Ticacard Tablet: Each film coated tablet contains Ticagrelor INN 90 mg.
Ticagrelor is a member of the chemical class cyclopentyltriazolopyrimidines (CPTP). It is a selective adenosine diphosphate (ADP) receptor antagonist acting on the P2Y12 ADP-receptor that can prevent ADP-mediated platelet activation and aggregation. Ticagrelor reversibly interacts with the platelet P2Y12 ADP-receptor. Ticagrelor does not interact with the ADP binding site itself, but interacts with platelet P2Y12 ADP-receptor to prevent signal transduction. Thus it prevents platelet activation & aggregation.
Ticacard is indicated for the prevention of atherothrombotic events in adult patients with Acute Coronary Syndromes (unstable angina, non ST elevation Myocardial Infarction [NSTEMI] or ST elevation Myocardial Infarction [STEMI]); including patients managed medically, and those who are managed with percutaneous coronary intervention (PCI) or coronary artery by-pass grafting (CABG).
CYP3A inhibitors: Avoid use of strong inhibitors of CYP3A (e.g., ketoconazole, itraconazole, voriconazole, clarithromycin, nefazodone, ritonavir, saquinavir, nelfinavir, indinavir, atazanavir and telithromycin). CYP3A inducers: Avoid use with potent inducers of CYP3A (e.g., rifampin, dexamethasone, phenytoin, carbamazepine and phenobarbital). Aspirin:Use of Ticagrelor with aspirin maintenance doses above 100 mg reduced the effectiveness of Ticagrelor. Simvastatin, lovastatin: Ticagrelor will result in higher serum concentrations of simvastatin and lovastatin because these drugs are metabolized by CYP3A4. Avoid simvastatin and lovastatin doses greater than 40 mg. Digoxin: Because of inhibition of the P-glycoprotein transporter, monitor digoxin levels with initiation of or any change in ticagrelor therapy. Other Concomitant Therapy: Ticagrelor can be administered with unfractionated or low-molecular-weight heparin, GPIIb/IIIa inhibitors, proton pump inhibitors, beta-blockers, angiotensin converting enzyme inhibitors, and angiotensin receptor blockers.
Ticagrelor is contraindicated in case of any hypersensitivity to ticagrelor or to any of the excipients, active pathological bleeding (peptic ulcer),history of intracranial haemorrhage, moderate to severe hepatic impairment, co-administration of ticagrelor with strong CYP3A4 inhibitors (e.g., ketoconazole, clarithromycin, nefazodone, ritonavir, and atazanavir).
Bleeding (major & minor), dyspnea, headache, cough, dizziness, nausea, atrial fibrillation, hypertension, diarrhea, back pain, hypotension, fatigue, chest pain.
Use in pediatrics: Fenofibrate has not been investigated in adequate and well controlled trials in pediatric patients.
Use in pregnancy & nursing mothers: Fenofibrate is contraindicated during pregnancy & nursing mothers.