Upsides

Brilinta, in combination with aspirin, may be given to people who have had a heart attack or who have acute coronary syndrome (ACS) to lower their risk of having a stroke or other heart problems.

Brilinta may also be given to patients who have had a stent inserted in order to reduce the risk of stent thrombosis (a blood clot forming and blocking an area near a stent).

Brilinta may also be prescribed to people with other heart conditions who are sensitive to aspirin.

Brilinta is more effective than clopidogrel (Plavix). A 180mg loading dose of Brilinta inhibited 41% of platelets in 30 minutes. Clopidogrel 600mg takes nearly 8 hours to achieve the same effect.

Brilinta appears to work faster when tablets are crushed and then administered.

Brilinta is not a prescription medication. Unlike clopidogrel and prasugrel, it does not require metabolism to be active.

Because clopidogrel is a prodrug that must be converted to its active form in the liver, clinical response is variable, with 20-40% of patients classified as non-responders, poor responders, or resistant to clopidogrel.

Brilinta has an active metabolite that is just as powerful and active as the parent drug. This extends the time it works.

Brilinta is an oral medication that is typically administered twice daily.

Brilinta is currently preferred over clopidogrel in people with ACS or who have had a myocardial infarction (heart attack).

Brilinta was found to be more effective than clopidogrel in reducing the percentage of CV death, MI or stroke in people taking low-dose aspirin in the first year of treatment. Aside from genetics (including CYP2C19 variations), other factors that influence clopidogrel response include age, diabetes, renal failure, and cardiac failure.

Brilinta has a higher potency than clopidogrel. The risks of bleeding and bruising are similar, but Brilinta is more likely to cause shortness of breath.

In people with mild liver disease or kidney disease, a dosage adjustment is required. Brilinta should be avoided in patients with severe liver disease; there is limited experience in those with moderate liver disease.

Brilinta is also available as a generic drug under the brand name ticagrelor.