Ticlopidine (patient information)

IMPORTANT WARNING

Ticlopidine may cause a decrease in white blood cells, which fight infection in the body. If you have fever, chills, sore throat, or other signs of an infection, call your doctor immediately.

Ticlopidine may also cause a potentially life-threatening decrease in platelets, which may occur as part of a syndrome that includes injury to red blood cells, causing anemia, kidney abnormalities, neurologic changes, and fever. This condition is called thrombotic thrombocytopenic purpura (TTP).

Call your doctor immediately if you have yellowing of the skin or eyes, pinpoint dots (rash) on the skin, pale color, fever, difficulty speaking, seizures, weakness on a side of the body, or dark urine.

Keep all appointments with your doctor and the laboratory. Your doctor will order lab tests, especially during the first 3 months of treatment, to check your response to ticlopidine.

Why this medication is prescribed

Ticlopidine is used to reduce the risk of stroke. It works by preventing excessive blood clotting.

This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

How this medication should be used

Ticlopidine comes as a tablet to take by mouth. It usually is taken twice a day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take ticlopidine exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Continue to take ticlopidine even if you feel well. Do not stop taking ticlopidine without talking to your doctor.

Other uses for this medicine

Ticlopidine also is used before open heart surgery and in the treatment of sickle cell disease, certain types of kidney disease (primary glomerulonephritis), and blocked arteries in the legs. Talk to your doctor about the possible risks of using this drug for your condition.

Special Precautions

Before taking ticlopidine:

• tell your doctor and pharmacist if you are allergic to ticlopidine or any other drugs.
• tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially antacids, anticoagulants ('blood thinners') such as warfarin (Coumadin), aspirin, cimetidine (Tagamet), digoxin (Lanoxin), theophylline (Theo-Dur), and vitamins.
• if you also take antacids (Maalox, Mylanta) take them 1 hour before or 2 hours after taking ticlopidine.
• tell your doctor if you have or have ever had liver disease, bleeding disorders, bleeding ulcers, low blood cell counts (neutropenia, thrombocytopenia, anemia, TTP), kidney disease, high blood cholesterol, or high blood fats (triglycerides).
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking ticlopidine, call your doctor.
• if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking ticlopidine. Your doctor may tell you to stop taking ticlopidine 10-14 days before your procedure. Follow these directions.

Special dietary instructions

Take ticlopidine with meals or just after eating to prevent upset stomach.

What to do if you forget a dose

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

Side Effects

Minor Side Effects

Ticlopidine may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• upset stomach
• diarrhea
• vomiting
• stomach pain
• loss of appetite
• gas
• headache
• itching

Severe Side Effects

If you experience any of the following symptoms, or those listed in the IMPORTANT WARNING section, call your doctor immediately:

• fever, sore throat, or other signs of infection
• unusual bleeding or bruising
• light-colored stools
• skin rash

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/MedWatch/report.htm] or by phone [1-800-332-1088].

Storage conditions needed for this medication

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

In case of emergency/overdose

In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

Other information

Ticlopidine prevents blood from clotting so it may take longer than usual for you to stop bleeding if you are cut or injured. Avoid activities that have a high risk of causing injury. Call your doctor if bleeding is unusual.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

Brand names

• Ticlid®