Details
Stereochemistry | ABSOLUTE |
Molecular Formula | C23H28F2N6O4S |
Molecular Weight | 522.568 |
Optical Activity | UNSPECIFIED |
Defined Stereocenters | 6 / 6 |
E/Z Centers | 0 |
Charge | 0 |
SHOW SMILES / InChI
SMILES
CCCSC1=NC2=C(N=NN2[C@@H]3C[C@H](OCCO)[C@@H](O)[C@H]3O)C(N[C@@H]4C[C@H]4C5=CC=C(F)C(F)=C5)=N1
InChI
InChIKey=OEKWJQXRCDYSHL-FNOIDJSQSA-N
InChI=1S/C23H28F2N6O4S/c1-2-7-36-23-27-21(26-15-9-12(15)11-3-4-13(24)14(25)8-11)18-22(28-23)31(30-29-18)16-10-17(35-6-5-32)20(34)19(16)33/h3-4,8,12,15-17,19-20,32-34H,2,5-7,9-10H2,1H3,(H,26,27,28)/t12-,15+,16+,17-,19-,20+/m0/s1
Molecular Formula | C23H28F2N6O4S |
Molecular Weight | 522.568 |
Charge | 0 |
Count |
|
Stereochemistry | ABSOLUTE |
Additional Stereochemistry | No |
Defined Stereocenters | 6 / 6 |
E/Z Centers | 0 |
Optical Activity | UNSPECIFIED |
DescriptionCurator's Comment: description was created based on several sources, including http://www.ema.europa.eu/docs/en_GB/document_library/PIP_decision/WC500123240.pdf; http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Summary_for_the_public/human/002303/WC500100562.pdf; https://www.accessdata.fda.gov/drugsatfda_docs/nda/2011/022433Orig1s000PharmR.pdf
Curator's Comment: description was created based on several sources, including http://www.ema.europa.eu/docs/en_GB/document_library/PIP_decision/WC500123240.pdf; http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Summary_for_the_public/human/002303/WC500100562.pdf; https://www.accessdata.fda.gov/drugsatfda_docs/nda/2011/022433Orig1s000PharmR.pdf
Ticagrelor (known trade names Brilinta, Brilique and Possia) is a P2Y12 platelet inhibitor. Brilinta has been approved by the US Food and Drug administration (FDA) in 2011 and is indicated to reduce the rate of cardiovascular death, myocardial infarction, and stroke in patients with acute coronary syndrome (ACS) or a history of myocardial infarction. Brilinta also reduces the rate of stent thrombosis in patients who have been stented for treatment of ACS. Ticagrelor and its major metabolite reversibly interact with the platelet P2Y12 ADP-receptor to prevent signal transduction and platelet activation. Ticagrelor and its active metabolite are approximately equipotent. In vitro metabolism studies demonstrate that ticagrelor and its major active metabolite are weak inhibitors of CYP3A4, potential activators of CYP3A5 and inhibitors of the P-gp transporter. Most common adverse reactions are bleeding 12% and dyspnea 14%.
Originator
Approval Year
Targets
Primary Target | Pharmacology | Condition | Potency |
---|---|---|---|
Target ID: CHEMBL2001 |
Conditions
Condition | Modality | Targets | Highest Phase | Product |
---|---|---|---|---|
Secondary | BRILINTA Approved UseIndicated to reduce the rate of cardiovascular death, myocardial infarction, and stroke in patients with acute coronary syndrome (ACS) or a history of myocardial infarction (MI). For at least the first 12 months following ACS, it is superior to clopidogrel. Reduces the rate of stent thrombosis in patients who have been stented for treatment of ACS. Launch Date2011 |
|||
Secondary | BRILINTA Approved UseIndicated to reduce the rate of cardiovascular death, myocardial infarction, and stroke in patients with acute coronary syndrome (ACS) or a history of myocardial infarction (MI). For at least the first 12 months following ACS, it is superior to clopidogrel. Reduces the rate of stent thrombosis in patients who have been stented for treatment of ACS. Launch Date2011 |
Cmax
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
1583 ng/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/20642549/ |
200 mg 2 times / day multiple, oral dose: 200 mg route of administration: Oral experiment type: MULTIPLE co-administered: |
TICAGRELOR plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
|
1208 ng/mL Clinical Trial https://clinicaltrials.gov/ct2/show/NCT01898442 |
270 mg single, oral dose: 270 mg route of administration: oral experiment type: single co-administered: |
TICAGRELOR plasma | Homo sapiens |
|
1208 ng/mL Clinical Trial https://clinicaltrials.gov/ct2/show/NCT01898442 |
360 mg single, oral dose: 360 mg route of administration: oral experiment type: single co-administered: |
TICAGRELOR plasma | Homo sapiens |
AUC
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
10160 ng × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/20642549/ |
200 mg 2 times / day multiple, oral dose: 200 mg route of administration: Oral experiment type: MULTIPLE co-administered: |
TICAGRELOR plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
|
12379 ng*h/mL Clinical Trial https://clinicaltrials.gov/ct2/show/NCT01898442 |
270 mg single, oral dose: 270 mg route of administration: oral experiment type: single co-administered: |
TICAGRELOR plasma | Homo sapiens |
|
12381 ng*h/mL Clinical Trial https://clinicaltrials.gov/ct2/show/NCT01898442 |
360 mg single, oral dose: 360 mg route of administration: oral experiment type: single co-administered: |
TICAGRELOR plasma | Homo sapiens |
T1/2
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
7 h |
90 mg single, oral dose: 90 mg route of administration: Oral experiment type: SINGLE co-administered: |
TICAGRELOR plasma | Homo sapiens population: UNKNOWN age: ADULT sex: FEMALE / MALE food status: UNKNOWN |
Funbound
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
1% |
90 mg single, oral dose: 90 mg route of administration: Oral experiment type: SINGLE co-administered: |
TICAGRELOR plasma | Homo sapiens population: UNKNOWN age: ADULT sex: FEMALE / MALE food status: UNKNOWN |
Doses
Dose | Population | Adverse events |
---|---|---|
1260 mg single, oral Highest studied dose Dose: 1260 mg Route: oral Route: single Dose: 1260 mg Sources: |
healthy n = 6 |
DLT: Gastrointestinal disorder NOS, Sinus arrest... Dose limiting toxicities: Gastrointestinal disorder NOS (50%) Sources: Sinus arrest (serious, 16.7%) High grade atrioventricular block (serious, 16.7%) Ventricular escape rhythm (serious, 16.7%) |
900 mg single, oral MTD |
healthy n = 6 |
|
90 mg 2 times / day multiple, oral Recommended Dose: 90 mg, 2 times / day Route: oral Route: multiple Dose: 90 mg, 2 times / day Co-administed with:: aspirin, p.o Sources: Page: p.3 |
unhealthy n = 9333 Health Status: unhealthy Condition: acute coronary syndrome Sex: M+F Population Size: 9333 Sources: Page: p.3 |
Disc. AE: Dyspnea... AEs leading to discontinuation/dose reduction: Dyspnea (0.9%) Sources: Page: p.3 |
90 mg 2 times / day multiple, oral Recommended Dose: 90 mg, 2 times / day Route: oral Route: multiple Dose: 90 mg, 2 times / day Sources: Page: p.1 |
unhealthy Health Status: unhealthy Condition: acute coronary syndrome Sources: Page: p.1 |
Disc. AE: Bleeding... AEs leading to discontinuation/dose reduction: Bleeding (grade 3-5) Sources: Page: p.1 |
AEs
AE | Significance | Dose | Population |
---|---|---|---|
Gastrointestinal disorder NOS | 50% DLT |
1260 mg single, oral Highest studied dose Dose: 1260 mg Route: oral Route: single Dose: 1260 mg Sources: |
healthy n = 6 |
High grade atrioventricular block | serious, 16.7% DLT |
1260 mg single, oral Highest studied dose Dose: 1260 mg Route: oral Route: single Dose: 1260 mg Sources: |
healthy n = 6 |
Sinus arrest | serious, 16.7% DLT |
1260 mg single, oral Highest studied dose Dose: 1260 mg Route: oral Route: single Dose: 1260 mg Sources: |
healthy n = 6 |
Ventricular escape rhythm | serious, 16.7% DLT |
1260 mg single, oral Highest studied dose Dose: 1260 mg Route: oral Route: single Dose: 1260 mg Sources: |
healthy n = 6 |
Dyspnea | 0.9% Disc. AE |
90 mg 2 times / day multiple, oral Recommended Dose: 90 mg, 2 times / day Route: oral Route: multiple Dose: 90 mg, 2 times / day Co-administed with:: aspirin, p.o Sources: Page: p.3 |
unhealthy n = 9333 Health Status: unhealthy Condition: acute coronary syndrome Sex: M+F Population Size: 9333 Sources: Page: p.3 |
Bleeding | grade 3-5 Disc. AE |
90 mg 2 times / day multiple, oral Recommended Dose: 90 mg, 2 times / day Route: oral Route: multiple Dose: 90 mg, 2 times / day Sources: Page: p.1 |
unhealthy Health Status: unhealthy Condition: acute coronary syndrome Sources: Page: p.1 |
Overview
OverviewOther
Drug as perpetrator
Target | Modality | Activity | Metabolite | Clinical evidence |
---|---|---|---|---|
Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2011/022433Orig1s000ClinPharmR.pdf#page=13 Page: 13.0 |
likely | |||
Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2011/022433Orig1s000ClinPharmR.pdf#page=13 Page: 13.0 |
likely | |||
Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2011/022433Orig1s000ClinPharmR.pdf#page=12 Page: 12-13 |
likely | |||
Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2011/022433Orig1s000ClinPharmR.pdf#page=12 Page: 12-13 |
likely | |||
Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2011/022433Orig1s000ClinPharmR.pdf#page=9, Page: 9-11 |
moderate [IC50 10.5 uM] | |||
Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2011/022433Orig1s000ClinPharmR.pdf#page=9, Page: 9-11 |
moderate [IC50 11.7 uM] | |||
Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2011/022433Orig1s000ClinPharmR.pdf#page=9, Page: 9-11 |
moderate [IC50 26.7 uM] | |||
moderate [IC50 33 uM] | ||||
moderate [IC50 43 uM] | ||||
Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2011/022433Orig1s000ClinPharmR.pdf#page=9, Page: 9-11 |
moderate [IC50 6.9 uM] | no (co-administration study) Comment: Human liver microsomes, dicrofenac (substrate); Co-administration of ticagrelor (180 mg BID x 9 days) did not alter the systemic exposure of tolbutamide (500 mg QD on Day 5, CYP2C9 substrate) (GM ratio of AUCinf and Cmax were 103%, 110%, while 4-OH tolbutamide AUCinf GM ratio and Cmax GM ratio were 94% and 90%). Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2011/022433Orig1s000ClinPharmR.pdf#page=9, Page: 9-11 |
||
moderate [IC50 7.6 uM] | ||||
Page: 9-12, 60-61, 66-67, (PMDA) 130 |
moderate [IC50 8.2 uM] | yes (co-administration study) Comment: Human liver microsomes, midazolam (4-hydroxylation, substrate), no time-dependent inhibition; Co-administration of ticagrelor (270 mg AM + 180 mg PM on Day1, 180 mg BID on Days 2-7) significantly increased simvastatin (80 mg on Day 5, CYP3A4/5 substrate) AUCinf by 56% and Cmax 81%, and simvastatin acid AUCinf by 52% and Cmax by 64%. Co-administration of ticagrelor (270 mg AM + 180 mg PM on Day1, 180 mg BID on Days 2-7) significantly reduced oral midazolam (7.5 mg AM on Days 1 & 7) AUCinf by 10%, and 4’-OH-midazolam by 42%. Co-administration of ticagrelor (270 mg AM + 180 mg PM on Day 1, 180 mg BID on Days 2-7) does not alter the systemic exposure of IV midazolam (2.5 mg IV over 2 min AM on Days 1 & 7) and significantly reduced 4’-OH- midazolam systemic exposure by ~ 23%. Page: 9-12, 60-61, 66-67, (PMDA) 130 |
||
no [IC50 40 uM] | ||||
Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2011/022433Orig1s000ClinPharmR.pdf#page=9, Page: 9-11 |
no [IC50 >50 uM] | |||
Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2011/022433Orig1s000ClinPharmR.pdf#page=9, Page: 9-11 |
no [IC50 >50 uM] | |||
Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2011/022433Orig1s000ClinPharmR.pdf#page=9, Page: 9-11 |
no [IC50 >50 uM] | |||
no [IC50 >50 uM] | ||||
Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2011/022433Orig1s000ClinPharmR.pdf#page=9, Page: 9-11 |
no [IC50 >50 uM] | |||
Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2011/022433Orig1s000ClinPharmR.pdf#page=9, Page: 9-11 |
no [IC50 >50 uM] | |||
Page: 9-12, 62-63, 64-65, 66-67 (PMDA) 124-125, 130 |
no [IC50 >50 uM] | weak (co-administration study) Comment: Human liver microsomes, midazolam (1-hydroxylation, substrate), midazolam 1-hydroxylation was activated in the presence of Cyt-b5 by 144.9% (CYP3A4 (cDNA expressed enzyme):Cyp-b5 = 1: 3 + 5.56 mcM ticagrelor), no time-dependent inhibition; Inhibited testosterone intrinsic clearance (IC50 = 23 mcM, pooled human liver microsomes (33 male and female donors); Co-administration of ticagrelor (270 mg AM + 90 mg PM on Day 1, 90 mg BID on Days 2-7) significantly increased atorvastatin (80 mg QD on Day 5) AUCinf 36% and Cmax 23%, atorvastatin lactone AUCinf 32% and Cmax 39%, s 2-OH atorvastatin AUCinf 33% and Cmax 13%, and 4-OH atorvastatin AUCinf 67% and Cmax 55%. Co-administration of ticagrelor (90 mg BID x 21 days) significantly increased ethinyl estradiol AUCinf, Cmax, and Cmin by 20%, 30.6%, and 20.2%, respectively. Co-administration of ticagrelor does not alter the systemic exposure of levonorgestrel. Co-administration of ticagrelor (270 mg AM + 180 mg PM on Day1, 180 mg BID on Days 2-7) significantly reduced oral midazolam (7.5 mg AM on Days 1 & 7) AUCinf by 10%, but did not alter 1’-OH- midazolam AUC. Co-administration of ticagrelor (270 mg AM + 180 mg PM on Day 1, 180 mg BID on Days 2-7) did not alter the systemic exposure of IV midazolam (2.5 mg IV over 2 min AM on Days 1 & 7) and 1’-OH-midazolam. Page: 9-12, 62-63, 64-65, 66-67 (PMDA) 124-125, 130 |
||
no | ||||
Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2011/022433Orig1s000ClinPharmR.pdf#page=12 Page: 12-13 |
no | |||
Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2011/022433Orig1s000ClinPharmR.pdf#page=12 Page: 12-13 |
no | |||
Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2011/022433Orig1s000ClinPharmR.pdf#page=12 Page: 12-13 |
no | |||
Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2011/022433Orig1s000ClinPharmR.pdf#page=12 Page: 12-13 |
no | |||
no | ||||
Sources: https://www.pmda.go.jp/drugs/2016/P20161026001/670227000_22800AMX00680_I100_1.pdf#page=160 Page: (PMDA) 160-161 |
no | |||
Sources: https://www.pmda.go.jp/drugs/2016/P20161026001/670227000_22800AMX00680_I100_1.pdf#page=160 Page: (PMDA) 160-161 |
no | |||
Sources: https://www.pmda.go.jp/drugs/2016/P20161026001/670227000_22800AMX00680_I100_1.pdf#page=160 Page: (PMDA) 160-161 |
strong [Ki 13.4 uM] | |||
Sources: https://www.pmda.go.jp/drugs/2016/P20161026001/670227000_22800AMX00680_I100_1.pdf#page=160 Page: (PMDA) 160-161 |
strong [Ki 16.3 uM] | |||
Sources: https://www.pmda.go.jp/drugs/2016/P20161026001/670227000_22800AMX00680_I100_1.pdf#page=160 Page: (PMDA) 160-161 |
strong [Ki 4.9 uM] | |||
Sources: https://www.pmda.go.jp/drugs/2016/P20161026001/670227000_22800AMX00680_I100_1.pdf#page=160 Page: (PMDA) 160-161 |
strong | |||
Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2011/022433Orig1s000PharmR.pdf#page=116 Page: 116.0 |
weak | |||
Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2011/022433Orig1s000PharmR.pdf#page=116 Page: 116.0 |
weak | |||
Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2011/022433Orig1s000PharmR.pdf#page=117 Page: 26, 117 |
yes [IC50 0.759 uM] | |||
Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2011/022433Orig1s000PharmR.pdf#page=117 Page: 26, 117 |
yes [IC50 1 uM] | |||
Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2011/022433Orig1s000PharmR.pdf#page=117 Page: 117.0 |
yes [IC50 10 uM] | |||
Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2011/022433Orig1s000PharmR.pdf#page=117 Page: 117.0 |
yes [IC50 16.9 uM] | |||
Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2011/022433Orig1s000PharmR.pdf#page=117 Page: 117.0 |
yes [IC50 19.2 uM] | |||
Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2011/022433Orig1s000PharmR.pdf#page=117 Page: 117.0 |
yes [IC50 19.9 uM] | |||
Page: 4-5, 58-59 (PMDA) 157 |
yes [IC50 7.8 uM] | yes (co-administration study) Comment: MDR1-MDCK monolayer, H3-digoxin (5 mcM) as a substrate, Flux ratio = 19.5 (digoxin only), 3.1 (digoxin + 10 mcM Ticagrelor); Co-administration of ticagrelor (400 mg QD, Days 1-16) significantly increased digoxin (0.25 mg BID on Day 6, 0.25 mg QD on Days 7-14, P-gp substrate) AUC0-72, Css,max, and Css, min by 28%, 75% and 31%, respectively. Page: 4-5, 58-59 (PMDA) 157 |
||
yes [IC50 9.9 uM] |
Drug as victim
Target | Modality | Activity | Metabolite | Clinical evidence |
---|---|---|---|---|
Page: 123, (ClinPharm) 5-6, 43-44, 45-47, 47-49 |
major [Km 11 uM] | yes (co-administration study) Comment: Human liver microsomes (determination of CYPs) and human cDNA expressed emzymes (Km for AR-C124910XX formation), Km (AR-C124910XX, human liver microsomes) = 27 mcM; Km (AR-C133913XX formation) = 41 mcM; Co-administration of ketoconazole (200 mg BID for 10 days, CYP3A4 inhibitor) significantly increased ticagrelor (90 mg QD on Day 4) AUCinf by 7.32 fold and Cmax by 2.35 fold, and decreased AR-C124910XX AUCinf by 56% and Cmax by 89%. Co-administration of diltiazem (240 mg QD x 14 days, moderate CYP3A4 inhibitor) significantly increased ticagrelor (90 mg QD on Day 8) AUCinf by 2.74 fold and Cmax by 1.69, and decreased AR-C124910XX AUCinf by 13% and Cmax by 38%. Co-administration of rifampin (600 mg QD Days 4-17, strong CYP3A4/P-gp inducer) significantly decreased ticagrelor (180 mg QD Days 1 & 15) AUCinf by 86% and Cmax by 73%, and decreased AR-C124910XX AUCinf by 46% and did not affect Cmax. Page: 123, (ClinPharm) 5-6, 43-44, 45-47, 47-49 |
||
no | ||||
no | ||||
no | ||||
no | ||||
no | ||||
no | ||||
yes [Km 5.36 uM] | ||||
yes | ||||
yes |
Tox targets
Target | Modality | Activity | Metabolite | Clinical evidence |
---|---|---|---|---|
Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2011/022433Orig1s000PharmR.pdf#page=117 Page: 117.0 |
||||
Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2011/022433Orig1s000PharmR.pdf#page=117 Page: 117.0 |
||||
Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2011/022433Orig1s000PharmR.pdf#page=117 Page: 117.0 |
||||
Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2011/022433Orig1s000PharmR.pdf#page=117 Page: 117.0 |
||||
Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2011/022433Orig1s000PharmR.pdf#page=119 Page: 119.0 |
PubMed
Title | Date | PubMed |
---|---|---|
Update on antiplatelet therapy in acute coronary syndromes: what do new drugs bring into clinical practice? | 2009 |
|
Test before you stop. | 2009 Aug |
|
[Anticoagulants of primary haemostasis]. | 2009 Aug |
|
Ticagrelor yields consistent dose-dependent inhibition of ADP-induced platelet aggregation in patients with atherosclerotic disease regardless of genotypic variations in P2RY12, P2RY1, and ITGB3. | 2009 Aug |
|
P2Y(12) inhibitors: differences in properties and mechanisms of action and potential consequences for clinical use. | 2009 Aug |
|
Ticagrelor--a new platelet aggregation inhibitor in patients with acute coronary syndromes. An improvement of other inhibitors? | 2009 Dec |
|
Antiplatelet therapy: Ticagrelor in ACS-what does PLATO teach us? | 2009 Dec |
|
Oral antiplatelet therapy for acute and chronic management of NSTE ACS: residual ischemic risk and opportunities for improvement. | 2009 Dec |
|
Ticagrelor versus clopidogrel in acute coronary syndromes. | 2009 Dec 10 |
|
Ticagrelor versus clopidogrel in acute coronary syndromes. | 2009 Dec 10 |
|
Ticagrelor versus clopidogrel in acute coronary syndromes. | 2009 Dec 10 |
|
ACP Journal Club. Ticagrelor was more effective than clopidogrel, with no increase in major bleeding in acute coronary syndromes. | 2009 Dec 15 |
|
Randomized double-blind assessment of the ONSET and OFFSET of the antiplatelet effects of ticagrelor versus clopidogrel in patients with stable coronary artery disease: the ONSET/OFFSET study. | 2009 Dec 22 |
|
New P2Y12 blockers. | 2009 Jul |
|
Future of oral antiplatelet therapy: four challenged hypotheses. | 2009 Jun |
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Update on oral antiplatelet therapy: principles, problems and promises. | 2009 May |
|
Strategy for the treatment of clopidogrel low responsiveness in diabetes mellitus and stent implantation. | 2009 Nov |
|
HOTLINE I, PLATO favours ticagrelor over clopidogrel in ACS. | 2009 Nov |
|
P2Y12 inhibitors: thienopyridines and direct oral inhibitors. | 2009 Nov |
|
European Society of Cardiology--2009 annual congress. 31 August - 2 September 2009, Barcelona, Spain. | 2009 Nov |
|
Comparison of ticagrelor and thienopyridine P2Y(12) binding characteristics and antithrombotic and bleeding effects in rat and dog models of thrombosis/hemostasis. | 2009 Nov |
|
Ticagrelor binds to human P2Y(12) independently from ADP but antagonizes ADP-induced receptor signaling and platelet aggregation. | 2009 Sep |
|
New P2Y12 antagonists. | 2009 Sep |
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Ticagrelor versus clopidogrel in patients with acute coronary syndromes. | 2009 Sep 10 |
|
Ticagrelor--is there need for a new player in the antiplatelet-therapy field? | 2009 Sep 10 |
|
Ticagrelor: the first reversibly binding oral P2Y12 receptor antagonist. | 2009 Winter |
|
[Ticagrelor versus clopidogrel in patients with acute coronary syndromes: results of the PLATO study]. | 2010 |
|
Antiplatelet therapy prasugrel: a novel platelet ADP P2Y12 receptor antagonist. | 2010 Apr |
|
The PLATO trial: do you believe in magic? | 2010 Apr |
|
Balancing the benefits and risks of antiplatelet agents in patients with non-ST-segment elevated acute coronary syndromes and undergoing percutaneous coronary intervention. | 2010 Aug |
|
Mechanism of action and clinical development of ticagrelor, a novel platelet ADP P2Y12 receptor antagonist. | 2010 Feb |
|
The year in cardiothoracic and vascular anesthesia: selected highlights from 2009. | 2010 Feb |
|
Limitations of current therapies to prevent thrombosis: a need for novel strategies. | 2010 Feb |
|
New drugs for the treatment of coronary artery syndromes: otamixaban and ticagrelor. | 2010 Feb |
|
Pharmacokinetic, pharmacodynamic and clinical profile of novel antiplatelet drugs targeting vascular diseases. | 2010 Feb 1 |
|
Emerging P2Y12 receptor antagonists: role in coronary artery disease. | 2010 Jan |
|
[Update on new antithrombotic treatments]. | 2010 Jan 20 |
|
Ticagrelor in ACS: redefining a new standard of care? | 2010 Jan 23 |
|
Comparison of ticagrelor with clopidogrel in patients with a planned invasive strategy for acute coronary syndromes (PLATO): a randomised double-blind study. | 2010 Jan 23 |
|
The case for routine genotyping in dual-antiplatelet therapy. | 2010 Jul 6 |
|
Advances in antiplatelet therapy for stroke prevention: the new P2Y12 antagonists. | 2010 Mar |
|
Efficacy and safety of ticagrelor: a reversible P2Y12 receptor antagonist. | 2010 Mar |
|
The novel P2Y 12 antagonist AZD6140 rapidly and reversibly reduces platelet activation in diabetic rats. | 2010 Mar |
|
Role of ticagrelor in clopidogrel nonresponders: resistance is futile? | 2010 Mar 16 |
|
Response to ticagrelor in clopidogrel nonresponders and responders and effect of switching therapies: the RESPOND study. | 2010 Mar 16 |
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Pharmacokinetics, pharmacodynamics, tolerability and safety of single ascending doses of ticagrelor, a reversibly binding oral P2Y(12) receptor antagonist, in healthy subjects. | 2010 May |
|
Advances in antiplatelet treatment for acute coronary syndromes. | 2010 May |
|
Forecasting drug utilization and expenditure in a metropolitan health region. | 2010 May 17 |
|
The year in interventional cardiology. | 2010 May 18 |
|
State of the art of new P2Y12 antagonists. | 2010 Oct |
Patents
Sample Use Guides
Initiate treatment with 180 mg (two 90 mg tablets) oral loading dose. Continue treatment with 90 mg twice daily.
Route of Administration:
Oral
In Vitro Use Guide
Sources: https://www.ncbi.nlm.nih.gov/pubmed/?term=21177984
In human liver microsomes, ticagrelor inhibited midazolam 4-hydroxylation with an IC50 of 8.2 uM. Evaluated in fresh human hepatocytes at concentration up to 20 uM, ticagrelor was not an inducer of CYP1A2 or CYP3A4.
Substance Class |
Chemical
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GLH0314RVC
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Classification Tree | Code System | Code | ||
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EMA ASSESSMENT REPORTS |
POSSIA (WITHDRAWN: PERIPHERAL VASCULAR DISEASES)
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EMA ASSESSMENT REPORTS |
BRILIQUE (AUTHORIZED: PERIPHERAL VASCULAR DISEASES)
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WHO-ATC |
B01AC24
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EMA ASSESSMENT REPORTS |
POSSIA (WITHDRAWN: ACUTE CORONARY SYNDROME)
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WHO-VATC |
QB01AC24
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NCI_THESAURUS |
C80483
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NDF-RT |
N0000182142
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EMA ASSESSMENT REPORTS |
BRILIQUE (AUTHORIZED:ACUTE CORONARY SYNDROME)
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LIVERTOX |
NBK548529
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Code System | Code | Type | Description | ||
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m10853
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PRIMARY | Merck Index | ||
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C76404
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PRIMARY | |||
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1667177
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4184
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1116632
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PRIMARY | RxNorm | ||
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C503700
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PRIMARY | |||
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8772
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PRIMARY | |||
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100000115464
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PRIMARY | |||
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Ticagrelor
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PRIMARY | |||
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274693-27-5
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PRIMARY | |||
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N0000182141
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PRIMARY | Cytochrome P450 3A4 Inhibitors [MoA] | ||
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DTXSID901009337
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PRIMARY | |||
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CHEMBL398435
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PRIMARY | |||
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N0000190482
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PRIMARY | Phenylalanine Hydroxylase Activators [MoA] | ||
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9871419
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PRIMARY | |||
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N0000185503
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PRIMARY | P-Glycoprotein Inhibitors [MoA] | ||
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8306
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PRIMARY | |||
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N0000182143
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PRIMARY | P2Y12 Receptor Antagonists [MoA] | ||
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68558
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PRIMARY | |||
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Ticagrelor
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DB08816
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TT-94
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SUB30898
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GLH0314RVC
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1765
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PRIMARY | |||
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N0000190115
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PRIMARY | Cytochrome P450 3A5 Inhibitors [MoA] | ||
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GLH0314RVC
Created by
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PRIMARY |
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SALT/SOLVATE -> PARENT | |||
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METABOLIC ENZYME -> SUBSTRATE | |||
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INHIBITOR -> TARGET |
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METABOLIC ENZYME -> INHIBITOR |
WEAK
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TRANSPORTER -> INHIBITOR | |||
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BINDER->LIGAND |
BINDING
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SOLVATE->ANHYDROUS | |||
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TARGET -> INHIBITOR |
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TRANSPORTER -> SUBSTRATE |
Related Record | Type | Details | ||
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METABOLITE -> PARENT |
MAJOR
URINE
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ACTIVE MOIETY |
Name | Property Type | Amount | Referenced Substance | Defining | Parameters | References |
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Biological Half-life | PHARMACOKINETIC |
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Volume of Distribution | PHARMACOKINETIC |
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Tmax | PHARMACOKINETIC |
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