ticlopidine (Rx)

Brand and Other Names:Ticlid
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Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

tablet

  • 250mg
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Stroke

250 mg PO q12hr with food

Coronary Artery Stent Thrombosis, Prevention

250 mg PO q12hr with aspirin for 30 days OR

ACCP: Load 500 mg, THEN 250 mg q12hr for at least 10-14 days following successful stent placement

Renal Impairment

Dose adjustment not necessary

Hepatic Impairment

Caution; contraindicated in severe hepatic impairment

Other Information

Monitor: CBC, LFT's prior to starting & q2Weeks for first 3 months

Other Indications & Uses

Reduce risk of thrombotic stroke: only in patients allergic to ASA or who failed ASA; prevention of coronary artery stent thrombosis

Off-label: CABG, chronic arterial occlusion, glomerulonephritis, intermittent claudication, open heart surgery, sickle cell disease, unstable angina

<18 years old: safety & efficacy not established

Causes orthostatic hypotension and more effective alternatives available (Beers criteria)

Stroke

250 mg PO q12hr with food; monitor (greater sensitivity possible)

Coronary artery stent thrombosis, prevention

250 mg PO q12hr with food; monitor (greater sensitivity possible)

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Interactions

Interaction Checker

and ticlopidine

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            >10%

            Diarrhea (12.5%)

            1-10%

            Elevated alkaline phosphatase (7.6%)

            Nausea (7%)

            Dyspepsia (7%)

            Rash (5%)

            GI pain (3.7%)

            Elevated AST/SGOT (3.1%)

            Neutropenia (2.4%)

            Purpura (2.2%)

            Vomiting (1.9%)

            Flatulence (1.5%)

            Pruritus (1.3%)

            Dizziness (1%)

            Abnormal LFTs (1%)

            Anorexia (1%)

            <1%

            Agranulocytosis

            Aplastic anemia

            Pancytopenia

            TTP

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            Warnings

            Black Box Warnings

            May cause life-threatening hematologic events, including neutropenia, agranulocytosis, thrombocytopenia purpura, and aplastic anemia

            Contraindications

            Documented hypersensitivity

            Neutropenia, thrombocytopenia, hemostatic disorder or active bleeding (GI bleed, ICH), severe hepatic impairment, history of either thrombotic thrombocytopenic purpura (TTP) or aplastic anemia

            Current use of other anticoagulant drugs

            Cautions

            Due to risk of adverse hematologic events, for stroke prevention use only in ASA-intolerant patients

            Patients with lesions that have a propensity to bleed

            Discontinue 10-14 days before elective major surgery in patients with bleeding diathesis

            Increases serum chlesterol & triglyceride concentrations

            Long-term use with concurrent aspirin not recommended

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            Pregnancy & Lactation

            Pregnancy Category: B

            Lactation: not known whether excreted in breast milk, discontinue drug or do not nurse

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

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            Pharmacology

            Mechanism of Action

            Platelet aggregation inhibitor; reversibly interacts with the platelet P2Y12 ADP-receptor to prevent signal transduction and platelet activation

            Pharmacokinetics

            Peak Plasma: 2 hr

            Onset of action: 6 hr

            Absorption: >80%

            Half-Life elimination: 13 hr

            Max Effect: 8-11 days postinitiation

            Protein Bound: 98%

            Metabolism: Liver

            Excretion: Urine (60%); feces (23%)

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            Images

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            Formulary

            FormularyPatient Discounts

            Adding plans allows you to compare formulary status to other drugs in the same class.

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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