Ticagrelor also known via brand names Brilinta or Brilique, is a platelet inhibitor used to prevent infarction, stroke or cardiovascular death. Once administered orally it travels to the bloodstream and acts on platelets' P2Y receptors which inhibits the formation of thromboses. An activated P2Y receptor couples with guanine nucleotide-binding protein subunit i2 that inhibits adenylyl cyclase. By inhibiting adenylyl cyclase, it stops the formation of cAMP, leading to a stop of calcium efflux causing platelet aggregation and activation. Grapefruit products should be avoided as it inhibits the CYP3A4 metabolism of ticagrelor and cause an increase in the drug which may lead to an overdose. Herbs and supplements with anticoagulant and antiplatelet activity should be avoided such as garlic, ginger, bilberry, danshen, piracetam and ginkgo biloba. St. John's Wort induces the CYP3A4 metabolism of the drug and will reduce its efficacy and concentration.

Ticagrelor Pathway References