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Ticlopidine

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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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

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Ticlopidine

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