Brilinta (Ticagrelor) is a prescription antiplatelet medication used to reduce the risk of heart attack, stroke, and cardiovascular death in people with acute coronary syndrome or a history of heart attack.

What Is Brilinta?

Brilinta is the brand name for Ticagrelor, a medication in a class called P2Y12 platelet inhibitors. It's made by AstraZeneca and was first approved by the FDA for use in the United States.

Unlike older antiplatelet drugs like Clopidogrel (Plavix), Brilinta is not a prodrug — it doesn't need to be converted by your liver to work. This means it works the same way in everyone, regardless of genetics. Some patients are "poor metabolizers" of Clopidogrel due to variations in the CYP2C19 gene, which can make Clopidogrel less effective. Brilinta doesn't have this problem.

Brilinta is also reversible, meaning platelet function recovers faster after you stop taking it compared to Clopidogrel or Prasugrel (Effient), which bind permanently to platelets. For a detailed explanation, see our mechanism of action guide.

Brilinta is not a controlled substance and comes in two strengths: 60 mg and 90 mg oral tablets.

What Is Brilinta Used For?

Brilinta is FDA-approved for three main indications:

1. Acute Coronary Syndrome (ACS)

This is the most common reason Brilinta is prescribed. ACS includes heart attacks (myocardial infarction) and unstable angina. After a cardiac event, your blood is more likely to form clots that could cause another heart attack or stroke. Brilinta, taken with low-dose aspirin, helps prevent those clots from forming.

2. Coronary Artery Disease (CAD) with History of Heart Attack

For patients who have already had a heart attack, long-term Brilinta therapy (at the lower 60 mg dose) helps reduce the risk of future cardiovascular events. This is sometimes called secondary prevention.

3. Acute Ischemic Stroke or High-Risk TIA

Brilinta is also approved to reduce the risk of stroke and death in patients who've had an acute ischemic stroke or a high-risk transient ischemic attack (TIA, sometimes called a "mini-stroke").

How Is Brilinta Taken?

Brilinta is an oral tablet taken twice daily. Here's how dosing typically works:

• For ACS (first year): A 180 mg loading dose (two 90 mg tablets taken at once), followed by 90 mg twice daily. Must be taken with low-dose aspirin (75–100 mg per day).
• For long-term CAD prevention (after the first year): 60 mg twice daily with low-dose aspirin.
• For acute ischemic stroke: A 180 mg loading dose, followed by 90 mg twice daily for 30 days.

Important details about taking Brilinta:

• You can take it with or without food
• If you can't swallow tablets, they can be crushed, mixed with water, and taken by mouth or through a nasogastric tube
• Do not skip doses. Missing doses or stopping Brilinta increases your risk of heart attack, stroke, and death — especially if you have a stent
• Aspirin dose matters. Brilinta carries a boxed warning that aspirin doses above 100 mg per day reduce its effectiveness. Stick to low-dose aspirin only

Who Should Not Take Brilinta?

Brilinta is not appropriate for everyone. You should not take Brilinta if you have:

• Active bleeding — such as a peptic ulcer or any condition causing active pathological bleeding
• History of intracranial hemorrhage — bleeding inside the brain at any point in the past
• Severe liver disease — Brilinta is processed by the liver, and severe hepatic impairment makes it unsafe
• Allergy to Ticagrelor — or any inactive ingredient in the tablet

Additionally, Brilinta should not be taken with:

• Strong CYP3A4 inhibitors — medications like Ketoconazole, Itraconazole, Clarithromycin, Ritonavir, and Atazanavir, which dramatically increase Ticagrelor levels in your blood
• Strong CYP3A4 inducers — medications like Rifampin, Phenytoin, Carbamazepine, and Phenobarbital, which reduce Ticagrelor to ineffective levels

For a complete list, see our Brilinta drug interactions guide.

If you're planning to have surgery — especially coronary artery bypass grafting (CABG) — tell your surgeon you're on Brilinta. It should be stopped at least 5 days before surgery when possible.

How Much Does Brilinta Cost?

Cost is one of the biggest concerns for Brilinta patients. Here's what you can expect to pay:

• Brand-name Brilinta: $450–$665 per month without insurance for 60 tablets (either strength)
• Generic Ticagrelor: Around $30–$100 per month with discount cards. Retail without discount is approximately $430 per month
• With insurance: Most commercial and Medicare Part D plans cover Brilinta or generic Ticagrelor, typically on Tier 3. Copays vary by plan

Ways to Save

• AstraZeneca Savings Card: Commercially insured patients may pay as little as $5 per 30-day supply (up to $200 maximum savings per fill)
• Generic Ticagrelor: Available since mid-2025 from manufacturers including Alembic, Novadoz, Ascend, Teva, and Hisun Pharmaceuticals. This is the most significant cost-saver for most patients
• Discount cards: GoodRx, SingleCare, and other discount card programs can reduce the price of generic Ticagrelor to $30–$100 per month
• Patient assistance: While AstraZeneca's AZ&Me program no longer covers Brilinta as of January 2026, organizations like NeedyMeds, RxAssist, and RxHope may be able to help

For a complete breakdown of savings options, read our Brilinta savings guide.

Side Effects at a Glance

The most common side effects of Brilinta include minor bleeding, shortness of breath (about 14% of patients), dizziness, nausea, diarrhea, and headache. The most serious risk is severe bleeding, which is covered by a boxed warning. For a detailed breakdown, see our Brilinta side effects guide.

Final Thoughts

Brilinta is an important medication for preventing heart attacks, strokes, and cardiovascular death. It works differently from older antiplatelet drugs — it doesn't depend on your genetics to be effective, and it wears off faster if you need surgery. It also costs more, though generic Ticagrelor has made it much more accessible in 2026.

If you've been prescribed Brilinta, take it exactly as directed, keep your aspirin dose at 100 mg or below, and never stop without talking to your doctor. If you're having trouble finding it or affording it, Medfinder can help you find pharmacies with stock and the best prices near you.