Ticlopidine

Definition
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Antiplatelets.

Half-life
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30–50 h

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Indication
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Prophylaxis of arterial and venous thromboses, arterial occlusive disease of the peripheral type.

Limited indication
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Severe liver dysfunction.

Dosage and method of use
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1-3 times/day 250 mg p.o.

Remember! Ticlopidine should not be administered to patients with increased bleeding tendency or gastrointestinal ulcers. The preparation should be discontinued 1 week before planned operations. In emergencies the effect of Ticlopidine can be reversed by a single administration of 20 mg methylprednisolone. Before the start of therapy and during the first 3 months of treatment, a differential BB and platelet count is required at 14-day intervals!

Undesirable effects
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Nausea, abdominal pain, diarrhea, allergic reactions, BB changes, jaundice with hepatitis and cholestasis, headache and dizziness.

Interactions
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See Table 1.

Contraindication
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Pregnancy, lactation, agranulocytosis, bleeding tendency also in the medical history, chronic inflammatory bowel diseases, children and adolescents < 16 years, leukopenia, gastrointestinal ulcers, neutropenia, operations, acute hemorrhagic apoplexy, thrombopenia.

Preparations
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Tiklyd

Patientinformation
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Remember! The patient should consult the doctor immediately if ulcers appear in the mouth and throat area, tonsillitis and fever. Ticlopidine should be taken after meals to reduce the gastrointestinal side effects!

Tables
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Significant interactions of ticlopidine

Antirheumatic drugs, non-steroidal	Bleeding tendency ↑
Cephalosporins	Bleeding tendency ↑
Cimetidine	Ticlopidine levels ↑
Clozapine	Agranulocytosis, avoid combination
Coumarins	Bleeding tendency ↑
Dihydroergotamine	Bleeding tendency ↑
Penicillin i.v.	Bleeding tendency ↑
Theophyllins	Theophylline levels ↑
Platelet concentrates	Ticlopidine effect ↓