NHS Greater Glasgow & Clyde Area Drug and Therapeutics Committee
Greater Glasgow and Clyde Medicines
Medicines Update

Ticagrelor 60mg

Following SMC advice that ticagrelor 60mg twice daily is not recommended for use in NHS Scotland, NHSGGC Heart MCN has recommended that the small number of patients currently receiving this should have their prescription changed to clopidogrel 75mg once daily. This will be managed by prescribing support teams.

All of these patients have had coronary intervention following a myocardial infarction and felt by the initiating cardiologist to be at high risk of further atherothrombotic events. The main evidence for use of ticagrelor 60mg in this patient cohort comes from PEGASUS-TIMI 54. Absolute reduction in MI, stroke or cardiovascular death in this trial was small. In addition, there was no significant reduction in cardiovascular or all-cause mortality in the total study population and treatment was associated with a significantly increased risk of major bleeding.

The requirement for long term dual antiplatelet therapy with clopidogrel should be reviewed in primary care. If there is any uncertainty for a specific patient, primary care should liaise with specialist teams.

Published 25/07/2017