Each film-coated tablet of Tigor® contains: 

• Ticagrelor        60 mg
• Ticagrelor        90 mg

• It is used to treat patients who have had a heart attack or severe chest pain that occurred due to lack of oxygen delivered to their heart.
• This medicine is used to decrease the chance of developing heart attacks or dying from stroke or a heart attack.
• It is used with aspirin to decrease your chance of having another serious heart or blood vessels problem (e.g. stroke, heart attack, or blood clots in your stent) which may be fatal.

• If you are allergic to Ticagrelor, or any of the ingredients in this medicine. Tell your doctor about the allergy and what signs you had.
• If you have previously experienced bleeding in the brain.
• If you are currently bleeding.

• Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medications including prescription medicines, over the counter medicines, herbals, vitamins and supplements.
• If you are taking Digoxin (used to treat some heart problems).
• If you are taking medicine used to decrease high blood cholesterol levels (e.g. lovastatin or simvastatin).
• If you are taking an HIV-AIDS medicine.
• If you are taking medicines used for heart conditions or high blood pressure.
• If you are taking an oral anti-fungal medicine.
• If you are taking a medicine that is used to treat seizures.
• If you are taking a blood thinner medicine.
• If you are taking rifampin (antibiotic).

¤ Talk to your doctor before taking this medicine if you are pregnant, plan on getting pregnant or breastfeeding.

¤ Discuss risks and benefits that this medicine may impose on you and your baby.

• It is not known if this medicine can cause harm to your unborn baby during pregnancy. You and your doctor will decide if you need to take this medicine during pregnancy or not.
• It is not known yet if this medicine can cross your breast milk during breastfeeding and therefore you and your doctor should decide whether you need to take this medicine or to breastfeed (you should not do both without consulting your doctor).

Most common side effects:

• Bleeding (e.g. easy bruising and bleeding, nose bleeds, delayed wound healing and delayed blood clotting).
• Dyspnea (difficulty breathing)

Possible side effects:

Although it may be rare, some patients may experience undesirable side effects when taking a medication. Contact your healthcare provider if you experience any side effect. Tell your doctor or get medical help right away if you have any of following signs or symptoms:

• Signs of an allergic reaction, like rash, hives, itching; red, swollen, blistered, or peeling skin with or without fever, wheezing, tightness in the chest or throat, trouble breathing, swallowing, or talking, unusual hoarseness, or swelling of the mouth, face, lips, tongue, or throat.
• Signs of serious bleeding, like severe bleeding, bleeding that you cannot control, pink, brown or red urine, coughing up blood or blood clots, vomiting blood or vomit that looks like “coffee grounds”, black or red stools or stools that look like tar.
• New or unexpected shortness of breath at night, at rest, or during any activity.

• The usual recommended initial dose is 180 mg orally given as a loading dose (an initial higher dose that may be given at the start of a course of therapy before decreasing the dose down to a maintenance dose) following an acute coronary syndrome (ACS) event (conditions associated with sudden, reduced blood flow to the heart like heart attack).
• It is usually recommended that you continue treatment with 90 mg twice daily during the first year after an ACS event, followed by 60 mg twice daily after 1 year.
• This medicine is usually given with a daily maintenance dose of aspirin of 75-100mg.
• Take this medicine exactly as prescribed by your doctor.
• It is not known if this medicine is safe and effective in children yet.
• Your doctor will determine how many tablets you need to take and when to take them.
• Take with or without food.
• Take your doses at the same time every day.
• If you are unable to swallow the tablet, you may crush it and mix it with water, Make sure to drink the entire cup, then rinse the cup with water and drink all the water again.

• Stop the medication right away and talk to your doctor or pharmacist if you develop allergic reactions such as shortness of breath, skin rash, swelling of the face or neck, decreased blood pressure and dizziness.
• This medicine may cause dyspnea (difficulty breathing). Talk to your doctor if this happens.
• Talk to your doctor if you have liver problems before you start/continue taking this medicine ,Your doctor may recommend another alternative depending on the severity of your liver damage if needed.
• You may have an increased risk of bleeding when taking this medicine if you have severe liver damage ,This medicine may increase the risk of bleeding which may be serious andsometimes may be fatal. You may need blood transfusion or surgery if you experience serious bleeding (e.g. internal bleeding). You may be at higher risk of experiencing bleeding signs like easy bruising and bleeding, nose bleeds, delayed wound healing and delayed blood clotting. Contact your doctor immediately if you experience any of the following serious bleeding signs; severe bleeding, bleeding that you cannot control, pink, brown or red urine, coughing up blood or blood clots, vomiting blood or vomit that looks like “coffee grounds”, black or red stools or stools that look like tar.
• This medicine is usually taken with aspirin. Ask your doctor about the dose of aspirin that you should take. Do not take more than 100 mg of aspirin per day in order not to affect the efficacy of Ticagrelor. Take your aspirin dose exactly as prescribed by your doctor, do not take higher than prescribed doses. Talk to your doctor if you are taking other medications that contain aspirin, and make sure not to take new over-the-counter medicines (do not require a prescription) that contain aspirin.
• Talk to your doctor before starting this medicine if you have a history of bleeding problems.
• Talk to your doctor before starting this medicine if you have a history of stomach ulcers (sore in your stomach) or colon polyps.
• Talk to your doctor before starting this medicine if you have recently had any serious injury or surgery or if you have a planned dental procedure or a surgery.
• Talk to your doctor before starting this medicine if you have lung problems (e.g.COPD or asthma).
• Talk to your doctor before starting this medicine if you have a history of stroke.
• Make sure to tell your doctors and dentists that you are taking this medicine. They should also inform the doctor who prescribed your medicine about any planned surgical procedures that you have.

If you take more Ticagrelor than you should:

• Contact your doctor or the poison center if available or go immediately to the nearest hospital (emergency room in case of overdose).

If you forget to take Ticagrelor:

• If you miss a dose, take your next dose at its usual time. Do not double the dose.

If you stop taking Ticagrelor:

• Do not stop taking this medicine without talking to your doctor first.
• Stopping this medicine too soon may increase the risk of developing blood clots, having heart attacks or death if you have a stent. You are at higher risk of having a stroke or heart attack if you stop taking this medicine too soon. If you experience bleeding or any other side effect, make sure to contact your doctor before you stop taking this medicine. Your doctor may recommend that you stop taking Ticagrelor five days before surgery or other medical procedures in order to reduce the risk of bleeding.
• Your doctor should tell you when you need to continue taking Ticagrelor again, as soon as possible after undergoing the medical procedure or surgery.

Driving and using machines:

• It is generally safe to drive or use machineries after taking this medication. Do not drive or use machines if you are not feeling well.

• Tigor® 60 Tablets (Blister of 10  Tablets, Pack of two blisters).
• Tigor® 90 Tablets (Blister of 10  Tablets, Pack of two blisters).

• Store in a dry place at a temperature not exceeding 25 ºC.
• Keep out of the reach of children.