The usage and dosage of Brilinta should be adjusted according to the indications, and special populations should pay attention to liver and kidney function and bleeding risks when using it. The following provides a detailed explanation from two aspects: conventional dosage regimen and adjustment for special populations.

1. Conventional usage and dosage

(1) The initial loading dose for acute coronary syndrome is 180mg orally, and the maintenance dose is 90mg twice daily, in combination with aspirin. The treatment course is usually 12 months, and non revascularization patients may consider extending it.

(2) After percutaneous coronary intervention (PCI), a loading dose of 180mg was immediately administered, followed by 90mg twice daily for maintenance. If missed, the regular dose should be taken at the next scheduled time, and double supplementation is prohibited.

2. Medication for special populations

(3) Mild liver dysfunction with liver dysfunction does not require dose adjustment; Patients with moderate to severe liver dysfunction are contraindicated as it may increase the risk of bleeding.

(4) Mild to moderate renal dysfunction does not require adjustment; Patients with severe renal insufficiency should use it with caution and closely monitor their bleeding tendency.

(5) Elderly patients aged 75 years or older do not need to adjust their dosage, but the risk of bleeding increases with age and requires strengthened monitoring.

(6) During pregnancy and lactation, use only when the potential benefits outweigh the risks; Breastfeeding should be suspended during the lactation period as medication may be secreted into the breast milk.

(7) The safety and efficacy of pediatric patients under 18 years old have not been established and are not recommended for use.

3 Medication precautions

(8) The principle of dose adjustment is to avoid interrupting medication during treatment, as premature discontinuation can increase the risk of cardiovascular events. If medication needs to be discontinued, it is recommended to gradually reduce the dosage.

(9) If there is difficulty breathing (unrelated to dosage) or bleeding events in adverse reaction management, timely evaluation should be conducted to determine whether to continue treatment. Severe bleeding requires immediate discontinuation of medication.