ticagrelor Indications/Contra | FAERs-F | FAERs-M | Orange Bk | BioActivity |

Stem definitionDrug idCAS RN
platelet aggregation inhibitors 4184 274693-27-5

Description:

MoleculeDescription

Molfile Inchi Smiles

Synonyms:

  • ticagrelor
  • brilinta
  • AZD 6140
  • possia
  • brilique
a cyclopentyltriazolopyrimidine, inhibitor of platelet activation and aggregation mediated by the P2Y12 ADP-receptor indicated to reduce the rate of cardiovascular death, myocardial infarction, and stroke in patients with acute coronary syndrome or a history of myocardial infarction
  • Molecular weight: 522.57
  • Formula: C23H28F2N6O4S
  • CLOGP: 2.55
  • LIPINSKI: 1
  • HAC: 10
  • HDO: 4
  • TPSA: 138.44
  • ALOGS: -3.92
  • ROTB: 10

  • Status: OFP

  • Legend:
    OFP - off patent
    OFM - off market
    ONP - on patent

Drug dosage:

DoseUnitRoute
0.18 g O

ADMET properties:

PropertyValueReference
BDDCS (Biopharmaceutical Drug Disposition Classification System) 2 Hosey CM, Chan R, Benet LZ
Vd (Volume of distribution) 1.25 L/kg Lombardo F, Berellini G, Obach RS
CL (Clearance) 3.38 mL/min/kg Lombardo F, Berellini G, Obach RS
fu (Fraction unbound in plasma) 0.00 % Lombardo F, Berellini G, Obach RS
t_half (Half-life) 6.80 hours Lombardo F, Berellini G, Obach RS

Approvals:

DateAgencyCompanyOrphan
July 20, 2011 FDA ASTRAZENECA LP

FDA Adverse Event Reporting System (Female)

MedDRA adverse event termLikelihood ratioLikelihood ratio thresholdPatients taking drug having adverse eventPatients taking drug not having adverse eventPatients not taking drug having adverse eventPatients not taking drug not having adverse event
Vascular stent thrombosis 620.58 19.05 116 10824 755 46674367
Thrombosis in device 348.40 19.05 90 10850 2889 46672233
Rhabdomyolysis 320.00 19.05 168 10772 41741 46633381
Acute myocardial infarction 290.21 19.05 144 10796 31780 46643342
Myocardial infarction 266.92 19.05 204 10736 97324 46577798
Dyspnoea 220.72 19.05 414 10526 515134 46159988
Drug interaction 167.33 19.05 221 10719 202873 46472249
Gastrointestinal haemorrhage 158.84 19.05 137 10803 77236 46597886
Haemorrhage 122.47 19.05 102 10838 54767 46620355
Haemorrhage intracranial 108.42 19.05 55 10885 12669 46662453
Acute coronary syndrome 101.47 19.05 49 10891 10155 46664967
Angina pectoris 98.12 19.05 67 10873 26708 46648414
Vascular stent stenosis 85.88 19.05 21 10919 535 46674587
Epistaxis 84.39 19.05 89 10851 64216 46610906
Cerebral haemorrhage 83.22 19.05 62 10878 28309 46646813
Acute kidney injury 82.63 19.05 175 10765 235680 46439442
Chest pain 72.61 19.05 140 10800 176184 46498938
Melaena 71.15 19.05 56 10884 27716 46647406
Angina unstable 65.38 19.05 33 10907 7515 46667607
Atrioventricular block complete 65.05 19.05 33 10907 7594 46667528
Bradycardia 61.96 19.05 77 10863 66221 46608901
Coronary artery thrombosis 57.68 19.05 18 10922 1147 46673975
Sinus arrest 54.51 19.05 19 10921 1712 46673410
Cardiogenic shock 53 19.05 38 10902 16346 46658776
Haematoma 52.62 19.05 50 10890 31822 46643300
Coronary artery stenosis 51.02 19.05 24 10916 4689 46670433
Coronary artery restenosis 50.02 19.05 13 10927 426 46674696
Cardiac failure 49.31 19.05 76 10864 79872 46595250
Anaemia 46.07 19.05 148 10792 255631 46419491
Myopathy 44.31 19.05 27 10913 8854 46666268
Cardiac arrest 39.87 19.05 74 10866 90325 46584797
Platelet function test abnormal 39.71 19.05 8 10932 80 46675042
Intentional product misuse 39.69 19.05 52 10888 47076 46628046
Coronary artery occlusion 38.81 19.05 24 10916 8078 46667044
Rheumatoid arthritis 36.97 19.05 6 10934 240209 46434913
Coronary artery disease 34.43 19.05 41 10899 33711 46641411
Labelled drug-drug interaction medication error 33.94 19.05 23 10917 9038 46666084
Haemorrhagic stroke 33.22 19.05 19 10921 5547 46669575
Upper gastrointestinal haemorrhage 32.97 19.05 29 10911 16709 46658413
Atrioventricular block 32.18 19.05 20 10920 6791 46668331
Coronary artery dissection 31.41 19.05 10 10930 680 46674442
Diabetic macroangiopathy 30.48 19.05 7 10933 135 46674987
Subarachnoid haemorrhage 29.65 19.05 23 10917 11130 46663992
Product name confusion 29.60 19.05 6 10934 62 46675060
Device occlusion 29.47 19.05 18 10922 5927 46669195
Hepatitis 29.40 19.05 37 10903 32178 46642944
Alveolar proteinosis 29.39 19.05 8 10932 314 46674808
Forced vital capacity decreased 28.73 19.05 10 10930 897 46674225
Subdural haematoma 28.61 19.05 24 10916 12973 46662149
Arterial restenosis 28.37 19.05 5 10935 22 46675100
Ventricular asystole 27.93 19.05 6 10934 84 46675038
Eosinophilia 27.70 19.05 28 10912 19189 46655933
Faeces discoloured 27.06 19.05 26 10914 16761 46658361
Acid base balance abnormal 26.01 19.05 7 10933 263 46674859
Coma acidotic 25.55 19.05 6 10934 128 46674994
Brain natriuretic peptide increased 25.43 19.05 15 10925 4635 46670487
Toxicity to various agents 25.33 19.05 9 10931 211757 46463365
Arthralgia 25.25 19.05 29 10911 364574 46310548
Pyrexia 24.97 19.05 27 10913 348775 46326347
Myositis 24.80 19.05 18 10922 7886 46667236
Rectal haemorrhage 24.45 19.05 37 10903 38218 46636904
Spinal cord haemorrhage 23.89 19.05 6 10934 171 46674951
Drug-induced liver injury 22.93 19.05 29 10911 25339 46649783
Hepatitis cholestatic 22.77 19.05 16 10924 6661 46668461
Chest discomfort 22.74 19.05 59 10881 90210 46584912
Infarction 22.72 19.05 11 10929 2290 46672832
Capillary fragility test 21.66 19.05 4 10936 24 46675098
Drug ineffective 21.58 19.05 84 10856 677754 45997368
Iron deficiency anaemia 21.10 19.05 23 10917 17183 46657939
Fibroma 21.05 19.05 8 10932 921 46674201
Myocardial ischaemia 21.03 19.05 20 10920 12729 46662393
Vascular stent occlusion 20.88 19.05 4 10936 30 46675092
Haemoglobin decreased 20.81 19.05 72 10868 128877 46546245
Electrocardiogram ST segment elevation 20.42 19.05 12 10928 3683 46671439
Catheter site haematoma 19.92 19.05 5 10935 142 46674980
Hepatitis acute 19.82 19.05 16 10924 8198 46666924
Cell death 19.80 19.05 10 10930 2278 46672844
Eosinophil cationic protein increased 19.51 19.05 4 10936 44 46675078

FDA Adverse Event Reporting System (Male)

MedDRA adverse event termLikelihood ratioLikelihood ratio thresholdPatients taking drug having adverse eventPatients taking drug not having adverse eventPatients not taking drug having adverse eventPatients not taking drug not having adverse event
Vascular stent thrombosis 1238.90 15.77 294 20411 2049 29929724
Thrombosis in device 879.16 15.77 243 20462 3283 29928490
Acute myocardial infarction 432.21 15.77 329 20376 52610 29879163
Dyspnoea 400.36 15.77 773 19932 332522 29599251
Myocardial infarction 300.19 15.77 400 20305 125225 29806548
Gastrointestinal haemorrhage 182.64 15.77 255 20450 83191 29848582
Chest pain 178.09 15.77 303 20402 117324 29814449
Angina pectoris 170.04 15.77 150 20555 29368 29902405
Sinus arrest 159.85 15.77 54 20651 1466 29930307
Rhabdomyolysis 156.82 15.77 206 20499 63374 29868399
Acute coronary syndrome 155.78 15.77 104 20601 13469 29918304
Haemorrhage intracranial 155.47 15.77 108 20597 14924 29916849
Vascular stent stenosis 152.91 15.77 48 20657 1026 29930747
Angina unstable 152.65 15.77 99 20606 12211 29919562
Cerebral haemorrhage 150.50 15.77 147 20558 32740 29899033
Drug interaction 139.33 15.77 375 20330 199193 29732580
Sinoatrial block 130.27 15.77 35 20670 420 29931353
Melaena 124.72 15.77 132 20573 32305 29899468
Coronary artery occlusion 105.71 15.77 76 20629 11081 29920692
Haemorrhage 99.41 15.77 140 20565 45939 29885834
Toxicity to various agents 92.97 15.77 8 20697 177175 29754598
Intentional product misuse 87.96 15.77 114 20591 34553 29897220
Pulmonary haemorrhage 86.74 15.77 63 20642 9329 29922444
Bradycardia 86.26 15.77 159 20546 65367 29866406
Chest discomfort 84.79 15.77 129 20576 45351 29886422
Vascular stent occlusion 81.56 15.77 19 20686 120 29931653
Rectal haemorrhage 78.08 15.77 108 20597 34831 29896942
Coronary artery restenosis 75.32 15.77 29 20676 1154 29930619
Coronary artery stenosis 75.15 15.77 57 20648 9013 29922760
Coronary artery thrombosis 73.73 15.77 34 20671 2130 29929643
Subdural haematoma 70.74 15.77 76 20629 18896 29912877
Anaemia 66.52 15.77 302 20403 207690 29724083
Cardiac ventricular thrombosis 63.39 15.77 23 20682 774 29930999
Atrioventricular block complete 63.10 15.77 50 20655 8427 29923346
Epistaxis 61.61 15.77 122 20583 52859 29878914
Haematuria 60.49 15.77 110 20595 44724 29887049
Subarachnoid haemorrhage 60.41 15.77 52 20653 9834 29921939
Cardiogenic shock 60.16 15.77 66 20639 16795 29914978
Labelled drug-drug interaction medication error 59.52 15.77 53 20652 10485 29921288
Atrioventricular block 58.65 15.77 45 20660 7237 29924536
Coronary artery disease 57.23 15.77 114 20591 49598 29882175
Shock haemorrhagic 56.48 15.77 50 20655 9815 29921958
Febrile neutropenia 55.41 15.77 5 20700 106688 29825085
Device occlusion 54.12 15.77 40 20665 6080 29925693
Platelet aggregation inhibition 54.03 15.77 10 20695 14 29931759
Haemorrhagic stroke 53.97 15.77 40 20665 6107 29925666
Brain herniation 53.65 15.77 33 20672 3707 29928066
Cardiac arrest 53.34 15.77 163 20542 92687 29839086
Pyrexia 49.22 15.77 80 20625 294409 29637364
Completed suicide 45.87 15.77 7 20698 99485 29832288
Haematoma 44.68 15.77 68 20637 23885 29907888
Gastric haemorrhage 44.53 15.77 43 20662 9424 29922349
White blood cell count decreased 43.40 15.77 4 20701 83943 29847830
Pneumonia 42.86 15.77 106 20599 334200 29597573
Blood loss anaemia 42.35 15.77 38 20667 7589 29924184
Product dose omission issue 41.98 15.77 149 20556 91482 29840291
Arterial restenosis 41.43 15.77 10 20695 75 29931698
Gastric ulcer haemorrhage 40.96 15.77 32 20673 5282 29926491
Neutropenia 40.66 15.77 19 20686 128521 29803252
Thrombosis 40.61 15.77 90 20615 42141 29889632
Ventricular asystole 39.58 15.77 11 20694 151 29931622
Rash maculo-papular 38.97 15.77 66 20639 25352 29906421
Sinus bradycardia 38.66 15.77 44 20661 11651 29920122
Haematemesis 36.22 15.77 65 20640 26138 29905635
Malignant neoplasm progression 35.92 15.77 4 20701 72283 29859490
Diarrhoea 34.71 15.77 117 20588 333986 29597787
Haemoptysis 34.23 15.77 70 20635 31008 29900765
Therapy cessation 34.10 15.77 47 20658 15090 29916683
Muscle enzyme increased 31.75 15.77 10 20695 216 29931557
Base excess decreased 31.62 15.77 10 20695 219 29931554
Sepsis 31.33 15.77 33 20672 146362 29785411
Cheyne-Stokes respiration 31.28 15.77 10 20695 227 29931546
Ventricular fibrillation 31.13 15.77 45 20660 15093 29916680
Upper gastrointestinal haemorrhage 30.90 15.77 55 20650 21973 29909800
Constipation 30.90 15.77 20 20685 112886 29818887
Pericardial haemorrhage 30.23 15.77 21 20684 2897 29928876
Arterial thrombosis 29.80 15.77 16 20689 1390 29930383
Oxygen consumption decreased 29.71 15.77 9 20696 170 29931603
Decreased appetite 29.68 15.77 36 20669 149874 29781899
Mixed liver injury 29.64 15.77 18 20687 1975 29929798
Drug abuse 29.43 15.77 10 20695 82062 29849711
Troponin increased 28.73 15.77 33 20672 8824 29922949
Intrapericardial thrombosis 28.39 15.77 7 20698 58 29931715
Iron deficiency anaemia 28.23 15.77 33 20672 8991 29922782
Cardiac tamponade 27.50 15.77 24 20681 4620 29927153
Mallory-Weiss syndrome 27.33 15.77 15 20690 1361 29930412
Disease progression 26.52 15.77 11 20694 79863 29851910
Plasma cell myeloma 26.45 15.77 3 20702 53459 29878314
Dehydration 26.25 15.77 28 20677 123511 29808262
Brain natriuretic peptide increased 26.23 15.77 22 20683 4013 29927760
Retroperitoneal haematoma 25.71 15.77 18 20687 2514 29929259
Coronary artery dissection 25.52 15.77 8 20697 170 29931603
Haemoglobin decreased 25.42 15.77 150 20555 113948 29817825
Oedema peripheral 24.79 15.77 22 20683 105810 29825963
Anterior interosseous syndrome 24.47 15.77 5 20700 15 29931758
Atrioventricular block second degree 24.40 15.77 19 20686 3121 29928652
Orthopnoea 23.99 15.77 22 20683 4518 29927255
Nasopharyngitis 23.23 15.77 6 20699 58843 29872930
Sinus node dysfunction 23.04 15.77 20 20685 3823 29927950
Overdose 22.98 15.77 15 20690 84322 29847451
Circumstance or information capable of leading to medication error 22.49 15.77 14 20691 1605 29930168
Faeces discoloured 22.42 15.77 37 20668 13909 29917864
Left ventricular enlargement 22.41 15.77 10 20695 580 29931193
Ischaemic stroke 22.01 15.77 40 20665 16235 29915538
Stent placement 21.85 15.77 21 20684 4575 29927198
Hepatitis cholestatic 21.70 15.77 27 20678 7845 29923928
Gout 21.47 15.77 41 20664 17274 29914499
Seizure 21.27 15.77 22 20683 98453 29833320
Reperfusion injury 21.16 15.77 6 20699 89 29931684
Sleep apnoea syndrome 21.01 15.77 40 20665 16817 29914956
Pancytopenia 20.74 15.77 17 20688 85035 29846738
Hypertrophy 20.57 15.77 8 20697 327 29931446
Cerebral haematoma 20.28 15.77 20 20685 4494 29927279
Gastritis erosive 20.06 15.77 22 20683 5591 29926182
Post procedural haemorrhage 20.02 15.77 26 20679 7884 29923889
Walking disability 20.00 15.77 10 20695 749 29931024
Hepatocellular injury 19.82 15.77 50 20655 25421 29906352
Suffocation feeling 19.66 15.77 9 20696 554 29931219
Asphyxia 18.94 15.77 21 20684 5404 29926369
Microcytic anaemia 18.73 15.77 14 20691 2164 29929609
Bladder tamponade 18.62 15.77 8 20697 423 29931350
Hyperlipidaemia 18.58 15.77 34 20671 13873 29917900
Duodenal ulcer 18.30 15.77 28 20677 9873 29921900
Mean cell haemoglobin decreased 18.29 15.77 11 20694 1186 29930587
Weight increased 18.23 15.77 15 20690 74898 29856875
Platelet aggregation decreased 18.13 15.77 4 20701 19 29931754
Myelofibrosis 17.92 15.77 12 20693 1559 29930214
Myocardial ischaemia 17.88 15.77 38 20667 17279 29914494
Platelet aggregation abnormal 17.80 15.77 4 20701 21 29931752
Confusional state 17.79 15.77 42 20663 134792 29796981
Calculus urinary 17.68 15.77 11 20694 1260 29930513
Electrocardiogram abnormal 17.52 15.77 21 20684 5871 29925902
Urinary bladder haemorrhage 17.38 15.77 12 20693 1639 29930134
Neuropathy peripheral 17.29 15.77 14 20691 70461 29861312
Intracardiac thrombus 17.28 15.77 14 20691 2434 29929339
Pulmonary alveolar haemorrhage 17.23 15.77 22 20683 6559 29925214
Autoimmune myositis 17.07 15.77 4 20701 26 29931747
Electrocardiogram ST segment elevation 16.91 15.77 18 20687 4424 29927349
Muscle necrosis 16.83 15.77 9 20696 775 29930998
Cerebellar haemorrhage 16.68 15.77 11 20694 1393 29930380
Ventricular tachycardia 16.68 15.77 45 20660 23817 29907956
Gastric ulcer 16.57 15.77 34 20671 15087 29916686
Product administration error 16.56 15.77 33 20672 14344 29917429
Computerised tomogram head abnormal 16.46 15.77 4 20701 31 29931742
Diverticulitis intestinal haemorrhagic 16.44 15.77 7 20698 362 29931411
Back pain 16.03 15.77 29 20676 102567 29829206

Pharmacologic Action:

SourceCodeDescription
ATC B01AC24 BLOOD AND BLOOD FORMING ORGANS
ANTITHROMBOTIC AGENTS
ANTITHROMBOTIC AGENTS
Platelet aggregation inhibitors excl. heparin
FDA PE N0000008832 Decreased Platelet Aggregation
MeSH PA D006401 Hematologic Agents
MeSH PA D018377 Neurotransmitter Agents
MeSH PA D010975 Platelet Aggregation Inhibitors
MeSH PA D058914 Purinergic Antagonists
MeSH PA D058919 Purinergic P2 Receptor Antagonists
MeSH PA D058921 Purinergic P2Y Receptor Antagonists
FDA MoA N0000182141 Cytochrome P450 3A4 Inhibitors
FDA EPC N0000182142 P2Y12 Platelet Inhibitor
FDA MoA N0000182143 P2Y12 Receptor Antagonists
FDA MoA N0000185503 P-Glycoprotein Inhibitors
FDA MoA N0000190115 Cytochrome P450 3A5 Inhibitors
FDA MoA N0000190482 Phenylalanine Hydroxylase Activators
CHEBI has role CHEBI:50427 platelet aggregation inhibitors
CHEBI has role CHEBI:68563 purinergic receptor subtype p2y12 antagonist

Drug Use (View source of the data)

DiseaseRelationSNOMED_IDDOID
Acute coronary syndrome indication 394659003
Peripheral vascular disease indication 400047006
Percutaneous coronary intervention indication 415070008
Myocardial Reinfarction Prevention indication
Intracranial hemorrhage contraindication 1386000
Hepatic failure contraindication 59927004
Disease of liver contraindication 235856003 DOID:409
Surgical procedure contraindication 387713003
Significant Bleeding contraindication

Acid dissociation constants calculated using MoKa v3.0.0

Dissociation levelDissociation constantType (acidic/basic)
pKa1 3.07 Basic

Orange Book patent data (new drug applications)

None

Orange Book exclusivity data (new drug applications)

Formulation strengthTrade nameApplicantApplication numberApproval dateTypeDose formRouteExclusivity dateDescription
60MG BRILINTA ASTRAZENECA N022433 Sept. 3, 2015 RX TABLET ORAL May 28, 2023 TO REDUCE THE RISK OF A FIRST MYOCARDIAL INFARCTION (MI) OR STROKE IN PATIENTS WITH CORONULLRY ARTERY DISEASE (CAD) AT HIGH RISK FOR SUCH EVENTS
90MG BRILINTA ASTRAZENECA N022433 July 20, 2011 RX TABLET ORAL May 28, 2023 TO REDUCE THE RISK OF A FIRST MYOCARDIAL INFARCTION (MI) OR STROKE IN PATIENTS WITH CORONULLRY ARTERY DISEASE (CAD) AT HIGH RISK FOR SUCH EVENTS
60MG BRILINTA ASTRAZENECA N022433 Sept. 3, 2015 RX TABLET ORAL Nov. 5, 2023 REDUCE THE RISK OF STROKE IN PATIENTS WITH ACUTE ISCHEMIC STROKE (NIH STROKE SCALE SCORE <=5) OR HIGH-RISK TRANSIENT ISCHEMIC ATTACK (TIA)
90MG BRILINTA ASTRAZENECA N022433 July 20, 2011 RX TABLET ORAL Nov. 5, 2023 REDUCE THE RISK OF STROKE IN PATIENTS WITH ACUTE ISCHEMIC STROKE (NIH STROKE SCALE SCORE <=5) OR HIGH-RISK TRANSIENT ISCHEMIC ATTACK (TIA)

Bioactivity Summary:

TargetClassPharosUniProtActionTypeActivity value
(-log[M])
Mechanism
action
Bioact sourceMoA source
P2Y purinoceptor 12 GPCR NEGATIVE ALLOSTERIC MODULATOR Ki 7.85 CHEMBL CHEMBL
Equilibrative nucleoside transporter 1 Transporter INHIBITOR Ki 7.30 IUPHAR
P2Y purinoceptor 12 Unclassified IC50 5.38 CHEMBL

External reference:

IDSource
4030908 VUID
N0000182973 NUI
D09017 KEGG_DRUG
4030908 VANDF
C1608718 UMLSCUI
CHEBI:68558 CHEBI
TIQ PDB_CHEM_ID
CHEMBL398435 ChEMBL_ID
D000077486 MESH_DESCRIPTOR_UI
9871419 PUBCHEM_CID
8772 INN_ID
DB08816 DRUGBANK_ID
GLH0314RVC UNII
1765 IUPHAR_LIGAND_ID
1116632 RXNORM
182026 MMSL
235692 MMSL
27677 MMSL
d07721 MMSL
013611 NDDF
698805004 SNOMEDCT_US
704464003 SNOMEDCT_US

Pharmaceutical products:

ProductCategoryIngredientsNDCFormQuantityRouteMarketingLabel
BRILINTA HUMAN PRESCRIPTION DRUG LABEL 1 0186-0776 TABLET 60 mg ORAL NDA 31 sections
BRILINTA HUMAN PRESCRIPTION DRUG LABEL 1 0186-0777 TABLET 90 mg ORAL NDA 31 sections
BRILINTA HUMAN PRESCRIPTION DRUG LABEL 1 55154-9618 TABLET 90 mg ORAL NDA 28 sections
ticagrelor HUMAN PRESCRIPTION DRUG LABEL 1 69238-1134 TABLET 90 mg ORAL ANDA 28 sections