What You Need to Know About Ticagrelor Side Effects

Ticagrelor (brand name Brilinta) is a blood-thinning medication used to prevent heart attacks, strokes, and other serious cardiovascular events. Like all medications, it can cause side effects. Some are mild and expected. Others are serious and require immediate medical attention.

This guide covers the most common Ticagrelor side effects based on FDA labeling, explains which ones are normal, and tells you exactly when to call your doctor.

What Is Ticagrelor?

Ticagrelor is a P2Y12 platelet inhibitor — a type of antiplatelet medication that prevents blood clots by stopping platelets from sticking together. It's prescribed for patients with acute coronary syndrome (ACS), coronary artery disease (CAD), or after an ischemic stroke. You can learn more in our complete guide: What Is Ticagrelor?

Common Side Effects

The following side effects are commonly reported with Ticagrelor. Most are mild to moderate and often improve over time:

• Shortness of breath (dyspnea) — This is the most distinctive Ticagrelor side effect, affecting up to 14% of patients. It usually occurs within the first week and is often mild. It typically improves on its own but tell your doctor if it persists or worsens.
• Bleeding — Minor bleeding such as bruising more easily, nosebleeds, and bleeding gums is common with all antiplatelet medications. This is a sign the medication is working.
• Dizziness — Some patients feel lightheaded, especially when standing up quickly.
• Nausea — Mild stomach upset may occur, particularly when first starting the medication.
• Diarrhea — Loose stools are reported by some patients.
• Headache — Usually mild and treatable with acetaminophen (Tylenol). Avoid ibuprofen and naproxen, which can increase bleeding risk.
• Elevated uric acid levels — This may show up in blood tests but usually doesn't cause symptoms. In rare cases, it can trigger gout.

Serious Side Effects

The following side effects are rare but serious. Seek medical attention right away if you experience any of these:

• Serious or life-threatening bleeding — Signs include blood in your urine or stool, vomiting blood, coughing up blood, or bleeding that won't stop. Ticagrelor carries an FDA boxed warning about bleeding risk.
• Intracranial hemorrhage — Sudden severe headache, confusion, vision changes, difficulty speaking, or weakness on one side of the body. Call 911 immediately.
• GI bleeding — Black, tarry stools or vomiting material that looks like coffee grounds.
• Bradycardia (slow heart rate) — Ticagrelor can cause your heart to beat more slowly than usual, especially in the first week. Symptoms include feeling faint, extreme tiredness, or dizziness.
• Severe allergic reaction — Swelling of your face, throat, or tongue; difficulty breathing; or a rash with hives. Seek emergency care immediately.
• Ventricular pauses — Brief pauses in heart rhythm have been observed in clinical trials. Most patients don't feel these, but report any fainting or feeling like your heart skips beats.

Specific Populations

Older Adults

Patients over 65 don't need a dose adjustment, but they do have a higher risk of bleeding. More frequent monitoring may be recommended.

Patients with Asthma or COPD

The shortness of breath side effect can be more concerning for patients with existing lung conditions. Your doctor should monitor you closely and may consider alternative medications if breathing difficulties become severe.

Pregnancy and Breastfeeding

Ticagrelor should only be used during pregnancy if the benefit clearly outweighs the risk. It is not recommended while breastfeeding.

Liver Disease

Ticagrelor is contraindicated in patients with moderate to severe liver impairment due to increased drug levels and bleeding risk.

How to Manage Side Effects

Here are practical tips for managing the most common Ticagrelor side effects:

• Shortness of breath: This often improves after the first few weeks. If it doesn't affect your daily activities, your doctor may recommend continuing the medication. Don't stop Ticagrelor on your own.
• Bleeding: Use a soft toothbrush, an electric razor instead of a blade, and be careful with sharp objects. Avoid contact sports or activities with high injury risk.
• Headache: Take acetaminophen (Tylenol). Avoid NSAIDs like Ibuprofen or Naproxen — they increase bleeding risk when combined with Ticagrelor. See our drug interactions guide for more.
• Dizziness: Stand up slowly from sitting or lying positions. Stay hydrated.
• Nausea: Try taking Ticagrelor with food if stomach upset occurs.

Important: Never stop taking Ticagrelor without talking to your doctor first. Stopping suddenly can significantly increase your risk of a heart attack or stroke, especially if you have a stent.

Final Thoughts

Most Ticagrelor side effects are manageable, and many patients tolerate the medication well. Shortness of breath and minor bleeding are the most commonly reported issues. The key is knowing the difference between expected side effects and warning signs that need immediate attention.

Talk to your doctor about any side effects you experience — they may be able to adjust your treatment or offer solutions. And if you need help finding Ticagrelor at an affordable price, visit Medfinder to check pharmacy availability and compare costs.