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Ticlid

Last reviewed on RxList: 6/10/2008
Ticlid Side Effects Center

Last reviewed on RxList 1/8/2016

Ticlid (ticlopidine hydrochloride) is a platelet aggregation inhibitor used to prevent blood clots after a recent heart attack or stroke, and in people with certain disorders of the heart or blood vessels. Common side effects of Ticlid include diarrhea, stomach upset or pain, nausea, vomiting, dizziness, ringing in your ears, or itching.

The recommended dose of Ticlid after stroke is 250 mg twice daily taken with food. The recommended dose after coronary artery stenting is 250 mg twice daily taken with food together with antiplatelet doses of aspirin for up to 30 days of therapy following successful stent implantation. Ticlid may interact with aspirin, warfarin, heparin, dalteparin, enoxaparin, clopidogrel, dipyridamole, NSAIDs (non-steroidal anti-inflammatory drugs), antacids or cimetidine, digoxin, theophylline, or phenytoin. Ticlid should be used only when prescribed during pregnancy. It is unknown if this drug passes into breast milk, but it may have undesirable effects on a nursing infant. Consult your doctor before breastfeeding.

Our Ticlid (ticlopidine hydrochloride) Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Ticlid Consumer Information

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Stop using ticlopidine and call your doctor at once if you have a serious side effect such as:

  • nosebleed or other bleeding that will not stop;
  • black, bloody, or tarry stools;
  • coughing up blood or vomit that looks like coffee grounds;
  • chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling;
  • sudden numbness or weakness, especially on one side of the body;
  • sudden headache, confusion, problems with vision, speech, or balance; or
  • pale skin, easy bruising or bleeding, weakness, fever, and urinating more or less than usual;
  • signs of infection such as fever, chills, sore throat, flu symptoms, mouth sores; or
  • nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Less serious side effects may include:

  • upset stomach, nausea, or vomiting;
  • ringing in your ears;
  • diarrhea;
  • dizziness; or
  • itching.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Read the entire detailed patient monograph for Ticlid (Ticlopidine Hcl)

Ticlid Professional Information

SIDE EFFECTS

Adverse reactions in stroke patients were relatively frequent with over 50% of patients reporting at least one. Most (30% to 40%) involved the gastrointestinal tract. Most adverse effects are mild, but 21% of patients discontinued therapy because of an adverse event, principally diarrhea, rash, nausea, vomiting, GI pain and neutropenia. Most adverse effects occur early in the course of treatment, but a new onset of adverse effects can occur after several months.

The incidence rates of adverse events listed in the following table were derived from multicenter, controlled clinical trials in stroke patients described above comparing TICLID (ticlopidine hcl) , placebo and aspirin over study periods of up to 5.8 years. Adverse events considered by the investigator to be probably drug-related that occurred in at least 1% of patients treated with TICLID (ticlopidine hcl) are shown in the following table:

Percent of Patients With Adverse Events in Controlled Studies (TASS and CATS)

Event TICLID (ticlopidine hcl)
(n = 2048)
Incidence
Aspirin
(n = 1527)
Incidence
Placebo
(n = 536)
Incidence
Any Events 60.0 (20.9) 53.2 (14.5) 34.3 (6.1)
Diarrhea 12.5 (6.3) 5.2 (1.8) 4.5 (1.7)
Nausea 7.0 (2.6) 6.2 (1.9) 1.7 (0.9)
Dyspepsia 7.0 (1.1) 9.0 (2.0) 0.9 (0.2)
Rash 5.1 (3.4) 1.5 (0.8) 0.6 (0.9)
GI Pain 3.7 (1.9) 5.6 (2.7) 1.3 (0.4)
Neutropenia 2.4 (1.3) 0.8 (0.1) 1.1 (0.4)
Purpura 2.2 (0.2) 1.6 (0.1) 0.0 (0.0)
Vomiting 1.9 (1.4) 1.4 (0.9) 0.9 (0.4)
Flatulence 1.5 (0.1) 1.4 (0.3) 0.0 (0.0)
Pruritus 1.3 (0.8) 0.3 (0.1) 0.0 (0.0)
Dizziness 1.1 (0.4) 0.5 (0.4) 0.0 (0.0)
Anorexia 1.0 (0.4) 0.5 (0.3) 0.0 (0.0)
Abnormal Liver Function Test 1.0 (0.7) 0.3 (0.3) 0.0 (0.0)

Incidence of discontinuation, regardless of relationship to therapy, is shown in parentheses.

Hematological: Neutropenia/thrombocytopenia, TTP, aplastic anemia (see BOXED WARNING and WARNINGS), leukemia, agranulocytosis, eosinophilia, pancytopenia, thrombocytosis and bone-marrow depression have been reported.

Gastrointestinal: TICLID (ticlopidine hcl) therapy has been associated with a variety of gastrointestinal complaints including diarrhea and nausea. The majority of cases are mild, but about 13% of patients discontinued therapy because of these. They usually occur within 3 months of initiation of therapy and typically are resolved within 1 to 2 weeks without discontinuation of therapy. If the effect is severe or persistent, therapy should be discontinued. In some cases of severe or bloody diarrhea, colitis was later diagnosed.

Hemorrhagic: TICLID (ticlopidine hcl) has been associated with increased bleeding, spontaneous posttraumatic bleeding and perioperative bleeding including, but not limited to, gastrointestinal bleeding. It has also been associated with a number of bleeding complications such as ecchymosis, epistaxis, hematuria and conjunctival hemorrhage.

Intracerebral bleeding was rare in clinical trials in stroke patients with TICLID (ticlopidine hcl) , with an incidence no greater than that seen with comparator agents (ticlopidine 0.5%, aspirin 0.6%, placebo 0.75%). It has also been reported postmarketing.

Rash: Ticlopidine has been associated with a maculopapular or urticarial rash (often with pruritus). Rash usually occurs within 3 months of initiation of therapy with a mean onset time of 11 days. If drug is discontinued, recovery occurs within several days. Many rashes do not recur on drug rechallenge. There have been rare reports of severe rashes, including Stevens-Johnson syndrome, erythema multiforme and exfoliative dermatitis.

Less Frequent Adverse Reactions (Probably Related): Clinical adverse experiences occurring in 0.5% to 1.0% of stroke patients in controlled trials include: Digestive System: GI fullness

Skin and Appendages: urticaria

Nervous System: headache

Body as a Whole: asthenia, pain

Hemostatic System: epistaxis

Special Senses: tinnitus

In addition, rarer, relatively serious and potentially fatal events associated with the use of TICLID (ticlopidine hcl) have also been reported from postmarketing experience: Hemolytic anemia with reticulocytosis, immune thrombocytopenia, hepatitis, hepatocellular jaundice, cholestatic jaundice, hepatic necrosis, hepatic failure, peptic ulcer, renal failure, nephrotic syndrome, hyponatremia, vasculitis, sepsis, allergic reactions (including angioedema, allergic pneumonitis, and anaphylaxis), systemic lupus (positive ANA), peripheral neuropathy, serum sickness, arthropathy and myositis.

Read the entire FDA prescribing information for Ticlid (Ticlopidine Hcl)

Related Resources for Ticlid

Read the Ticlid User Reviews »

© Ticlid Patient Information is supplied by Cerner Multum, Inc. and Ticlid Consumer information is supplied by First Databank, Inc., used under license and subject to their respective copyrights.

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