Ticagrelor is an active substance that is used to treat thromboembolic events such as a heart attack or stroke. It is a platelet aggregation inhibitor and belongs to the group of P2Y12 antagonists. It is usually administered in combination with acetylsalicylic acid. The advantage of ticagrelor is that it acts more quickly than other active substances.

Graphic structural formula of the active substance ticagrelor

Drugs with Ticagrelor

Drug Substance(s) Authorisation holder
Possia 90 mg film-coated tablets Ticagrelor AstraZeneca AB
Brilique 90 mg film-coated tablets Ticagrelor AstraZeneca AB


Ticagrelor works by binding to the P2Y12-ADP receptor in the blood platelets (thrombocytes) and thus blocking the binding of ADP (adenosine diphosphate) to this receptor (antagonism). The binding of ADP to this receptor causes the blood platelets to clump together, thereby "thickening" the blood, which can be observed in cuts or small wounds and is also desirable. After activation of the receptor by ADP, the platelets change their shape and form protrusions (pseudopodia), whereby they adhere to each other and can thus cause blood to stop flowing in small wounds. This effect is disadvantageous in the blood vessels because clot formation (thrombus formation) in the blood vessels should be prevented so that they do not become blocked. In the case of a heart attack or stroke, however, it is precisely this thrombus formation that occurs and the blood vessel is partially(angina pectoris) or completely(heart attack or stroke) blocked by this clot (thrombus). However, this is prevented by blocking the P2Y12 receptor with ticagrelor. Ticagrelor is not only used in acute cases, but can also be used as a long-term therapy to minimize risk.

Ticagrelor is metabolized in the liver and excreted via faeces and urine. The bioavailability of the active ingredient, i.e. the percentage of the active ingredient available in the blood, is 36%. The half-life, i.e. the time the body needs to excrete half of the active substance, is around 8 hours. The maximum plasma concentration (Cmax), i.e. the maximum concentration of the active substance in the blood plasma (liquid cell-free part of the blood) is reached after about 1.5 hours.


Always take Ticagrelor exactly as described in the package leaflet or as advised by your doctor.

The usual recommended dose in acute cases is 180 mg once.

The recommended dose for long-term therapy is 90 mg twice daily in the first year after the thromboembolic event.

After one year, the recommended dose is 60 mg twice a day.

Side Effects

The following side effects may occur:

Very common:

  • High uric acid levels in the blood
  • Bleeding
  • Feeling of shortness of breath



  • allergic reactions
  • Confusion
  • Visual disturbances
  • Bleeding from the vagina (independent of menstrual bleeding)
  • Increased or prolonged menstrual bleeding
  • Bleeding in joints and/or muscles
  • Blood in the ear
  • Internal bleeding

Frequency unknown:

If the following side effects occur, please seek medical help immediately:

  • Bleeding into the brain or inside the brain skull
    • Symptoms:
      • sudden possibly one-sided numbness in arms, legs or face
      • sudden confusion and speech difficulties
      • sudden coordination problems
      • sudden dizziness
  • bleeding
    • Symptoms:
      • Unstoppable or prolonged bleeding
      • pink, red or brown urine
      • vomiting blood
      • Red or black stool
      • hemoptysis
  • fainting
  • Thrombotic thrombocytopenic purpura


Interactions may occur if the following medicines are taken at the same time:


Ticagrelor must NOT be taken in the following cases

Age Restriction

Ticagrelor is NOT recommended under the age of 18.

Pregnancy & Lactation

Ticagrelor should NOT be taken during pregnancy and breastfeeding unless your doctor considers it absolutely necessary.

History to the active ingredient

Ticagrelor was first prescribed in 2003. The drug is marketed by the pharmaceutical company AstraZeneca. The active ingredient was approved in the EU in December 2010 and in the USA in July 2011.

Chemical & physical properties

ATC Code B01AC24
Formula C23H28F2N6O4S
Molar Mass (g·mol−1) 522,568
Physical State solid
Density (g·cm−3) 1,7
Boiling Point (°C) 777,6
PKS Value 12,94
CAS Number 274693-27-5
PUB Number 9871419
Drugbank ID DB08816

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All information used for the content comes from verified sources (recognised institutions, experts, studies by renowned universities). We attach great importance to the qualification of the authors and the scientific background of the information. Thus, we ensure that our research is based on scientific findings.
Thomas Hofko

Thomas Hofko

Thomas Hofko is in the final third of his bachelor's degree in pharmacy and is an author and lecturer on pharmaceutical topics. He is particularly interested in the fields of clinical pharmacy and phytopharmacy.

The content of this page is an automated and high-quality translation from DeepL. You can find the original content in German here.


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