ticlopidine
Last reviewed 01/2018
This drug acts by blocking the platelet ADP receptor, which promotes aggregation when activated.
- currently used in the UK, in combination with aspirin, to prevent thrombosis with coronary stents
- 1-2 % incidence of neutropaenia in patients taking ticlopidine
- current evidence suggests that ticlodipine is more effective than aspirin in preventing a stroke in patients who have already had a transient ischaemic attack or previous stroke - however because of ticlodipine's potential side effect of bone marrow suppression, aspirin remains the treatment of choice in secondary prevention (1)
- ticlodipine has uncommon (0.5-3%) but very serious haematological toxicity including neutropaenia, thrombocytopaenia, thrombotic thrombocytopaenia purpura and (very rarely) aplastic anaemia (2); gastrointestinal side effects and rash are common
- ticlopidine is inactive and metabolised to active metabolites in the liver
The summary of product characteristics should be consulted before prescribing this drug.
Reference:
- Drug and Therapeutics Bulletin (1999), 37 (8), 59-61.
- Patrano C et al.Platelet-active drugs: the relationships among dose, effectiveness, and side effects. Chest 2001;119:39S-63S