PCI or who have stent thrombosis despite previous clopidogrel therapy) It is not recommended for over 75 or pt weighing less than 60kg due to increased risk of bleeding. It is contraindicated in patients with a history of CVA/TIA.

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