Tigemac contains Ticagrelor. Tigemac uses:

Tigemac is indicated for the prevention of atherothrombotic events in adult patients with Acute Coronary Syndromes (unstable angina, non ST elevation Myocardial Infarction [NSTEMI] or ST elevation Myocardial Infarction [STEMI]); including patients managed medically, and those who are managed with percutaneous coronary intervention (PCI) or coronary artery by-pass grafting (CABG).

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Brand Name: Tigemac
Generic: Ticagrelor
Weight: 90.0 Mg
Type: Tablet
Therapeutic Class: Anti-platelet drugs
Manufacturer: MACLEODS PHARMACEUTICALS
Price: 212.5
Last Updated: 2020-11-20 18:15:00

Doses

Tigemac contains Ticagrelor 90.0 Mg. Tigemac doses

Tigemac treatment should be initiated with a single 180 mg loading dose (two tablets of 90 mg) and then continued at 90 mg twice daily. Patients taking Tigemac should also take aspirin daily, unless specifically contraindicated. Following an initial dose of aspirin (usually 325 mg), Tigemac should be used with a maintenance dose of aspirin of 75-100 mg. Maintenance dose of Aspirin above 100 mg decreased the efficacy of Tigemac. So, maintenance dose of aspirin above 100 mg should be avoided.

A patient who misses a dose of Tigemac should take only one 90 mg tablet (the next dose) at its scheduled time. Patients treated with Clopidogrel can be directly switched to Tigemac if needed. Switching from prasugrel to ticagrelor has not been investigated.

Treatment is recommended for up to 12 months unless discontinuation of Tigemac is clinically indicated. Tigemac can be administered with or without food.

 

Side Effects

Dyspnea,bleeding,headache,cough,dizziness,nausea,atrial fibrillation, hypertension, non-cardiac chest pain, diarrhea, back pain, hypotension, fatigue, chest pain.

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Introduction

Tigemac is a selective adenosine diphosphate (ADP) receptor antagonist acting on the P2Y12 ADP-receptor that can prevent ADP-mediated platelet activation and aggregation. Tigemac reversibly interacts with the platelet P2Y12 ADP-receptor.Tigemac does not interact with the ADP binding site itself, but interacts with platelet P2Y12 ADP-receptor to prevent signal transduction.Thus it prevents platelet activation & aggregation.

Precaution

General Risk of Bleeding: Drugs that inhibit platelet function including Tigemac increase the risk of bleeding.     

Concomitant Aspirin Maintenance Dose: Use of Tigemac with maintenance doses of aspirin above 100 mg decreased the effectiveness of Tigemac. Therefore, after the initial loading dose of aspirin (usually 325 mg), use Tigemac with a maintenance dose of aspirin of 75-100 mg.   

 Moderate Hepatic Impairment: Tigemac has not been studied in patients with moderate hepatic impairment.     

Discontinuation of Tigemac: Discontinuation of Tigemac will increase the risk of myocardial infarction, stent thrombosis, and death.

Interaction

CYP3A inhibitors: Avoid use of strong inhibitors of CYP3A (e.g., ketoconazole, itraconazole, voriconazole, clarithromycin, nefazodone, ritonavir, saquinavir, nelfinavir, indinavir, atazanavir and telithromycin).

CYP3A inducers: Avoid use with potent inducers of CYP3A (e.g., rifampin, dexamethasone, phenytoin,carbamazepine and phenobarbital).

Aspirin: Use of Tigemac with aspirin maintenance doses above 100 mg reduced the effectiveness ofTigemac.

Simvastatin, Lovastatin: Tigemac will result in higher serum concentrations of simvastatin and lovastatin because these drugs are metabolized by CYP3A4. Avoid simvastatin and lovastatin doses greater than 40 mg.

Digoxin: Because of inhibition of the P-glycoprotein transporter, monitor digoxin levels with initiation of or any change in ticagrelor therapy.

Other Concomitant Therapy: Tigemac can be administered with unfractionated or low-molecular-weight heparin, GPIIb/llla inhibitors, proton pump inhibitors, beta-blockers, angiotensin converting enzyme inhibitors, and angiotensin receptor blockers.

Pregnancy Lactation use

Pregnancy category C. There are no or limited amount of data from the use of Tigemac in pregnant women.Tigemac is not recommended during pregnancy.

Nursing mothers: Available pharmacodynamic/toxicological data in animals have shown excretion of Tigemac and its active metabolites in milk. A risk to newborns/infants cannot be excluded. A decision must be made whether to discontinue breastfeeding or to discontinue/abstain from ticagrelor therapy taking into account the benefit of breastfeeding for the child and the benefit of therapy for the women.

Contraindication

Tigemac is contraindicated in case of-

  • Hypersensitivity to Tigemac or to any of the excipients
  • Active pathological bleeding (peptic ulcer)
  • History of intracranial haemorrhage
  • Moderate to severe hepatic impairment
  • Co-administration of Tigemac with strong CYP3A4 inhibitors (e.g., ketoconazole, clarithromycin, nefazodone, ritonavir, and atazanavir)
Special Warning

Pediatric Use: The safety and effectiveness of Tigemac in pediatric patients have not been established. 

Geriatric Use: No overall differences in safety or effectiveness were observed in geriatric patients.

Hepatic Impairment: Tigemac has not been studied in the patients with moderate or severe hepatic impairment. Tigemac is metabolized by the liver and impaired hepatic function can increase risks for bleeding and other adverse events. Hence, 

Renal Impairment: No dosage adjustment is needed in patients with renal impairment. Patients receiving dialysis have not been studied.

Acute Overdose

There is currently no known antidote to reverse the effects ofTigemac and it is not expected to be dialysable.Treatment of overdose should follow local standard medical practice.The expected effect of excessive ticagrelor dosing is prolonged duration of bleeding risk associated with platelet inhibition. If bleeding occurs appropriate supportive measures should be taken.

Interaction with other Medicine

 

Storage Condition

Protect from light & moisture. Store below 25° C. Keep out of reach of children.

Tigemac Tablet price in India 212.5

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