ticlopidine

Ticlopidine is an oral drug that inhibits the ability of platelets to clump and form blood clots. It prevents blood clots by binding to the P2Y12 receptor on platelets, preventing adenosine diphosphate (ADP) from activating platelets. It belongs to a class of drugs called P2Y12 inhibitors. Other drugs in this class include clopidogrel (Plavix), ticagrelor (Brilinta) and prasugrel (Effient). Clopidogrel is similar to ticlopidine (Ticlid) in chemical structure and in the way it works. Blood clots that form within the arteries of the brain or pieces of blood clots that break off from clots in other parts of the body and lodge in blood vessels in the brain cause strokes. Similarly, heart attacks occur when blood clots block an artery in the heart. In both cases the blood supply to part of the brain or heart is blocked, and that part of the brain or heart is damaged or dies. Ticlopidine works by making the blood less likely to clot, therefore, reducing the likelihood of a stroke or heart attack. The FDA approved ticlopidine in October 1991.

What brand names are available for ticlopidine?

Ticlid (Discontinued brand in the US)

Is ticlopidine available as a generic drug?

GENERIC AVAILABLE: Yes

Do I need a prescription for ticlopidine?

Yes

Ticlopidine is used for preventing strokes or transient ischemic attacks (TIAs, mini-strokes), and for preventing blood clots in stents placed in the heart. Off-label uses include prevention of heart attacks in individuals with unstable angina or who have experienced previous heart attacks, in combination with aspirin for preventing blood clots in stents, and for intermittent claudication.

Common side effects of ticlopidine include:

• diarrhea,
• nausea,
• rash,
• stomach upset, and
• vomiting.

Ticlopidine has been associated with a severe reduction in white blood cell count. Ticlopidine also causes a condition called thrombotic thrombocytopenic purpura (TTP). TTP is a serious condition in which blood clots form throughout the body. Blood platelets, which participate in clotting, are consumed, and the result can be bleeding because enough platelets are no longer left to allow blood to clot normally.

The recommended dose is 250 mg twice daily with food for stroke prevention. For preventing blood clots in stents, a single 500 mg loading dose is administered several hours before stent placement, and then 250 mg is administered twice daily for 10-14 days after successful stent placement.

Combining ticlopidine with other drugs that promote bleeding increases the risk of bleeding. Examples include aspirin, warfarin (Coumadin), and heparin. Ticlopidine may increase duloxetine (Cymbalta) levels by reducing the break down of duloxetine in the liver and thereby lead to side effects from duloxetine. The combination may also increase the risk of bleeding because duloxetine can interfere with platelet function. Ticlopidine may increase pimozide (Orap) levels by reducing the break-down of pimozide in the liver. Increased pimozide levels may cause abnormal heart rhythms.

Ticlopidine has not been adequately studied in pregnant women.

It is not known if ticlopidine is secreted in human breast milk.

What preparations of ticlopidine are available?

Tablets: 250 mg

How should I keep ticlopidine stored?

Ticlopidine should be stored at room temperature, 15 to 30 C (59 to 86 F).