Ticlid (Oral)

Ticlopidine is used to reduce the risk of having a stroke. It is prescribed for people who have already experienced a stroke and for those with specific health issues that could lead to a stroke. Because ticlopidine can cause serious side effects, especially during the first 3 months of treatment, it is mainly used for individuals who cannot take aspirin to prevent strokes.

A stroke can happen when blood flow to the brain is blocked by a blood clot. Ticlopidine lowers the risk of a harmful blood clot forming by stopping certain cells in the blood from sticking together. This action of ticlopidine may also raise the risk of serious bleeding in some individuals.

This medicine is available only with a doctor's prescription.

It is very important to have blood tests done before starting treatment with ticlopidine, and then every 2 weeks for the first 3 months of treatment with ticlopidine. These tests help to check for certain side effects. Finding these side effects early can help prevent them from becoming serious. Your doctor will set up the blood tests for you. Make sure you do not miss any appointments for these tests. After the first 3 months of treatment, you will likely not need to have your blood tested as often, because the side effects are less likely to happen after that time.

Tell all doctors, dentists, nurses, and pharmacists you see that you are taking this medicine. Ticlopidine may increase the risk of serious bleeding during surgery or certain dental procedures. Therefore, treatment may need to stop about 10 days to 2 weeks before the surgery or dental work.

Ticlopidine may cause serious bleeding, especially after an injury. Sometimes, internal bleeding can happen without you knowing it. Ask your doctor if there are any activities you should avoid while taking this medicine (for example, contact sports). Also, contact your doctor right away if you get injured while taking this medicine.

Contact your doctor immediately if you notice any of the following side effects:

• Bruising or bleeding, especially bleeding that is difficult to stop. Internal bleeding may show up as bloody or black, tarry stools, or feelings of faintness. You may also notice bleeding from your gums when brushing or flossing your teeth.
• Any signs of infection, such as fever, chills, or a sore throat.
• Sores, ulcers, or white spots in your mouth.
• Dark or bloody urine, trouble speaking, fever, pale skin, tiny red spots on your skin, convulsions (seizures), weakness, or yellowing of the eyes or skin.

After you stop taking ticlopidine, the risk of bleeding may last for 1 or 2 weeks. During this time, continue to follow the same precautions you took while on the medicine.

In deciding to use a medicine, you and your doctor need to consider the risks of taking the medicine versus the benefits it will provide. For this medicine, keep the following in mind:

Allergies

Inform your doctor if you have ever had any unusual or allergic reactions to this medicine or any other medicines. Also, let your healthcare professional know about any other allergies you have, such as to foods, dyes, preservatives, or animals. For over-the-counter products, read the label or package ingredients carefully.

Pediatric

There is no specific information comparing the use of ticlopidine in children to its use in other age groups.

Geriatric

This medicine has been tested and has not shown different side effects or problems in older adults compared to younger adults.

Breast Feeding

There are no adequate studies in women to determine the risk to infants when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before using this medication while breastfeeding.

Interactions with Medicines

Some medicines should never be used together, while others may be used together even if an interaction could happen. In these cases, your doctor may adjust the dose, or other precautions may be needed. When taking this medicine, it is especially important for your healthcare professional to know if you are taking any of the following medicines. The interactions listed below are selected for their potential significance and are not necessarily a complete list.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to prescribe this medication or may change some of the other medicines you take.

• Abrocitinib
• Defibrotide
• Mavacamten

Using this medicine with any of the following medicines is usually not recommended, but may be necessary in some cases. If both medicines are prescribed together, your doctor may adjust the dose or how often you use one or both medicines.

• Abciximab
• Aceclofenac
• Acemetacin
• Alipogene Tiparvovec
• Alteplase, Recombinant
• Amtolmetin Guacil
• Anagrelide
• Apixaban
• Ardeparin
• Argatroban
• Aspirin
• Belzutifan
• Bemiparin
• Betrixaban
• Bivalirudin
• Bromfenac
• Bufexamac
• Bupropion
• Caplacizumab-yhdp
• Celecoxib
• Certoparin
• Choline Salicylate
• Cilostazol
• Citalopram
• Clonixin
• Clopidogrel
• Curcumin
• Dabigatran Etexilate
• Dalteparin
• Danaparoid
• Desirudin
• Desvenlafaxine
• Dexibuprofen
• Dexketoprofen
• Diclofenac
• Diflunisal
• Dipyridamole
• Dipyrone
• Droxicam
• Duloxetine
• Edoxaban
• Enoxaparin
• Eptifibatide
• Escitalopram
• Etodolac
• Etofenamate
• Etoricoxib
• Felbinac
• Fenoprofen
• Fepradinol
• Feprazone
• Floctafenine
• Flufenamic Acid
• Fluoxetine
• Flurbiprofen
• Fluvoxamine
• Fondaparinux
• Heparin
• Ibrutinib
• Ibuprofen
• Indomethacin
• Inotersen
• Ketoprofen
• Ketorolac
• Lepirudin
• Levomilnacipran
• Lornoxicam
• Loxoprofen
• Lumiracoxib
• Meclofenamate
• Mefenamic Acid
• Meloxicam
• Melphalan
• Milnacipran
• Morniflumate
• Nabumetone
• Nadroparin
• Naproxen
• Nefazodone
• Nepafenac
• Niflumic Acid
• Nimesulide
• Nimesulide Beta Cyclodextrin
• Oxaprozin
• Oxyphenbutazone
• Parecoxib
• Parnaparin
• Paroxetine
• Phenindione
• Phenobarbital
• Phenprocoumon
• Phenylbutazone
• Piketoprofen
• Piracetam
• Piroxicam
• Primidone
• Proglumetacin
• Propyphenazone
• Proquazone
• Protein C
• Reviparin
• Rivaroxaban
• Rofecoxib
• Salicylic Acid
• Salsalate
• Selumetinib
• Sertraline
• Sodium Salicylate
• Sulindac
• Tenecteplase
• Tenoxicam
• Tiaprofenic Acid
• Ticagrelor
• Tinzaparin
• Tizanidine
• Tolfenamic Acid
• Tolmetin
• Trazodone
• Turmeric
• Valdecoxib
• Venlafaxine
• Vilazodone
• Vortioxetine
• Warfarin

Using this medicine with any of the following medicines may increase the risk of certain side effects, but using both medicines may be the best treatment for you. If both medicines are prescribed together, your doctor may adjust the dose or how often you use one or both of the medicines.

• Aluminum Carbonate, Basic
• Aluminum Hydroxide
• Aluminum Phosphate
• Calcium
• Carbamazepine
• Dihydroxyaluminum Aminoacetate
• Dihydroxyaluminum Sodium Carbonate
• Fosphenytoin
• Magaldrate
• Magnesium Carbonate
• Magnesium Hydroxide
• Magnesium Oxide
• Magnesium Trisilicate
• Phenytoin
• Theophylline

Interactions with Food/Tobacco/Alcohol

Some medicines should not be used at the same time as certain foods or drinks because interactions can occur. Using alcohol or tobacco with certain medicines may also lead to interactions. The following interactions have been selected based on their potential significance and are not necessarily a complete list.

Other Medical Problems

Having other medical issues may affect how you can use this medicine. Be sure to tell your doctor if you have any other medical conditions, especially:

• Blood clotting problems, like hemophilia and von Willebrand's disease, or
• Severe liver disease, or
• Stomach ulcers—This may increase the chance of serious bleeding

• Blood disease—This may increase the chance of serious side effects

• Severe kidney disease—Ticlopidine is cleared from the body more slowly when the kidneys are not working well. This may increase the chance of side effects

Also, inform your doctor if you have ever had a condition called thrombotic thrombocytopenic purpura (TTP). This condition could happen again if you take ticlopidine.

Along with its needed effects, Ticlid (Oral) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Less common or rare

• Severe abdominal or stomach pain or swelling
• Back pain
• Blistering, peeling, or loosening of the skin or lips or mucous membranes (the moist lining of many body cavities, including the mouth, lips, inside of nose, anus, and vagina)
• Blood in eyes
• Bloody or black tarry stools
• Bruising or purple areas on skin
• Change in mental status
• Convulsions (seizures)
• Coughing up blood
• Dark or bloody urine
• Decreased alertness
• Dizziness
• Fever, chills, or sore throat
• Severe or continuing headache
• Joint pain or swelling
• Nosebleeds
• Pale color of skin
• Paralysis or problems with coordination
• Pinpoint red spots on skin
• Red lesions on the skin, often with a purple center
• Red, thickened, or scaly skin
• Sores, ulcers, or white spots in mouth
• Stammering or other difficulty in speaking
• Unusually heavy bleeding or oozing from cuts or wounds
• Unusual tiredness
• Unusually heavy or unexpected menstrual bleeding
• Vomiting of blood or material that looks like coffee grounds
• Weakness
• Yellow eyes or skin

Check with your doctor as soon as possible if any of the following side effects occur:

More common

• Skin rash

Less common or rare

• General feeling of discomfort or illness
• Hives or itching of skin
• Ringing or buzzing in ears

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

• Mild abdominal or stomach pain
• Diarrhea
• Indigestion
• Nausea

Less common

• Bloating or gas
• Dizziness
• Vomiting

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

In the U.S.

• Ticlid

Available Dosage Forms:

• Tablet

Therapeutic Class: Platelet Aggregation Inhibitor

Pharmacologic Class: ADP-Induced Aggregation Inhibitor

Ticlopidine should be taken with food. This increases the amount of medicine that is absorbed into the body. It may also lessen the chance of stomach upset.

Take this medicine only as directed by your doctor. Ticlopidine will not work properly if you take less of it than directed. Taking more ticlopidine than directed may increase the chance of serious side effects without increasing the helpful effects.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For oral dosage form (tablets): For prevention of strokes: Adults—1 tablet (250 mg) two times a day, with food. Children—It is not likely that ticlopidine would be used to help prevent strokes in children. If a child needs this medicine, however, the dose would have to be determined by the doctor. For prevention of strokes or heart attack following heart stent procedure: Adults—1 tablet (250 mg) two times a day, with food together with your doctor's recommended dose of aspirin for up to 30 days following the procedure Children—It is not likely that ticlopidine would be used to help prevent strokes or heart attack in children. If a child needs this medicine, however, the dose would have to be determined by the doctor

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.