Ticlopidine

Ticlopidine (trade name Ticlid) is an antiplatelet drug in the thienopyridine family. Like clopidogrel, it is an adenosine diphosphate (ADP) receptor inhibitor. It is used in patients in whom aspirin is not tolerated, or in whom dual antiplatelet therapy is desirable. Because it has been reported to increase the risk of thrombotic thrombocytopenic purpura (TTP) and neutropenia, its use has largely been supplanted by the newer drug, clopidogrel, which is felt to have a much lower hematologic risk. The usual dose is 250 mg twice daily by the oral route.

Action

 * Inhibits platelet aggregation by altering the function of platelet membranes by blocking ADP receptors. This prevents the conformational change of glycoprotein IIb/IIIa which allows platelet binding to fibrinogen.
 * Prolongs bleeding time.
 * Decreased incidence of stroke in high-risk patients.

Contraindications

 * Hypersensitivity
 * Bleeding disorders
 * Active bleeding
 * Severe liver disease

Precautions

 * Risk of bleeding (trauma, surgery, history of peptic ulcer disease)
 * Renal or hepatic impairment
 * Geriatric patients (increased sensitivity)
 * Pregnancy, lactation, or children under 18
 * Neutropenia
 * Thrombotic thrombocytopenic purpura

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