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November 22, 2009
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Medications and Drugs

Pharmacy Author: Omudhome Ogbru, PharmD
Medical and Pharmacy Editor: Jay W. Marks, MD

GENERIC NAME: ticlopidine

BRAND NAME: Ticlid

DRUG CLASS AND MECHANISM: Ticlopidine is an oral drug that inhibits the ability of platelets to clump and form blood clots in a manner similar to clopidogrel (Plavix). It is used to prevent blood clots from forming. Blood clots that form within the arteries of the brain or 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.

PRESCRIPTION: Yes

GENERIC AVAILABLE: Yes

PREPARATIONS: Tablets: 250 mg

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

PRESCRIBED FOR: Ticlopidine is used for preventing strokes in patients who have a history of stroke or transient ischemic attacks (TIAs or "mini-stroke"). It also is used for preventing blood clots in stents placed in the arteries of the heart.

Non-FDA approved (off-label) uses include prevention of heart attacks in patients with unstable angina (often associated with heart attacks) or who have experienced prior heart attacks; combination with aspirin for preventing blood clots in stents; and intermittent claudication (due to blockage by clots of blood flowing to the legs). Ticlopidine is most often used when aspirin has failed, is not tolerated, or cannot be used for other reasons. It is rarely used otherwise because of a serious side effect that can reduce white blood cells and platelets.

DOSING: The recommended dose is 250 mg twice daily. A single 500 mg dose is administered several hours before stent placement.

DRUG INTERACTIONS: 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 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.

PREGNANCY: Ticlopidine has not been adequately studied in pregnant women.

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

SIDE EFFECTS: 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.

Reference: FDA Prescribing Information


Last Editorial Review: 9/10/2009




Report Problems to the Food and Drug Administration

 

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.


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What is a heart attack?

A heart attack (also known as a myocardial infarction) is the death of heart muscle from the sudden blockage of a coronary artery by a blood clot. Coronary arteries are blood vessels that supply the heart muscle with blood and oxygen. Blockage of a coronary artery deprives the heart muscle of blood and oxygen,causing injury to the heart muscle. Injury to the heart muscle causes chest pain and chest pressure sensation. If blood flow is not restored to the heart muscle within 20 to 40 minutes, irreversible death of the heart muscle will begin to occur. Muscle continues to die for six to eight hours at which time the heart attack usually is "complete." The dead heart muscle is eventually replaced by scar tissue.

Approximately one million Americans suffer a heart attack each year. Four hundred thousand of them die as a result of their heart attack.

What causes a heart att...

Read the Heart Attack article »










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