Ticlopidine

Table of contents

  • Brand Names
  • Chemistry
  • Pharmacologic Category
  • Mechanism of Action
  • Therapeutic Use
  • Unlabeled Use
  • Pregnancy and Lactation Implications
  • Contraindications
  • Warnings and Precautions
  • Adverse Reactions
  • Caution and personalized dose adjustment in patients with the following genotypes
  • Other genes that may be involved
  • Substrate of
  • Inhibits
  • Drug Interactions
  • Nutrition/Nutraceutical Interactions
  • Dosage
  • Pharmacokinetics and Pharmacodynamics
  • Special Considerations

Brand Names

Europe

Austria: Thrombodine, Tiklid; Belgium: Ticlid, Ticlopidin, Ticlopidine; Bulgaria: Ticlopid; Cyprus: Ticlopid; Czech Republic: Apo-Tic, Ipaton, Tagren, Ticlid, Ticlopidin; France: Ticlid, Ticlopidine; Germany: Desitic Lopidin, Ticlopidin, Ticlopidina, Tiklid, Tiklyd; Greece: Anghostan, Etfariol, Iriflexin, Neo Fulvigal, Platigren, Ruxicolan, Ticlid, Ticlodone; Hungary: Aclotin, Aplatic, Ipaton, Placor, Ticlid, Ticlogal, Ticlopidin; Italy: Antigreg, Aplaket, Chiaro, Clox, Fluilast, Flupid, Fluxidin, Klodin, Opteron, Ticlodone, Ticlopidina, Tiklid; Lithuania: Tagren; Luxembourg: Ticlid; Malta: Antigreg, Ebrilon, Ticlid; Poland: Aclotin, Aplaket, Apo-Clodin, Iclopid, Ifapidin, Ticlid, Ticlo, Ticlopidine, Tiklopidyna; Portugal: Aplaket, Plaquetal, Previta, Ticlodix, Ticlopidina, Tiklyd, Tiropa; Romania: Ipaton, Ticlid, Ticlodin, Ticlopidin; Slovakia: Aclotin, Ipaton, Ticlid, Ticlopidin; Slovenia: Tagren; Spain: Ticlodone, Ticlopidina, Tiklid; Sweden: Ticlid.

North America

Canada: Ticlid, Ticlopidine; USA: Ticlopidine.

Latin America

Argentina: Dosier, Ticlid, Trombenal; Brazil: Plaketar, Ticlid, Ticlobal, Ticlopidina.

Asia

Japan: Beachilon, Dilpender, Hishimidon, Iparazin, Maitozin, Neopidine, Nichistate, Panaldine, Panapidin, Paraclodin, Patyuna, Pharlodine, Piclodin, Piclonadine, Pietenale, Propacall, Solozorin, Soper, Ticpilone.

Drug combinations

Chemistry

Ticlopidine Hydrochloride: C~14~H~14~ClNS HCl. Mw: 300.25. (1) Thieno[3,2-c]pyridine, 5-[(2-chlorophenyl)methyl]-4,5,6,7-tetrahydro-, hydrochloride; (2) 5-(o-Chlorobenzyl)-4,5,6,7-tetrahydrothieno-[3,2-c]pyridine hydrochloride. CAS-53885-35-1; CAS-55142-85-3 (ticlopidine)(1978).

Pharmacologic Category

Antithrombotic Agents; Platelet-aggregation Inhibitors. (ATC-Code: B01AC05).

Mechanism of action

Ticlopidine requires in vivo biotransformation to unidentified active metabolite. This active metabolite irreversibly blocks P2Y12 component of ADP receptors, which prevents activation of GPIIb/IIIa receptor complex, thereby reducing platelet aggregation. Platelets blocked by ticlopidine affected for remainder of their lifespan.

Therapeutic use

Reduces risk of thrombotic stroke in patients who have had a stroke or stroke precursors. Adjunctive therapy (with aspirin) following successful coronary stent implantation, to reduce incidence of subacute stent thrombosis.

Pregnancy and lactiation implications

Use with caution in pregnancy and lactation (excretion in breast milk unknown).

Unlabeled use

Protection of aortocoronary bypass grafts, diabetic microangiopathy, ischemic heart disease, prevention of postoperative DVT, reduction of graft loss following renal transplant.

Contraindications

Hypersensitivity to ticlopidine or any component of the formulation. Active pathological bleeding such as peptic ulcer disease or intracranial hemorrhage. Severe liver dysfunction. Hematopoietic disorders (neutropenia, thrombocytopenia, past history of thrombotic thrombocytopenia purpura (TTP) or aplastic anemia).

Warnings and precautions

May cause life-threatening hematologic reactions, including neutropenia, agranulocytosis, TTP, and aplastic anemia. Use with caution in platelet disorders, bleeding disorders and/or at increased risk for bleeding. Use with caution in mild-to-moderate hepatic impairment; use contraindicated with severe hepatic impairment. Use with caution in moderate-to-severe renal impairment (bleeding times may be significantly prolonged and risk of hematologic adverse events may be increased), and in patients receiving either anticoagulants or other platelet aggregation inhibitors (increased bleeding risk). In patients who have received bare-metal or drug-eluting stents (sirolimus or paclitaxel), premature interruption of antiplatelet therapy may result in stent thrombosis with subsequent fatal and nonfatal myocardial infarction. Consider discontinuing before elective surgery.

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