Brilinta and Eliquis are brand names for prescription drugs used to prevent blood clots in certain patient groups. Here we will explain how they work, their similarities and differences, their side effects, and more. This should provide you with the basics to better understand your options.
What is Brilinta?
Brilinta is an FDA (U.S. Food and Drug Administration) approved medication manufactured by AstraZeneca. It is an antiplatelet drug used to reduce the risk of heart attacks, strokes, and death from heart disease caused by blood clots. It’s prescribed to adults who:
- Have previously had a heart attack
- Have coronary artery disease (CAD) and who are at a high risk of having a heart attack or a stroke
- Have acute coronary syndrome (ACS), which occurs when blood flow to the heart is suddenly blocked. (According to the American Heart Association (AHA) and American College of Cardiology (ACC), Brilinta is a preferred treatment for people with ACS. Brilinta works faster and has a reversible mode of action).
- Have ACS and who have been treated with a stent
If you have CAD, ACS, or have a stent due to ACS, you may be at a higher risk of blood clots. Brilinta helps to stop your blood clotting, reducing your risk of a heart attack or stroke. The active ingredient in Brilinta, ticagrelor, inhibits platelet activation by binding to receptors on the surface of your platelets. This stops them from being able to stick together preventing the process that causes clotting.
Brilinta is available in tablet form, in the following doses: 60 mg and 90 mg. Your loading dose and maintenance dose will be based on the condition you are being treated for. Take Brilinta with a daily dose of aspirin of 75-100 mg.
There is a high risk of stent thrombosis, or blood clots forming after stent placement (percutaneous coronary intervention/PCI). To stop thrombosis, Brilinta can be used to reduce platelet aggregation and prevent blood clots around the stent.
When Brilinta is prescribed for lowering the risk of stroke in people having an ischemic stroke or a transient ischemic attack, a loading dose of aspirin is also given. The combination of aspirin and a P2Y12 inhibitor such as Brilinta is called dual antiplatelet therapy (DAPT).
Take Brilinta for at least 12 months after stent placement. After the first 12 months, take Brilinta for a further 12 months at a reduced dose. Your doctor will decide your dose at your follow-up appointment to determine any changes.
What is Eliquis?
Eliquis is an FDA (U.S. Food and Drug Administration) approved medication manufactured by Bristol-Myers Squibb and Pfizer. Eliquis is an oral anticoagulant, a type of drug that stops blood clotting (thromboprophylaxis). This medication is used to prevent blood clots from forming in people who have:
- Nonvalvular atrial fibrillation (an irregular heartbeat not caused by a heart valve problem) and who have other clotting risk factors
- Had hip or knee replacement surgery
It’s also used to treat blood clots in the legs (deep vein thrombosis) and lungs (pulmonary embolism), and to stop blood clots from reoccurring in these places.
The active ingredient in Eliquis is an anticoagulant called apixaban. Apixaban is a highly specific factor Xa inhibitor. It has no direct effect on platelet aggregation, but indirectly inhibits platelet aggregation induced by thrombin. By inhibiting FXa, apixaban decreases thrombin generation and the development of clots.
Eliquis is available in tablet form, in the following doses: 2.5 mg and 5 mg.
After hip or knee replacement surgery, you have a higher risk of getting a DVT or PE. You’ll start taking Eliquis 12 to 24 hours after your surgery to prevent this. Your healthcare professional will check to make sure the bleeding from your surgery has stopped before you take your first dose of the drug.
The recommended dose of Eliquis is 5 mg orally twice daily. For patients 80 years of age or older, weighing 60 kg or less, or having serum creatinine equal to or above 1.5 mg/dL, the recommended dose is 2.5 mg orally twice daily. Always speak with a healthcare professional about any changes to your dose so they can monitor and evaluate your condition.
Common side effects of Brilinta and Eliquis
The most common side effects of Brilinta in clinical trials include:
- An increase in minor bleeding risk, including nosebleeds and bruising
- Shortness of breath (dyspnea)
- Feeling sick (nausea)
More serious side effects of Brilinta include:
- Major bleeding such as serious internal and external bleeding that could potentially be fatal
- Severe allergic reactions to the medication that could cause swelling in your face, mouth, or throat, heart palpitations, or problems breathing
The most common side effects of Eliquis in clinical trials (incidence ≥1%) compared to placebo include:
- Increased bruising
- Blood in your urine and feces
- Bleeding from your orifices, like your anus or vagina
More serious side effects of Eliquis include
- The potential risk of cardiovascular events such as myocardial infarction or stroke
- Heavy menstrual bleeding
- Black or bloody stools, coughing up blood or vomit that looks like coffee grounds
These aren’t all the side effects Brilinta or Eliquis can cause. You can find more details in the patient leaflet that comes with your medication. If you have any concerns about side effects, talk to your physician or pharmacist.
Brilinta and Eliquis drug interactions
Brilinta can interact with other medications. These include:
- Any medications taken to treat heart conditions, high blood pressure, or high cholesterol
- Any blood thinner (anticoagulant) medications taken to reduce your risk of blood clots – clopidogrel, heparin, warfarin
- Any pain killers – codeine, ibuprofen
- Any antibiotics – erythromycin
- Any medications taken to treat HIV/AIDS
- Any antifungal medicines taken orally
- Any anti-seizure medications – carbamazepine, phenytoin
Eliquis can interact with other medications. These include:
- An antifungal medicine
- Antiviral medicines for HIV/AIDS
- Anti-inflammatory medicines
- Pain medications such as ibuprofen
- Medicines for high blood pressure or heart problems
- Vitamin K antagonists
- Medicines to prevent epilepsy or seizures
- Medicines to treat tuberculosis
- St John’s Wort
Brilinta and Eliquis can interact with other medications. This can change how Brilinta and Eliquis and other medications work and can make side effects more likely. Tell your prescribing physician about all your drugs, including vitamins and dietary supplements.
Brilinta and Eliquis contraindications
You should not use Brilinta if you:
- Are allergic to the active ingredient ticagrelor
- Are allergic to any of the other ingredients in Brilinta
- Have ever had bleeding in your brain
- Are currently bleeding
Talk to your doctor before using Brilinta if you:
- Have ever had a stroke
- Have ever had any problems with bleeding
- Have ever had stomach ulcers or colon polyps
- Have any liver problems
- Have asthma or chronic obstructive pulmonary disease (COPD)
- Have recently had surgery or a serious injury
- Are planning to have surgery or a dental procedure
- Are pregnant or are planning to become pregnant
- Are breastfeeding or are planning to breastfeed
You should not use Eliquis if you:
- Are allergic to the active ingredient apixaban
- Are allergic to any of the other ingredients found in Eliquis (listed in the leaflet which comes with the medication)
- Have artificial heart valves
- Have antiphospholipid syndrome (APS), especially with positive triple antibody testing, and have a history of blood clots
- Are under 18 years of age
- Are bleeding excessively
- Have an organ condition that increases the likelihood of serious internal bleeding, like a stomach ulcer
Talk to your doctor before using Eliquis if you:
- Have an increased risk of bleeding, such as a bleeding disorder or very high blood pressure
- Are over 75 years of age
- Weigh 60kg or less
- Have severe renal impairment or are on dialysis
- Have a liver problem or a history of liver problems
- Had a catheter or an injection into your spine
- Have antiphospholipid syndrome
- Are lactose intolerant
- Need to have surgery or another procedure that can cause bleeding
- Are pregnant or breastfeeding
Other drugs for the prevention of blood clotting
If you have any concerns about Brilinta or Eliquis side effects, talk to your physician, or pharmacist for medical advice. Also inform your healthcare provider about any medical conditions, supplements, and over-the-counter meds you are taking. You are also encouraged to report side effects to the FDA: visit http://www.fda.gov/medwatch or call 1-800-FDA-1088.