Ticlopidine Hydrochloride

Indications

Ticlopidine Hydrochloride is used for: Hereditary hemorrhagic telangiectasia, Intermittent claudication, Ischaemic heart disease

Adult Dose

Oral Prophylaxis of thrombotic stroke; Ischaemic heart disease; Intermittent claudication Adult: >18 yr: 250 mg bid. 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. Hepatic impairment: Severe: contraindicated.

Child Dose

<18 years old: safety & efficacy not established

Renal Dose

Renal impairment: Dose reduction or discontinuance if haemorrhagic or haematopoietic complications occur.

Administration

Should be taken with food.

Contra Indications

Pre-existing or history of blood dyscrasias; haemostatic disorder or active pathological bleeding (eg. bleeding peptic ulcer, intracranial bleeding); severe hepatic dysfunction. Hypersensitivity. Lactation.

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. Lactation: not known whether excreted in breast milk, discontinue drug or do not nurse

Pregnancy-Lactation

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.

Adverse Effects

Side effects of Ticlopidine Hydrochloride : >10% Diarrhea (12.5%) 1-10% Elevated alkaline phosphatase (7.6%),Nausea (7%),Dyspepsia (7%),Rash (5%),GI pain (3.7%),Elevated AST/SGOT (3.1%),Neutropenia (2.4%),Purpura (2.2%),Vomiting (1.9%),Flatulence (1.5%),Pruritus (1.3%),Dizziness (1%),Abnormal LFTs (1%),Anorexia (1%) <1% Agranulocytosis,Aplastic anemia,Pancytopenia,TTP Potentially Fatal: Neutropenia, agranulocytosis, thrombotic thrombocytopenic purpura and aplastic anaemia.

Mechanism of Action

Ticlopidine inhibits adenosine diphosphate-mediated platelet aggregation.