Generic Name: Ticlid
What is Ticlid?
Incidence of side-effects of ticlopidine after sirolimus-eluting stent implantation. Agranulocytosis and hepatic toxicity with ticlopidine therapy: a case report. Anselmino M, Moretti C, Ravera L, Sheiban I. Clopidogrel treatment in a patient with ticlopidine-induced hepatitis following percutaneous coronary stenting. Background Ticlopidine tye kloe' pi deen is an inhibitor of adenosine diphosphate ADP -induced platelet aggregation and is used to decrease the risk of recurrence of stroke in patients who have documented previous cerebrovascular thrombosis, and as adjunctive therapy with aspirin to reduce the risk of coronary stent thrombosis.
Mechanism of Injury The mechanism of ticlopidine hepatotoxicity is not known, but is clearly idiosyncratic and may be due to the complex hepatic metabolism of the chlorophenyl-methyl-pyridine molecule.
Outcome and Management The severity of liver injury with ticlopidine ranges from minor serum enzyme elevations to clinically apparent cholestatic hepatitis.
Aspirin and clopidogrel compared with clopidogrel alone after recent ischaemic stroke or transient ischaemic attack in high-risk patients MATCH : randomised, double-blind, placebo-controlled trial. Diener HC, Cunha L, Forbes C et al. European Stroke Prevention Study 2.
Thrombocytopenia severe lowering of the platelets that help to clot the blood is a rare but serious side effect caused by ticlopidine. Thrombocytopenia occurs during the first 3 to 12 weeks of therapy, and recovery usually occurs after the medication is stopped. Thrombotic thrombocytopenic purpura is a rare condition that may occur while taking ticlopidine and requires immediate medical attention. Signs include thrombocytopenia unusual bruising or bleeding, gums that bleed more easilyconfusion, becoming easily tired, a rapid heartbeat, purplish spots in the skin, and fever.
All people taking ticlopidine need to have lab tests done every 2 weeks, beginning prior to the time you start the medication, until the end of the third month of treatment. This is to make sure no blood cell problems such as those described above occur. Your doctor will monitor your lab results regularly, so it is important to get your blood tests done as recommended by your doctor. Blood clotting: If you take ticlopidine, you may bleed for a longer period of time, or your blood may require more time to clot.
Report any signs of unexpected or excessive bleeding e. Kidney function: If you have severely reduced kidney function, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Liver function: People with severely reduced liver function should not take this medication.
If you have reduced liver function, you should discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Surgery: It may be necessary to stop this medication temporarily if you are scheduled for surgery or are having teeth removed to ensure that you do not lose too much blood.
It is important to inform all doctors involved in your care, that you are taking this medication. Pregnancy: The medication should not be used during pregnancy.
How should I take Ticlid?
Sorafenib: Due to the thrombocytopenic effects of sorafenib, an additive risk of bleeding may be seen in patients receiving concomitant platelet inhibitors.
Sulfinpyrazone: Sulfinpyrazone, when used as a uricosuric agent should be avoided when possible with concurrent platelet inhibitors due to potential for additive antiplatelet effects and increased bleeding risk.
Tamoxifen: Ticlopidine is a CYP2C19 inhibitor. Tamoxifen is metabolized by CYP3A4, CYP2D6, and to a smaller extent by CYP2C19, to other potent, active metabolites including endoxifen, which have up to 33 times more affinity for the estrogen receptor than tamoxifen.
These metabolites are then inactivated by sulfotransferase 1A1 SULT1A1. Taxanes: An additive risk of bleeding may occur when platelet inhibitors are used with agents that cause clinically significant thrombocytopenia including antineoplastic agents, such as docetaxel and paclitaxel. Terbinafine: Due to the risk for terbinafine related adverse effects, caution is advised when coadministering ticlopidine.
Although this interaction has not been studied by the manufacturer, and published literature suggests the potential for interactions to be low, taking these drugs together may increase the systemic exposure of terbinafine.
What should I avoid while taking Ticlid?
Phenobarbital: In 6 normal volunteers, the inhibitory effects of TICLID on platelet aggregation were not altered by chronic administration of phenobarbital. Several cases of elevated phenytoin plasma levels with associated somnolence and lethargy have been reported following coadministration with TICLID. Caution should be exercised in coadministering this drug with TICLID, and it may be useful to remeasure phenytoin blood concentrations.
Caution should be exercised in coadministering this drug with TICLID.
Ticlid side effects
Thrombotic thrombocytopenic purpura can occur in some patients taking Ticlid and can be sometimes associated with serious consequences. It is characterized by a large fall in platelet count, anemia, central nervous system neurologic changes, kidney dysfunction and fever. Increased bleeding tendency manifested by prolonged bleeding from traumatic or surgical wounds, bruising, bleeding into the gastrointestinal tract manifested by black stooletc. More common side effects are upset stomach to minimize this possibility, always take Ticlid with mealsdiarrhea, and skin rashes.
Storage Keep out of the reach of children. Do not use this medicine after the expiry date on the package. Platelet aggregation inhibitor that interferes with platelet membrane functioning and therefore platelet interactions.
Common Ticlid ide effects may include:
Continue to take ticlopidine even if you feel well.
Ticlopidine trade name Ticlid is an antiplatelet drug in the thienopyridine family which is an adenosine diphosphate ADP receptor inhibitor.
In, Brunton LL, Chabner BA, Knollman BC, eds.
It is essential that you keep your appointments for the blood tests and that you call your doctor immediately if you have any indication that you may have TTP or neutropenia.
C:Use with caution if benefits outweigh risks. View explanations for tiers and restrictions Tier Description 1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs. Most commonly, these are "preferred" on formulary brand drugs.
Where can I get more information?
Tamoxifen is metabolized by CYP3A4, CYP2D6, and to a smaller extent by CYP2C19, to other potent, active metabolites including endoxifen, which have up to 33 times more affinity for the estrogen receptor than tamoxifen.
Is it possible to reduce the risk of cardiovascular events in subjects suffering from intermittent claudication of the lower limbs.