Ticlopidine: An Alternative Antiplatelet for Stroke Prevention
Ticlopidine is an anti-platelet medication used to prevent stroke and cardiovascular events, particularly in patients who are intolerant to clopidogrel. It works by preventing platelets from aggregating and forming blood clots that can obstruct blood flow in the brain or heart.
Mechanism of Action
Ticlopidine gets converted in vivo to its active metabolite which inhibits the P2Y12 receptors on platelets, similar to clopidogrel, blocking platelet activation and aggregation to prevent clot formation. Platelets blocked once by Ticlopidine gets affected for the remainder of their lifespan
Indications
● Stroke Prevention: For patients with a history of transient ischemic attacks (TIAs) or at high risk of stroke.
● Coronary Artery Disease (CAD): To prevent stent thrombosis or recurrent cardiovascular events.
Dosage and Administration
● Initial Dose: 250 mg twice daily for coronary artery disease and 300-600 mg/day in 2-3 divided doses in peripheral artery diseases.
● Maintenance Dose: The dose can be increased to 500 mg daily.
● Pediatric dose: Safety and efficacy have not been established.
Side Effects
● Common: Nausea, rash, diarrhea.
● Serious: Agranulocytosis (severe drop in white blood cells), liver dysfunction, and thrombocytopenia (low platelet count).
Pregnancy Category: Category C – Use only if clearly needed during pregnancy.
Common Brands
● Tiklid, Ticlograd, Tikleen.