Ticlopidine

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.

Ticlopidine is used to reduce the risk of stroke in people who have had a stroke or have had warning signs of a stroke and who cannot be treated with aspirin. Ticlopidine is also used along with aspirin to prevent blood clots from forming in coronary stents (metal tubes surgically placed in clogged blood vessels to improve blood flow). It works by preventing platelets (a type of blood cell) from collecting and forming clots.

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.

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 medication for your condition.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

Before taking ticlopidine,

• tell your doctor and pharmacist if you are allergic to ticlopidine,any other medications, or any of the ingredients in ticlopidine tablets.
• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to takewhile taking ticlopidine Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• the following nonprescription products may interact with ticlopidine: cimetidine (Tagamet); aspirin and nonsteroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen (Advil, Motrin, others) and naproxen (Aleve). Be sure to let your doctor and pharmacist know that you are taking these medications before you start taking ticlopidine. Do not start any of these medications while taking ticlopidine without discussing with your healthcare provider.
• 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.
• talk to your doctor about the risks and benefits of taking ticlopidine if you are 65 years of age or older. Older adults should not usually take ticlopidine because it is not as safe or effective as other medications that can be used to treat the same condition.
• 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 to 14 days before your procedure. Follow these directions.

Unless your doctor tells you otherwise, continue your usual diet.

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.

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

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

Some side effects can be serious. 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

Ticlopidine may cause other side effects. Call your doctor if you have any unusual problems while you are taking this medication.

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 (https://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

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).

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. https://www.upandaway.org

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (https://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

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.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

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