Pronunciation:

tye-KLOE-pi-deen

Brand Names:

• Ticlid

Dosage Forms:

• Tablet

Warnings:

Ticlopidine can cause life-threatening hematological adverse reactions, including neutropenia/agranulocytosis, thrombotic thrombocytopenic purpura (TTP) and aplastic anemia. Hematological adverse reactions cannot be reliably predicted by any identified demographic or clinical characteristics. During the first 3 months of treatment, patients receiving ticlopidine must, therefore, be hematologically and clinically monitored for evidence of neutropenia or TTP. If any such evidence is seen, ticlopidine should be immediately discontinued .

Classifications:

Therapeutic—

Platelet Aggregation Inhibitor

Pharmacologic—

ADP-Induced Aggregation Inhibitor

Uses of This Medicine:

Ticlopidine is used to lessen the chance of having a stroke. It is given to people who have already had a stroke and to people with certain medical problems that may lead to a stroke. Because ticlopidine can cause serious side effects, especially during the first 3 months of treatment, it is used mostly for people who cannot take aspirin to prevent strokes.

A stroke may occur when blood flow to the brain is interrupted by a blood clot. Ticlopidine reduces the chance that a harmful blood clot will form, by preventing certain cells in the blood from clumping together. This effect of ticlopidine may also increase the chance of serious bleeding in some people.

This medicine is available only with a doctor's prescription.

Before Using This Medicine:

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies—

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children—

There is no specific information comparing use of ticlopidine in children with use in other age groups.

Older adults—

This medicine has been tested and has not been shown to cause different side effects or problems in older people than it does in younger adults.

Breast-feeding—

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Other medicines—

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

• Abrocitinib
• Defibrotide
• Mavacamten

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Abciximab
• Aceclofenac
• Acemetacin
• Alipogene Tiparvovec
• Alteplase, Recombinant
• Amtolmetin Guacil
• Anagrelide
• Apixaban
• Ardeparin
• Argatroban
• Aspirin
• Belzutifan
• Bemiparin
• Betrixaban
• Bivalirudin
• Bromfenac
• Bufexamac
• Bupropion
• Caplacizumab-yhdp
• Carbamazepine
• Celecoxib
• Certoparin
• Choline Salicylate
• Cilostazol
• Citalopram
• Clonixin
• Clopidogrel
• Curcumin
• Cyclosporine
• Dabigatran Etexilate
• Dalteparin
• Danaparoid
• Desirudin
• Desvenlafaxine
• Dexibuprofen
• Dexketoprofen
• Diclofenac
• Diflunisal
• Dipyridamole
• Dipyrone
• Droxicam
• Duloxetine
• Edoxaban
• Enoxaparin
• Eptifibatide
• Escitalopram
• Etodolac
• Etofenamate
• Etoricoxib
• Felbinac
• Fenoprofen
• Fepradinol
• Feprazone
• Floctafenine
• Flufenamic Acid
• Fluoxetine
• Flurbiprofen
• Fluvoxamine
• Fondaparinux
• Heparin
• Ibrutinib
• Ibuprofen
• Indomethacin
• Inotersen
• Ketoprofen
• Ketorolac
• Lepirudin
• Levomilnacipran
• Lornoxicam
• Loxoprofen
• Lumiracoxib
• Meclofenamate
• Mefenamic Acid
• Meloxicam
• Melphalan
• Milnacipran
• Morniflumate
• Nabumetone
• Nadroparin
• Naproxen
• Nefazodone
• Nepafenac
• Niflumic Acid
• Nimesulide
• Nimesulide Beta Cyclodextrin
• Oxaprozin
• Oxyphenbutazone
• Parecoxib
• Parnaparin
• Paroxetine
• Phenindione
• Phenobarbital
• Phenprocoumon
• Phenylbutazone
• Piketoprofen
• Piracetam
• Piroxicam
• Primidone
• Proglumetacin
• Propyphenazone
• Proquazone
• Protein C
• Reviparin
• Rivaroxaban
• Rofecoxib
• Salicylic Acid
• Salsalate
• Selumetinib
• Sertraline
• Sodium Salicylate
• Sulindac
• Tenecteplase
• Tenoxicam
• Tiaprofenic Acid
• Ticagrelor
• Tinzaparin
• Tizanidine
• Tolfenamic Acid
• Tolmetin
• Trazodone
• Turmeric
• Valdecoxib
• Venlafaxine
• Vilazodone
• Vortioxetine
• Warfarin

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Aluminum Carbonate, Basic
• Aluminum Hydroxide
• Aluminum Phosphate
• Calcium
• Dihydroxyaluminum Aminoacetate
• Dihydroxyaluminum Sodium Carbonate
• Fosphenytoin
• Magaldrate
• Magnesium Carbonate
• Magnesium Hydroxide
• Magnesium Oxide
• Magnesium Trisilicate
• Phenytoin
• Theophylline

Other interactions—

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Other medical problems—

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

• Blood clotting problems, such as hemophilia and von Willebrand's disease, or
• Liver disease (severe) or
• Stomach ulcers—The chance of serious bleeding may be increased

• Blood disease—The chance of serious side effects may be increased

• Kidney disease (severe)—Ticlopidine is removed from the body more slowly when the kidneys are not working properly. This may increase the chance of side effects

Also, tell your doctor if you have ever had a problem called thrombotic thrombocytopenic purpura (TTP). This problem could reoccur if you take ticlopidine.

Proper Use of This Medicine:

Ticlopidine should be taken with food. This increases the amount of medicine that is absorbed into the body. It may also lessen the chance of stomach upset.

Take this medicine only as directed by your doctor. Ticlopidine will not work properly if you take less of it than directed. Taking more ticlopidine than directed may increase the chance of serious side effects without increasing the helpful effects.

Dosing—

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For oral dosage form (tablets):
  • For prevention of strokes:
    • Adults—1 tablet (250 mg) two times a day, with food.
    • Children—It is not likely that ticlopidine would be used to help prevent strokes in children. If a child needs this medicine, however, the dose would have to be determined by the doctor.
  • For prevention of strokes or heart attack following heart stent procedure:
    • Adults—1 tablet (250 mg) two times a day, with food together with your doctor's recommended dose of aspirin for up to 30 days following the procedure
    • Children—It is not likely that ticlopidine would be used to help prevent strokes or heart attack in children. If a child needs this medicine, however, the dose would have to be determined by the doctor

Missed dose—

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage—

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Precautions While Using This Medicine:

It is very important that blood tests be done before treatment is started with ticlopidine, and repeated every 2 weeks for the first 3 months of treatment with ticlopidine. The tests are needed to find out whether certain side effects are occurring. Finding these side effects early helps to prevent them from becoming serious. Your doctor will arrange for the blood tests to be done. Be sure that you do not miss any appointments for these tests. You will probably not need to have your blood tested so often after the first 3 months of treatment, because the side effects are less likely to occur after that time.

Tell all medical doctors, dentists, nurses, and pharmacists you go to that you are taking this medicine. Ticlopidine may increase the risk of serious bleeding during an operation or some kinds of dental work. Therefore, treatment may have to be stopped about 10 days to 2 weeks before the operation or dental work is done.

Ticlopidine may cause serious bleeding, especially after an injury. Sometimes, bleeding inside the body can occur without your knowing about it. Ask your doctor whether there are certain activities you should avoid while taking this medicine (for example, sports that can cause injuries). Also, check with your doctor immediately if you are injured while being treated with this medicine.

Check with your doctor immediately if you notice any of the following side effects:

• Bruising or bleeding, especially bleeding that is hard to stop. Bleeding inside the body sometimes appears as bloody or black, tarry stools, or faintness. Also, bleeding may occur from the gums when brushing or flossing teeth.
• Any sign of infection, such as fever, chills, or sore throat.
• Sores, ulcers, or white spots in the mouth.
• Dark or bloody urine, difficulty in speaking, fever, pale color of skin, pinpoint red spots on skin, convulsions (seizures), weakness, or yellow eyes or skin.

After you stop taking ticlopidine, the chance of bleeding may continue for 1 or 2 weeks. During this period of time, continue to follow the same precautions that you followed while you were taking the medicine.

Side Effects of This Medicine:

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Less common or rare

Abdominal or stomach pain (severe) or swelling

back pain

blistering, peeling, or loosening of the skin or lips or mucous membranes (moist lining of many body cavities, including the mouth, lips, inside of nose, anus, and vagina)

blood in eyes

bloody or black tarry stools

bruising or purple areas on skin

change in mental status

convulsions (seizures)

coughing up blood

dark or bloody urine

decreased alertness

dizziness

fever, chills, or sore throat

headache (severe or continuing)

joint pain or swelling

nosebleeds

pale color of skin

paralysis or problems with coordination

pinpoint red spots on skin

red lesions on the skin, often with a purple center

red, thickened, or scaly skin

sores, ulcers, or white spots in mouth

stammering or other difficulty in speaking

unusually heavy bleeding or oozing from cuts or wounds

unusual tiredness

unusually heavy or unexpected menstrual bleeding

vomiting of blood or material that looks like coffee grounds

weakness

yellow eyes or skin

Check with your doctor as soon as possible if any of the following side effects occur:

More common

Skin rash

Less common or rare

General feeling of discomfort or illness

hives or itching of skin

ringing or buzzing in ears

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Abdominal or stomach pain (mild)

diarrhea

indigestion

nausea

Less common

Bloating or gas

dizziness

vomiting

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.