Brilinta vs Plavix: what's the difference?

Brilinta vs Plavix: what’s the difference?

Prevention and treatment of blood clots in patients with ACS (acute coronary syndrome) includes the use of different types of medications. Two drugs that are commonly used, include Brilinta, brand name for ticagrelor, and Plavix brand name for clopidrogel. Both medications are antiplatelet medications used to reduce the risk of blood clots, with certain differences. Following subsections offer detailed information about both the drugs, and also offers answers to the question – Brilinta vs Plavix: what’s the difference? Before looking at the differences, here is a quick look at the condition treated by the drugs. ACS refers to a group of heart conditions that occur when the blood supply to the heart is reduced or blocked. This includes conditions such as unstable angina and heart attack.

Use of Brilinta and Plavix

Brilinta is typically used in combination with aspirin, another antiplatelet medication, to reduce the risk of future heart-related events in people who have had an ACS event. It is also used to reduce the risk of stroke and heart attack in people with a history of heart attack or severe blockages in their blood vessels, who have undergone a procedure to improve blood flow such as angioplasty or stent placement.

Plavix is used to prevent blood clots in people with certain heart and blood vessel conditions, for patients who have had a recent heart attack, stroke, or individuals with unstable angina. It is also be used to reduce the risk of blood clots in people with peripheral artery disease (PAD), which refers to a narrowing or blockage of blood vessels in the legs.

Mechanism of action of Brilinta vs Plavix

Here is a quick look at the mechanisms of action of Brilinta and Plavix to help understand the differences in outcomes better.

Brilinta as a selective and reversible P2Y12 receptor antagonist, inhibits platelet aggregation. It binds to the P2Y12 receptor, involved in ADP-mediated platelet activation, and prevents the activation and aggregation of platelets, thereby reducing the risk of blood clots.

Plavix as a prodrug is converted to its active metabolite by the liver. The active metabolite then irreversibly binds to the P2Y12 receptor on the surface of blood platelets, and inhibits platelet activation and aggregation, thereby reducing the risk of blood clots.

Both Brilinta and Plavix work by blocking the P2Y12 receptor on blood platelets to prevent their activation and aggregation, and ultimately reduce the risk of blood clots. The difference between the two is that Brilinta is a reversible antagonist while Plavix is an irreversible antagonist of the P2Y12 receptor.

Side effects of Brilinta and side effects of Plavix

Here is a short comparison of the side effects of Brilinta and Plavix.

Some patients may experience the following possible side effects of Brilinta

Bleeding, including nosebleeds, bruising, and heavy menstrual periods
Shortness of breath or difficulty breathing
Headache
Dizziness
Nausea
Diarrhea
Rash or itching
Increased levels of uric acid in the blood

In addition to the above, there is also the possibility of rare, serious side effects of Brilinta, listed below:

Severe bleeding
Heart rhythm problems, such as an irregular heartbeat or a slow heart rate
Shortness of breath or difficulty breathing

Some patients may experience the following possible side effects of Plavix

Bleeding, including nosebleeds, bruising, and heavy menstrual periods
Diarrhea
Stomach pain or indigestion
Headache
Dizziness
Rash or itching

Similar to Brilinta, there is the possibility of rare and serious side effects of Plavix, as listed here:

Severe bleeding
Allergic reactions, including swelling of the face, lips, tongue or throat
TTP (thrombotic thrombocytopenic purpura), a rare but serious blood disorder that causes blood clots to form in small blood vessels throughout the body

Drug interactions of Brilinta

The drug may interact with the following categories of drugs.

Strong CYP3A4 inhibitors, such as ketoconazole, clarithromycin, and grapefruit juice, may increase the blood levels of ticagrelor, increasing the risk of side effects, including bleeding.
Strong CYP3A4 inducers, such as rifampin and carbamazepine, may decrease the blood levels of ticagrelor, reducing its effectiveness.
Other medications that affect blood clotting, such as other antiplatelet medications or anticoagulants, may increase the risk of bleeding.

Drug interactions of Plavix

The drug may interact with the following types of medications.

Aspirin with Plavix can increase the risk of bleeding.
NSAIDs, such as ibuprofen and naproxen, can also increase the risk of bleeding when taken with Plavix.
Plavix with other blood-thinning medications such as heparin or warfarin can also increase the risk of bleeding.
Some PPIs, such as omeprazole, can reduce the effectiveness of Plavix.
Drugs that inhibit the enzyme CYP2C19 can reduce the effectiveness of Plavix. Examples include certain antidepressants, antifungal medications, and proton pump inhibitors.
Some selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine, can increase the risk of bleeding when taken with Plavix.
Drugs that induce or inhibit the enzyme CYP3A4 can affect the metabolism of Plavix. Examples include certain antibiotics, antifungal medications, and grapefruit juice.

Ideal dosage of Brilinta and Plavix

The recommended initial dosage for Brilinta is 180 mg taken orally as a loading dose, followed by 90 mg twice daily. After the first year, the recommended maintenance dosage is 60 mg twice daily.

The recommended dosage for Plavix is 75 mg once daily. For patients with acute coronary syndrome, a loading dose of 300 mg may be given initially.