Ticagrelor
- Class: P2Y12 inhibitor
- Used for: blood clots after a stent
- Say it: tye-KAG-reh-lor
- Forms: tablet
TICAGRELOR TICKS TWICE a day — unlike clopidogrel, which ticks once.
It is genuinely twice daily, and patients moved between the two get this wrong constantly. A missed dose soon after a stent is a serious matter, not a small slip.
Both block the platelet P2Y12 receptor. Clopidogrel is a prodrug and binds irreversibly; ticagrelor needs no activation, works faster and lets go — so function returns in 3-5 days rather than 7-10.
Side effects
Common: shortness of breath, bruising, bleeding
Serious: major bleeding, slow heart rate
Typical dose
90 mg twice daily
180 mg loading dose, then 90 mg twice daily. Keep the background aspirin at 75–100 mg, not higher.
Check yourself
How does ticagrelor differ from clopidogrel at the P2Y12 receptor?
- It binds reversibly and needs no metabolic activation, so it acts faster
- It blocks a different receptor altogether
- It is an anticoagulant rather than an antiplatelet
- It blocks COX-1 like aspirin
Show answer
A. It binds reversibly and needs no metabolic activation, so it acts faster
Clopidogrel must be converted by CYP2C19 first, so poor metabolisers respond badly, and its block is permanent. Ticagrelor arrives active and reversible — faster on, and faster off before surgery.
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