Ticlopidine

Indications
 Oral
Prophylaxis of thrombotic stroke
Adult: >18 yr: 250 mg bid.
Renal impairment: Dose reduction or discontinuance if haemorrhagic or haematopoietic complications occur.
Hepatic impairment: Severe: contraindicated.
Oral
Ischaemic heart disease
Adult: >18 yr: 250 mg bid.
Renal impairment: Dose reduction or discontinuance if haemorrhagic or haematopoietic complications occur.
Hepatic impairment: Severe: contraindicated.
Oral
Intermittent claudication
Adult: >18 yr: 250 mg bid.
Renal impairment: Dose reduction or discontinuance if haemorrhagic or haematopoietic complications occur.
Hepatic impairment: Severe: contraindicated.
Oral
Prophylaxis of subacute stent occlusion after intracoronary stenting
Adult: >18 yr: 250 mg bid for 4 wk, in conjunction with aspirin, starting at the time of stent placement.
Renal impairment: Dose reduction or discontinuance if haemorrhagic or haematopoietic complications occur.
Hepatic impairment: Severe: contraindicated.
Contraindications
 Pre-existing or history of blood dyscrasias; haemostatic disorder or active pathological bleeding (eg. bleeding peptic ulcer, intracranial bleeding); severe hepatic dysfunction. Hypersensitivity. Lactation.
Warnings / Precautions
 Patients with increased risk of bleeding from trauma, surgery or pathological disorder. Moderate to severe renal impairment. May need to stop therapy 10-14 days before elective surgery. Full blood counts should be performed prior to therapy and every 2 wk during the first 3 mth of treatment. Pregnancy.
Adverse Reactions
 Diarrhoea, nausea, dyspepsia, bleeding, pupura, skin rash, increase in serum cholesterol concentration, elevation of LFTs, hepatitis, cholestatic jaundice.
Potentially Fatal: Neutropenia, agranulocytosis, thrombotic thrombocytopenic purpura and aplastic anaemia.
Overdose Reactions
 GI haemorrhage, convulsions, hypothermia, dyspnoea, loss of equilibrium and abnormal gait.
Drug Interactions
 Reduced clearance with cimetidine; corticosteroid may antagonise effects on bleeding time. Avoid concurrent use with clopidogrel.
Potentially Fatal: Risk of haemorrhage increased with NSAIDs and oral anticoagulants; decreased metabolism of theophylline, phenytoin and bupropion.
See Below for More ticlopidine Drug Interactions
Food Interactions
 Increased risk of bleeding with Ginkgo biloba and Kangen-karyu.
Mechanism of Actions
 Ticlopidine inhibits adenosine diphosphate-mediated platelet aggregation.
Absorption: Rapidly and almost completely absorbed from the GI tract (oral). Oral bioavailability increased by 20% when taken after meals.
Distribution: Protein-binding: Extensive.
Metabolism: Hepatic: Extensive.
Excretion: As metabolites; via urine (60%), via faeces (25%). Terminal half-life: 30-50 hr.
Administration
 Should be taken with food.
ATC Classification
 B01AC05 - ticlopidine ; Belongs to the class of platelet aggregation inhibitors excluding heparin. Used in the treatment of thrombosis.
Available As
  • Ticlopidine 250 mg

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