The information in this leaflet is intended to help you use TICLID safely. Please read the leaflet carefully. Although it does not contain all the detailed medical information that is provided to your doctor, it provides facts about TICLID that are important for you to know. If you still have questions after reading this leaflet or if you have questions at any time during your treatment with TICLID, check with your doctor.

Stroke Patients: TICLID is recommended to help reduce your risk of having a stroke, but only for patients who have had a stroke or early stroke warning symptoms while on aspirin, or for those who have these symptomsbut are intolerant or allergic to aspirin.

Stent Patients: TICLID is recommended with aspirin for up to 30 days in patients who have had a stent implanted in their coronary arteries to reduce the risk of blood clots forming inside the stent.

Special Warning for Users of TICLID/Necessary Blood Tests: TICLID is not prescribed for those who can take aspirin to reduce the risk of stroke because TICLID can cause life-threatening blood problems. Getting your blood tests done and reporting symptoms to your doctor as soon as possible can avoid serious complications.

The white cells of the blood that fight infection may drop to dangerous levels (a condition called neutropenia). This occurs in about 2.4% (1 in 40) of people on ticlopidine. You should be on the lookout for signs of infection such as fever, chills or sore throat. If this problem is caught early, it can almost always be reversed, but if undetected it can be fatal.

Another problem that has occurred in some patients taking ticlopidine is a decrease in cells called platelets (a condition called thrombocytopenia). This 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 TTP and can be fatal.

Things you should watch for as possible early signs of TTP are yellow skin or eye color, pinpoint dots (rash) on the skin, pale color, fever, weakness on a side of the body, or dark urine. If any of these occur, contact your doctor immediately.

Both complications occur most frequently in the first 90 days after TICLID is started. To make sure you don't develop either of these problems, your doctor will arrange to have your blood tested before you start taking TICLID and then every 2 weeks for the first 3 months you are on TICLID. If detected, neutropenia and thrombocytopenia can almost always be reversed. It is essential that you keep your appointments for the blood tests and that you call your doctor immediately if you have any indication that you may have TTP or neutropenia. If you stop taking TICLID for any reason within the first 3 months, you will still need to have your blood tested for an additional 2 weeks after you have stopped taking TICLID.

Rarely, decreases in the white blood cells, red blood cells and platelets can occur together. This condition is called aplastic anemia and can be fatal.

Things you should watch for as possible early signs of aplastic anemia are feeling of excessive weakness and tiredness, paleness, bruising, and bleeding from areas such as your nose or gums. You may also develop signs of infection such as fever. If any of these occur, contact your doctor immediately.

Other Warnings and Precautions: A few people may develop jaundice while being treated with TICLID. The signs of jaundice are yellowing of the skin or the whites of the eyes or consistent darkening of the urine or lightening in the color of the stools. These symptoms should be reported to your physician promptly.

TICLID should be used only as directed by your doctor. Do not give TICLID to anyone else. Keep TICLID out of reach of children!

Some people may have such side effects as diarrhea, skin rash, stomach or intestinal discomfort. If any of these problems are persistent, or if you are concerned about them, bring them to your doctor's attention

It may take longer than usual to stop bleeding when taking TICLID. Tell your doctor if you have any more bleeding or bruising than usual, and, if you have emergency surgery, be sure to let your doctor or dentist know that you are taking TICLID. Also, tell your doctor well in advance of any planned surgery (including tooth extraction), because he or she may recommend that you stop taking TICLID temporarily.

Stroke Patients: A stroke occurs when a clot (or thrombus) forms in a blood vessel in the brain or forms in another part of the body and breaks off, then travels to the brain (an embolus). In both cases the blood supply to part of the brain is blocked and that part of the brain is damaged. TICLID works by making the blood less likely to clot, although not so much less that it causes you to become likely to bleed, unless you have a bleeding disorder or some injury (such as a bleeding ulcer of the stomach or intestine) that is especially likely to bleed.

Stent Patients: A heart attack or angina (chest pain) can occur when fatty deposits block the arteries that carry oxygen and nutrient-rich blood to your heart. To decrease the chance of fatty deposits building up over time, your doctor may recommend the placement of a coronary stent. TICLID may be given to you with aspirin to make blood clots less likely to form inside the stent so that the artery remains open.

Who Should Not Take TICLID? Contact your doctor immediately and do not take TICLID if:

· you have an allergic reaction to TICLID

· you have a blood disorder or a serious bleeding problem, such as a bleeding stomach ulcer

· you have previously been told you had TTP or aplastic anemia

· you have severe liver disease or other liver problems

· you are pregnant or you are planning to become pregnant

· you are breast-feeding

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