Article: Ticlopidine

Ticlopidine (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 250mg twice daily by the oral route.

Pregnancy Category: C

Action

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

Pharmacokinetic

Contraindications

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

Precautions

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

Adverse Reactions and Side Effects

• Central Nervous System: anxiety, drowsiness, fatigue, insomnia, nervousness, syncope, vertigo, weakness.
• Ear, Eye, Nose, Throat: cataracts, conjunctivits, glaucoma, pharyngitis, rhinitis, sinusitis.
• Respiratory: bronchitis.
• Cardiovascular: chest pain, dependent edema, hypertension, peripheral edema.
• Gastrointestinal: adbominal pain, anorexia, constipation, diarrhea, dry mouth, dysphagia, esophageal ulcer, esophagitis, flatulence, gastric ulcer, gastritis, nausea, tooth disorder, vomiting.
• Genitourinary: urinary tract infection.
• Dermatologic: flushing, sweating, pruritus, rash, skin disorder.
• Endocrine: hyperparathyroidism.
• Fluid and Electrolyte: hypocalcemia.
• Musculoskeletal: arthrosis, muscle contractions, pathological fractures.
• Neurological: paresthesia.
• Miscellaneous: infection.

Route and Dosage

• Adults: 400 mg/day taken with 8oz of plain water only, for 3 months.