ticlopidine

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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:

  1. Drug and Therapeutics Bulletin (1999), 37 (8), 59-61.
  2. Patrano C et al.Platelet-active drugs: the relationships among dose, effectiveness, and side effects. Chest 2001;119:39S-63S

Last reviewed 01/2018

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