Ticagrelor (Brilinta) Dosage Guide in Pakistan

The dose of Ticagrelor depends on the indication — 90mg for ACS, 60mg for chronic CAD. This guide covers dose, DAPT protocol, aspirin limit, and missed dose in complete detail.

Compiled by the PakVita Editorial Team · AI-assisted drafting with editorial review · Sourced from DRAP, WHO, BNF · Last updated: 2026-06-17

Dosage Guide

Quick Answer

The dose of Ticagrelor in ACS is 90mg twice daily. In chronic high-risk CAD / PAD it is 60mg twice daily. Aspirin should be only 75-100mg/day — a higher dose reduces the efficacy of Ticagrelor. Do not stop or adjust the dose yourself — there is a risk of stent thrombosis. Missed dose: take as soon as remembered, if next dose is due soon skip it, do not double dose.

Dose at a Glance

Adult Dose

ACS: 90mg twice daily; Chronic CAD/PAD: 60mg twice daily — always with aspirin 75-100mg/day

Twice daily (BD) — morning and evening at the same time

Max: 90mg BD (ACS) or 60mg BD (chronic) — do not adjust without a cardiologist

Child Dose (Adults only — paediatric use specialist-guided only)

Generally not recommended in children — consult a cardiologist or paediatric cardiologist

N/A

Missed Dose

If a dose is missed, take it as soon as remembered. If the next dose is due soon, skip the missed dose — absolutely no double dose. ACS/stent patients must take doses regularly — missing a dose can be dangerous. Inform your cardiologist.

Overdose

Ticagrelor overdose increases the risk of major bleeding. There is no specific antidote. Contact your doctor or emergency room immediately. Platelet transfusion offers limited benefit.

Ticagrelor (Brilinta) Dosage (Kitni leni hai)

The correct dose of Ticagrelor depends on the indication — 90mg BD for ACS, 60mg BD for chronic high-risk CAD. Always take as prescribed by your cardiologist.

Adult Dose (Baalgon ke liye)

ACS (Acute Coronary Syndrome) Dosing

Loading Dose: Usually 180mg (2 × 90mg tablets) — given by cardiologist in hospital

Maintenance Dose: 90mg twice daily (BD) — with aspirin 75-100mg once daily

Duration: Minimum 12 months

Chronic High-Risk CAD / PAD Dosing

Dose: 60mg twice daily (BD) — with aspirin 75-100mg once daily

Duration: Long-term — decided by cardiologist

CRITICAL: Aspirin Dose Limit

Aspirin Dose	Effect on Ticagrelor
75-100mg/day	Correct — efficacy maintained
>100mg/day (e.g., 300mg)	Ticagrelor efficacy REDUCED — avoid

This is a special property of Ticagrelor — many people in Pakistan take aspirin 300mg which is incorrect if taking Ticagrelor at the same time.

Child Dose (Bachon ke liye)

Ticagrelor is generally not recommended in children — a paediatric cardiologist will provide specialist guidance.

How to Take (Kaise lena hai)

Tablet can be taken with or without food
Take at the same time every day — morning and evening
Take with aspirin
Inform your doctor / surgeon before any surgery or dental procedure

Missed Dose (Dose chhoot jaye to kya karein)

If a dose is missed, take it as soon as remembered. If the next dose is due soon, skip the missed dose. Absolutely no double dose. For ACS/stent patients — taking doses regularly is essential — inform your cardiologist if doses are being missed frequently.

Overdose (Zyada Dose)

Ticagrelor overdose increases the risk of major bleeding. No specific antidote is available. Contact the emergency room immediately. Platelet transfusion offers limited benefit.

Pre-Surgery Protocol

Stop Ticagrelor 5 days before elective surgery (including dental surgery) — coordinate with your cardiologist and surgeon. In emergency surgery — inform the surgical team.

Dose Summary Table

Indication	Dose	Duration
ACS (acute)	180mg loading, then 90mg BD	Minimum 12 months
ACS maintenance	90mg BD + aspirin 75-100mg	12 months
Chronic CAD (PEGASUS)	60mg BD + aspirin 75-100mg	Long-term
PAD	60-90mg BD + aspirin	Specialist-guided

The information in this guide is for educational purposes only. Always confirm dose with your cardiologist or pharmacist.

Frequently Asked Questions

Ticagrelor 60mg aur 90mg mein kya farq hai?

90mg is for ACS (acute heart attack/stent) — more potent, for the first year. 60mg is for secondary prevention in chronic CAD — from the PEGASUS trial. The cardiologist decides based on the condition.

Ticagrelor ke saath aspirin kitni leni chahiye?

Aspirin only 75-100mg/day. Higher aspirin (e.g., 300mg/day) reduces the efficacy of Ticagrelor — this was proven in the PLATO trial. No high-dose aspirin.

Ticagrelor dose miss ho jaye to kya karein?

Take as soon as remembered. Skip if next dose is due soon. No double dose. Missing a dose in ACS/stent patients is serious — inform your cardiologist.

Ticagrelor surgery se pehle kab band karni chahiye?

Stop 5 days before elective surgery. In emergency surgery — inform the surgical team that you are taking Ticagrelor.

Ticagrelor kitne arsa tak leni chahiye?

Minimum 12 months after ACS. In chronic CAD the cardiologist decides. Do not stop on your own — there is a risk of stent thrombosis.

Sources

DRAP Registered Products Database — Drug Regulatory Authority of Pakistan
WHO Model List of Essential Medicines, 23rd ed. (2023) — World Health Organization
British National Formulary (BNF) — BMJ Group & Pharmaceutical Press

Medical disclaimer

This page is for educational use only and does not replace professional medical advice. Always confirm diagnosis, dose, and interactions with a qualified doctor or pharmacist before starting or changing any medicine.