Adding Brilinta to your regimen can be highly beneficial when managing cardiovascular conditions. Brilinta, also known as ticagrelor, is designed to address acute coronary syndrome and decrease the risk of death from heart attacks and strokes. As an antiplatelet agent, it helps prevent clots and sustains normal blood flow, offering essential protection from serious health problems.
However, Brilinta comes with its own set of side effects and high costs. That’s why many patients seek more affordable and safer alternatives. Below, we explore some popular substitutes for Brilinta.
Plavix
Both Brilinta and Plavix operate on similar mechanisms. They inhibit platelet aggregation by blocking the adenosine diphosphate (ADP) P2Y12 receptor on platelets. Reduced platelet clumping leads to less blood clotting, which can help in treating and preventing strokes.
Brilinta has a quicker onset and greater efficacy compared to Plavix. It can be more advantageous for those with hereditary resistance to P2Y12 inhibitors. Additionally, Brilinta is easier to discontinue before surgeries due to its shorter duration of action. On the flip side, Plavix may lose effectiveness when used alongside common proton pump inhibitors like Prilosec (omeprazole).
Despite the advantages of Brilinta, certain downsides may make Plavix a viable alternative. Plavix is often opted for because it is less likely to cause bruising. Studies indicate it is as effective as Brilinta in most scenarios, though it may be slightly less potent in older patients. The generic version of Plavix, clopidogrel, is much more affordable, unlike Brilinta.
Effient
Effient, closely related to Brilinta and commonly prescribed for acute myocardial infarctions (MI), is another potent ADP P2Y12 receptor inhibitor known for its rapid onset and high potency.
Effient has fewer FDA-approved indications than Brilinta but offers benefits that could make it a preferred option. Research shows Effient also reduces the incidence of dyspnea, a common side effect of Brilinta. However, like Brilinta, Effient carries a black box warning from the FDA due to the risk of bleeding.
Xarelto
Xarelto is another FDA-approved option that serves a preventative role. As a direct oral anticoagulant—or blood thinner—Xarelto prevents blood clots by inhibiting the Xa enzyme. It’s well-known for preventing strokes in patients with atrial fibrillation and treating blood clots.
Studies have shown that combining Xarelto with aspirin effectively helps prevent cardiovascular events, including strokes, in people with peripheral artery disease or coronary artery disease at a lower dose.
Note: When evaluating your choices, remember that taking two antiplatelet medications or combining an anticoagulant with an antiplatelet medication can increase the risk of bleeding.
Cilostazol
Cilostazol works by inhibiting phosphodiesterase 3 and reducing platelet aggregation, delivering an antiplatelet effect. The FDA has approved this drug for treating intermittent claudication, which refers to leg pain resulting from restricted blood flow due to blockages in peripheral arteries.
Additionally, Cilostazol is sometimes used off-label for the long-term prevention of a second stroke.