Used in patients who have had a stroke or stroke precursors who cannot take aspirin or for whom aspirin has been ineffective, in order to prevent another thrombotic stroke. Reduction of the risk of occurrence and recurrence of stroke in patients who have experienced at least one of the following events: established ischaemic stroke, minor stroke, reversible ischaemic neurological deficit, transie

Ticlopidine: Tabletki powlekane 250 mg

Haematological Careful monitoring of blood counts in the two aforementioned studies revealed an incidence of 2.4% of neutropenia (<1200 neutrophils/mm³), which included 0.8% of severe neutropenia (<450 neutrophils/mm³). In these clinical trials, as in most cases reported by pharmacovigilance studies, the majority of severe neutropenia or agranulocytosis (<300 neutrophils/mm³) developed during the

Ticlopidine

Q: Warnings?

Pregnancy Pregnancy: Except where formally indicated, Ticlopidine should not be prescribed during pregnancy. Breast-feeding Breast-feeding: Except where formally indicated, Ticlopidine should not be prescribed during breast-feeding. Renal impairment Renal impairment: Dose reduction may be necessary; discontinue therapy if haemorrhagic complications arise. Haematological monitoring Haematological

New Drugs Health Blog For Doctors

💊 All Drugs 🐾 Veterinary

This information is for educational purposes only. It is not intended as medical advice. Always consult a qualified healthcare professional.

Ticlopidine — Description, Dosage, Side Effects | PillsCard

Ticlopidine is a platelet aggregation inhibitor that exerts a dose-dependent effect on platelet aggregation, with release of platelet factors, as well as prolongation of bleeding time. The drug has no significant in vitro activity, only in vivo; however, there is no evidence suggesting the existence of an active circulating metabolite. Ticlopidine interferes with platelet aggregation through ADP-dependent inhibition of fibrinogen binding to the platelet membrane; it does not act by inhibiting cyclooxygenase, as acetylsalicylic acid does. Platelet cyclic AMP does not appear to play any role in its mechanism of action. Bleeding time, measured by the Ivy method with a tourniquet at a pressure of 40 mmHg, is prolonged to twice the baseline values. The prolongation of bleeding time without a tourniquet is less pronounced. After discontinuation of treatment, bleeding time as well as other platelet function tests return to normal values within one week in the majority of pa‍‍‍‍‍‍‍tients. The antiplatelet effect is observed within two days following administration of Ticlopidine 250 mg twice daily. The maximum antiplatelet effect is achieved 5 to 8 days after taking 250 mg twice daily. At the therapeutic dose, Ticlopidine inhibits ADP-induced platelet aggregation (2.5 μmol/L) by 50 to 70%. Lower doses are associated with lesser inhibition of platelet aggregation. The effect of Ticlopidine on the risk of cardiovascular events was evaluated in several double-blind clinical trials. In a comparative trial between Ticlopidine and acetylsalicylic acid (the Ticlopidine Aspirin Stroke Study or TASS), 3069 patients with a history of transient ischaemic cerebral attack or minor stroke were enrolled and followed for at least 2 to 5 years. Over the duration of the study, Ticlopidine significantly reduced the risk of stroke (fatal or non-fatal) by 27% (p=0.011) compared with acetylsalicylic acid. During the first year, when the risk of stroke is highest, the reduction in stroke risk (fatal and non-fatal) compared with acetylsalicylic acid was 48%. The reduction was similar in men and women. In a comparative trial between Ticlopidine and placebo (the Canadian American Ticlopidine Study or CATS), 1073 patients with a history of atherothrombotic stroke were treated for a period of 3 years. Ticlopidine significantly reduced the overall risk of stroke by 34% (p=0.017) compared with placebo. During the first year, the risk of stroke occurrence (fatal and non-fatal) compared with placebo was reduced by 33%. In a comparative study between Ticlopidine and placebo (the Swedish Ticlopidine Multicenter Study or STIMS), 687 patients with intermittent claudication were enrolled. The mean observation period from enrolment to final assessment was 5.6 years. Ticlopidine significantly reduced overall mortality by 29% (p=0.015). The incidence of cardiovascular and cerebrovascular events (fatal and non-fatal) was reduced by 41% (p=0.007).

⚠️ Warnings

Pregnancy Pregnancy: Except where formally indicated, Ticlopidine should not be prescribed during pregnancy. Breast-feeding Breast-feeding: Except where formally indicated, Ticlopidine should not be prescribed during breast-feeding. Renal impairment Renal impairment: Dose reduction may be necessary; discontinue therapy if haemorrhagic complications arise. Haematological monitoring Haematological parameters (including platelets) must be determined before starting treatment, every two weeks during the first three months of treatment with Ticlopidine, and during the 15 days following discontinuation if this occurs within the first three months. If neutropenia (<1500 neutrophils/mm³), thrombocytopenia (<100,000 platelets/mm³), or a decrease in haematocrit occurs, treatment should be discontinued.‍‍‍‍‍‍‍ A complete blood count should be performed, including platelets and blood film elements (schistocytes), and serum creatinine, with monitoring maintained until normal values are restored. Clinical monitoring All patients should be carefully monitored to detect any signs and symptoms related to adverse reactions, particularly during the first three months of treatment. Signs and symptoms that may be related to neutropenia (fever, tonsillitis, or oral ulceration), thrombocytopenia and/or haemostatic abnormalities (unusual or prolonged bleeding, bruising, purpura, and melaena), or jaundice (including dark urine and pale stools) should be explained to the patient. All patients should be advised to discontinue medication and consult their physician immediately if any of the above symptoms occur. The decision to resume treatment should be based on clinical and laboratory findings. The clinical diagnosis of Thrombotic Thrombocytopenic Purpura (TTP) is characterised by the presence of thrombocytopenia, haemolytic anaemia, neurological symptoms, renal dysfunction, and fever. Onset may be sudden. Most cases were reported in the first eight weeks after initiation of therapy. Due to the risk of a fatal outcome, if thrombotic thrombocytopenic purpura is suspected, a specialist medical team should be contacted. Plasma exchange treatment has been reported to improve prognosis. Haemostasis Ticlopidine should be used with caution in patients susceptible to haemorrhage. The drug should not be administered concomitantly with heparins, oral anticoagulants, or antiplatelet agents; however, in exceptional cases of concomitant administration, careful clinical and laboratory monitoring must be ensured. In patients undergoing elective surgery, treatment should, whenever possible, be discontinued at least 10 days before surgery. In an emergency surgical situation, in an attempt to minimise the haemorrhagic risk as well as the prolongation of bleeding time, three measures may be used, alone or in combination: − administration of 0.5 to 1 mg/kg of methylprednisolone I.V., which may be repeated. − desmopressin 0.2 to 0.4 μg/kg. − platelet transfusion. As Ticlopidine is extensively metabolised by the liver, the drug should be used with caution in patients with hepatic impairment, and treatment should be discontinued if hepatitis or jaundice develops. In cases of hepatitis or jaundice, investigation should be initiated to clarify the situation. In such cases, re-exposure to ticlopidine should be avoided.

Ticlopidine

User Reviews