Kogavant (Ticagrelor)

Kogavant (ticagrelor) is used to reduce thrombotic cardiovascular events in the acute coronary syndrome pathway.

• Acute coronary syndrome: lowers the risk of cardiovascular death, myocardial infarction and stroke.
• ST-elevation myocardial infarction (STEMI): improves outcomes when used with percutaneous coronary intervention.
• Non‑ST-elevation myocardial infarction (NSTEMI): reduces recurrent ischemic events.
• Unstable angina: decreases the incidence of subsequent myocardial infarction and urgent revascularisation.

• Ticagrelor acts as a reversible antagonist of the platelet P2Y12 ADP receptor, blocking ADP‑mediated activation of the GPIIb/IIIa complex and thereby inhibiting platelet aggregation without requiring metabolic activation.

Ticagrelor may be associated with a range of adverse reactions, which are classified by frequency.

Common Side Effects

• Dyspnea
• Headache
• Nausea
• Minor bleeding (e.g., bruising, gum bleeding)
• Dizziness

Serious or Rare Side Effects

• Severe or life‑threatening bleeding
• Intracranial hemorrhage
• Myocardial infarction recurrence
• Hepatic injury
• Anaphylactic or severe allergic reactions
• Thrombocytopenia

When prescribing Kogavant, clinicians should consider the following precautions.

• Bleeding risk assessment: evaluate for active or recent bleeding before initiation.
• Respiratory monitoring: observe for new or worsening dyspnea.
• Hepatic function: check liver enzymes in patients with hepatic impairment.
• Renal function: adjust use in severe renal impairment as recommended.
• Concomitant antithrombotic therapy: avoid use with other potent antiplatelet or anticoagulant agents unless clinically justified.
• Store at ambient temperature: keep in the original packaging, protect from moisture and light.

Kogavant can interact with several medicines, requiring avoidance or careful monitoring.

Major Interactions (Avoid)

• Strong CYP3A4 inhibitors (e.g., ketoconazole, clarithromycin): may increase ticagrelor exposure.
• Strong CYP3A4 inducers (e.g., rifampicin, carbamazepine): may reduce efficacy.
• Co‑administration with other potent antiplatelet agents (e.g., prasugrel) without clinical need.

Moderate Interactions (Monitor Closely)

• NSAIDs: increase risk of gastrointestinal bleeding.
• Selective serotonin reuptake inhibitors (SSRIs): may enhance bleeding tendency.
• Anticoagulants (e.g., warfarin, direct oral anticoagulants): require close monitoring of coagulation parameters.
• Statins metabolized by CYP3A4 (e.g., simvastatin): may raise statin levels.