Is not recommended the simultaneous use of drugs that affect blood clotting (anticoagulants for oral administration of heparin, acetylsalicylic acid). If the concomitant use of these drugs is absolutely necessary, should regularly monitor coagulation parameters.
Simultaneous use of antacid preparations group leads to decrease in the blood concentration of ticlopidine 18%. The simultaneous use of cimetidine leads to a significant increase in the concentration of ticlopidine in blood.
Ticlopidine may cause a slight clenbuterol before and after (approximately 15%) reduction in the concentration of digoxin in the bloodstream.
Drugs metabolism involving microsomal liver enzymes (e.g., some hypnotic and sedative drugs), are metabolized slowly under ticlopidine treatment. Violation of the liver may also reduce the rate of metabolism of other drugs.
Ticlopidine cephalosporins slows down and causes a rise of their blood concentrations. Patients taking ticlopidine, cephalosporins dose should be adjusted accordingly.
Ticlopidine slows excretion of theophylline. Simultaneous use of theophylline and ticlopidine may cause an increase in the concentration of theophylline, and lead to overdose.
Concomitant use of phenytoin and ticlopidine requires special care as ticlopidine increases the concentration of phenytoin in plasma. It is necessary to determine the level of serum phenytoin and adjust the dose.
The most common violations of blood and bleeding tendency associated with insufficiently frequent monitoring of coagulation parameters or late diagnosis of these disorders.
Excessive coagulation inhibition occurs primarily in patients treated concurrently with antikoagulyaty ticlopidine, acetylsalicylic acid or other non-steroidal anti-inflammatory drugs. Faults in the system of coagulation or signs of an inflammatory disease (eg, sore throat, fever, attacks on the mucous membrane of the tonsils) it is necessary to consult a doctor. Physicians also need to be informed about the reception of other drugs, especially the above. In the treatment of ticlopidine without consulting clenbuterol before and after a doctor can not be used painkillers and drugs to lower the temperature.
When the need for surgical intervention (even a small, such as, for example, tooth extraction), the doctor should say that the patient is taking ticlopidine, as it must take into account when planning manipulation or surgery. If possible, ticlopidine reception should be discontinued at least 10 days before the procedure. In the case of urgent surgical intervention is necessary to introduce a dose of methylprednisolone 0.5-1.0 mg / kg body masy or spend transfusion of platelets.
Ticlopidine is metabolized primarily by the liver. In patients with impaired liver function the drug should be used with extreme caution. You must inform the doctor about the presence of acute liver disease or an illness in the history.
There are reports of rare cases of hepatitis and cholestatic jaundice.
In the case of jaundice, icteric sclera, colorless stool or unusually dark urine should immediately consult a doctor.
Chronic use of ticlopidine may cause changes in the biochemical analysis of blood: an increase in alkaline phosphatase activity or enzymes, increased cholesterol and triglyceride levels. Blood must be monitored over time during the first three months of treatment. Prior to treatment ticlopidine and then every 2 weeks for the first 3 months of treatment necessary to control the number of platelets and the composition of the leukocyte formula.
Since the use of the drug due to the risk of severe neutropenia and / or agranulocytosis, ticlopidine should only be used in patients with hypersensitivity to aspirin patients or in patients in which the use acetylsalicylic acid inefficiently.
Use in pregnancy and lactation
The drug can be used during clenbuterol before and after pregnancy unless absolutely necessary. There has been no adequate studies on the excretion of ticlopidine with mother’s milk. If the use of ticlopidine is necessary during lactation, the drug should be used with extreme caution.