The use of ticagrelor in patients at known increased risk for bleeding should be balanced against the benefit in terms of prevention of atherothrombotic events. If clinically indicated, should be used with caution in patients with propensity to bleeding (e.g. due to recent trauma, recent surgery, coagulation disorders, active or recent gastrointestinal bleeding). Contraindicated in active pathological bleeding, history of intracranial hemorrhage, and in moderate-to-severe hepatic impairment. Caution in patients with concomitant administration of medicinal products that may increase the risk of bleeding (e.g. non-steroidal anti-inflammatory drugs [NSAIDs], oral anticoagulants and/or fibrinolytics) within 24 hours of ticagrelor dosing. Patients should be advised to inform physicians and dentists that they are taking ticagrelor before any surgery is scheduled and before any new medicinal product is taken. Caution should be exercised in patients with an increased risk of bradycardic events or when it is administered concomitantly with medicinal products known to induce bradycardia. Dyspnea has been reported (should be used with caution in patients with history of asthma and/or COPD; if a patient reports new, prolonged or worsened dyspnea, it may be necessary to stop treatment). Creatinine levels may increase during treatment (renal function should be checked after one month and it is recommended to pay special attention to patients ≥75 years, patients with moderate/severe renal impairment and those receiving concomitant treatment with an angiotensin receptor blocker). Patients on ticagrelor had a higher risk of hyperuricemia than those patients receiving clopidogrel (caution should be exercised when administering ticagrelor to patients with history of hyperuricemia or gouty arthritis; use of ticagrelor in patients with uric acid nephropathy is discouraged).