Ticlopidine

trade name: Ticlid; drug class: platelet aggregation inhibitor; action: inhibits first and second phases of adenosine diphosphate (ADP)-induced effects in platelet aggregation; use: effective in reducing the risk of stroke in high-risk patients.

Brand names: Ticlid®

Chemical formula:

Drug Forms:
• Ticlopidine Hydrochloride Oral tablet (below)
• Ticlopidine tablets

Español:
• Clorhidrato de ticlopidina, Tableta oral
• Tabletas de ticlopidina

Ticlopidine Hydrochloride Oral tablet

What is this medicine?

TICLOPIDINE helps to prevent blood clots. This medicine is used to prevent strokes in patients who have already had a stroke, or those who are at high risk of having a stroke. This medicine may also be used in combination with aspirin to prevent blood clots in patients who have had a coronary stent placed.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of the following conditions:
•anemia
•high cholesterol
•history of bleeding disorder
•kidney disease
•liver disease
•stomach ulcer
•an unusual or allergic reaction to ticlopidine, other medicines, foods, dyes, or preservatives
•pregnant or trying to get pregnant
•breast-feeding

How should I use this medicine?

Take this medicine by mouth with a glass of water. Follow the directions on the prescription label. Take with food or just after eating to reduce stomach upset. Take your doses at regular intervals. Do not take your medicine more often than directed.

Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.
NOTE: This medicine is only for you. Do not share this medicine with others.

What may interact with this medicine?

•agents that dissolve blood clots
•antacids
•antipyrine
•aspirin and aspirin-like drugs
•blood thinners such as warfarin
•cimetidine
•NSAIDs, medicines for pain and inflammation, like ibuprofen or naproxen
•phenytoin
•propranolol
•theophylline

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medicine?

Visit your doctor or health care professional for regular checks on your progress. Side effects to this medicine occur most frequently during the first 3 months of therapy. To make sure you do not develop any problems, you will need to have blood tests before you start this medicine and then every 2 weeks for the first 3 months.

This medicine can cause serious blood problems. This can mean risk of infection or bleeding. Avoid activities that increase your risk of bleeding. Tell your doctor or health care professional at once if have any unusual bleeding or bruise easily or an infection that will not get better.

If you are going to have surgery or dental work, tell your doctor or health care professional that you are taking this medicine.

What side effects may I notice from receiving this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:
•allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
•black, tarry stools
•blood in urine
•blood in vomit
•difficulty breathing or wheezing
•fever
•joint pain or swelling
•nosebleed
•pain or difficulty passing urine
•paleness
•ringing in the ears
•stomach pain
•sudden weakness
•unusual bleeding or bruising
•yellowing of skin or eyes

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):
•decreased appetite
•diarrhea
•headache
•nausea, vomiting

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medicine?

Keep out of the reach of children.

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Throw away any unused medicine after the expiration date.

Last updated: 7/1/2002

Important Disclaimer: The drug information provided here is for educational purposes only. It is intended to supplement, not substitute for, the diagnosis, treatment and advice of a medical professional. This drug information does not cover all possible uses, precautions, side effects and interactions. It should not be construed to indicate that this or any drug is safe for you. Consult your medical professional for guidance before using any prescription or over the counter drugs.

An antiplatelet drug used in thrombotic diseases such as heartworm disease in dogs.

Ticlopidine
Systematic (IUPAC) name
5-(2-chlorobenzyl)-4,5,6,7-tetrahydrothieno[3,2-c]pyridine
Identifiers
CAS number	55142-85-3
ATC code	B01AC05
PubChem	5472
DrugBank	APRD01257
Chemical data
Formula	C14H14ClNS
Mol. mass	263.786 g/mol
Pharmacokinetic data
Bioavailability	>80%
Protein binding	98%
Metabolism	Hepatic
Half life	12 hours (single dose) 4 to 5 days (after repeated dosing)
Excretion	Renal and fecal
Therapeutic considerations
Pregnancy cat.	B1(AU) C(US)
Legal status
Routes	Oral

Ticlopidine (trade name Ticlid) is an antiplatelet drug in the thienopyridine family. Like clopidogrel, it is an adenosine diphosphate (ADP) receptor inhibitor. It is used in patients in whom aspirin is not tolerated, or in whom dual antiplatelet therapy is desirable. Because it has been reported to increase the risk of thrombotic thrombocytopenic purpura (TTP) and neutropenia, its use has largely been supplanted by the newer drug, clopidogrel, which is felt to have a much lower hematologic risk. The usual dose is 250 mg twice daily by the oral route.

Action

• Inihibits platelet aggregation by altering the function of platelet membranes.
• Prolongs bleeding time.
• Decreased incidence of stroke in high-risk patients.

Contraindications

• Hypersensitivity
• Bleeding disorders
• Active bleeding
• Severe liver disease

Precautions

• Risk of bleeding (trauma, surgery, history of peptic ulcer disease)
• Renal or hepatic impairment
• Geriatric patients (increased sensitivity)
• Pregnancy, lactation, or children under 18
• Neutropenia
• Thrombotic thrombocytopenic purpura

v • d • e Antithrombotics (thrombolytics, anticoagulants and antiplatelet drugs) (B01) Antiplatelet drugs Glycoprotein IIb/IIIa inhibitors Abciximab • Eptifibatide • Tirofiban ADP receptor/P2Y12 inhibitors (Thienopyridines) Clopidogrel • Ticlopidine • Prasugrel Prostaglandin analogue (PGI2) Beraprost • Prostacyclin • Iloprost • Treprostinil COX inhibitors Acetylsalicylic acid/Aspirin # • Aloxiprin • Carbasalate calcium Other Ditazole • Cloricromen • Dipyridamole • Indobufen • Picotamide • Triflusal Anticoagulants Vitamin K antagonists (inhibit II, VII, IX, X) coumarins: Acenocoumarol • Coumatetralyl • Dicoumarol (Dicumarol) • Ethyl biscoumacetate • Phenprocoumon • Warfarin 1,3-Indandiones: Clorindione • Diphenadione • Phenindione other: Tioclomarol Factor Xa inhibitors (with some II inhibition) Heparin group/ glycosaminoglycans/ (bind antithrombin) low molecular weight heparin (Bemiparin, Certoparin, Dalteparin, Enoxaparin, Nadroparin, Parnaparin, Reviparin, Tinzaparin) oligosaccharides (Fondaparinux, Idraparinux) heparinoid (Danaparoid, Sulodexide, Dermatan sulfate) Direct Xa inhibitors xabans (Apixaban, Otamixaban, Rivaroxaban) Direct thrombin (II) inhibitors bivalent: Hirudin (Bivalirudin, Lepirudin, Desirudin) univalent: Argatroban • Dabigatran • Melagatran • Ximelagatran Other Defibrotide • Ramatroban • Antithrombin III • Protein C (Drotrecogin alfa) Thrombolytic drugs/ fibrinolytics plasminogen activators: TPA (Alteplase, Reteplase, Tenecteplase) • UPA (Urokinase, Saruplase) • Streptokinase # • Anistreplase • Monteplase other serine endopeptidases: Ancrod • Fibrinolysin Brinase Non-medicinal Citrate • EDTA • Oxalate #WHO-EM. †Undergoing clinical trials, not FDA approved. ‡Withdrawn from market. §Development halted.

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