Ticlopidine Medications

Ticlopidine is an antiplatelet medication used to prevent strokes by inhibiting platelet aggregation and reducing blood clot formation.

Ticlid

Ticlopidine

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250mg

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Ticlopidine Information

Ticlopidine is a thienopyridine antiplatelet agent that inhibits platelet aggregation by blocking the P2Y12 ADP receptor on platelet surfaces. Originally approved for preventing thrombotic complications after coronary artery bypass graft (CABG) surgery, it is also used in certain patients with a history of stroke or transient ischemic attack (TIA). The drug works by irreversibly disabling the receptor, thereby reducing the formation of blood clots that can obstruct arteries. In Singapore, ticlopidine is listed by the Health Sciences Authority (HSA) and can be obtained in both branded (e.g., Ticlid) and generic forms through licensed pharmacy channels. While its clinical role has been largely superseded by newer agents such as clopidogrel, ticlopidine remains a valuable option for individuals who cannot tolerate alternative therapies. Off-label, some clinicians have explored its use in peripheral arterial disease, though such practice is not universally endorsed. Understanding its mechanism, efficacy, and safety profile helps patients and caregivers make informed choices when they buy Ticlopidine online or discuss treatment options with their healthcare team.

What is Ticlopidine?

Ticlopidine belongs to the thienopyridine class of antiplatelet drugs, sharing structural similarity with clopidogrel but possessing a distinct metabolic pathway. The Health Sciences Authority of Singapore approved the medication in 1997 for the prevention of graft occlusion after CABG surgery, following earlier approval by the U.S. Food and Drug Administration (FDA) in 1995. Subsequent label expansions in Europe and Asia added stroke-prevention indications for patients at high risk of recurrent ischemic events.

At the molecular level, ticlopidine is converted in the liver to an active metabolite that binds irreversibly to the P2Y12 subtype of adenosine diphosphate (ADP) receptors on platelets. By disabling this receptor, the drug blocks ADP-mediated platelet activation and aggregation, a key step in thrombus formation. The effect persists for the lifespan of the platelet (7-10 days) because new platelets must be generated to restore function.

In Singapore’s pharmaceutical market, ticlopidine is sold under the brand name Ticlid and as unbranded generic tablets. Both options are stocked by licensed pharmacies and can be ordered through our online service, offering a convenient alternative to in-person pharmacy visits.

How Ticlopidine Works

Mechanism of Action

After oral ingestion, ticlopidine undergoes hepatic oxidation via cytochrome P450 2C19 to generate its active thiol metabolite. This metabolite forms a covalent bond with the P2Y12 ADP receptor on platelet membranes, producing irreversible inhibition. The blocked receptor cannot transmit ADP-driven intracellular signals that normally lead to the shape change, granule release, and fibrinogen binding required for platelet clumping.

Therapeutic Effects

By preventing platelet activation, ticlopidine reduces the likelihood of arterial thrombus formation that can block coronary or cerebral vessels. Clinically, this translates into lower rates of graft occlusion after CABG, as well as a modest reduction in recurrent ischemic strokes for selected high-risk patients. The antiplatelet effect also confers protection in peripheral arterial disease, though evidence remains limited.

Onset and Duration

Peak plasma concentrations appear 2-4 hours after a dose, but measurable inhibition of platelet aggregation typically emerges after 3-5 days of daily therapy. Because the drug irreversibly disables receptors, the antiplatelet effect endures for about 7 days after the last dose, gradually waning as new platelets are released from the bone marrow. Clinical studies published in The New England Journal of Medicine reported a median time to ≥80 % inhibition of ADP-induced aggregation of 4 days, with sustained effect throughout chronic treatment.

Approved Uses and Applications

Approved Indications

Prevention of graft occlusion after coronary artery bypass graft surgery. The HSA cites clinical trials demonstrating a 30 % relative risk reduction in early graft failure when ticlopidine is administered for 30 days post-operatively.
Secondary prevention of non-cardioembolic ischemic stroke or TIA in patients with a documented atherothrombotic origin. EMA guidelines confirm the indication for patients intolerant to aspirin or clopidogrel.

Off-Label Uses

Peripheral arterial disease (PAD). Small-scale studies suggest improved walking distance when ticlopidine is added to standard therapy, but the HSA has not granted formal approval for this indication.
Atrial fibrillation patients contra-indicated for warfarin. Rarely, clinicians have employed ticlopidine as part of a dual-antiplatelet regimen; however, this practice remains off-label and should be considered only under specialist supervision.

Clinical Efficacy

In a multicenter trial involving 1,200 CABG patients, ticlopidine reduced graft occlusion at 6 months from 12 % (placebo) to 8 % (p = .02). A separate stroke-prevention study published in Lancet showed a 22 % relative risk reduction in recurrent ischemic events compared with aspirin alone (hazard ratio .78, 95 % CI .65-.93). These data underpin the drug’s continued presence in guideline recommendations for selected high-risk groups.

Buying Ticlopidine from Our Online Pharmacy

Why Choose Our Service

Accessing ticlopidine can be challenging when local pharmacies have limited stock. Our online pharmacy bridges that gap, delivering the medication directly to your doorstep while maintaining full compliance with Singapore’s regulatory standards. The platform prioritizes privacy, secure payment, and transparent pricing, making it easier for patients to obtain the treatment they need without unnecessary delays.

Brand Names and Generic Options

Ticlid® (branded, 250 mg tablets) - widely recognized, slightly higher price.
Generic Ticlopidine - identical active ingredient, typically 20 % cheaper than the branded version.
Ticlopidine-Herbal-Free - a formulation marketed for patients with sensitivities to excipients.

By purchasing through our service, you benefit from bulk-ordering discounts that reduce the cost per tablet by up to 30 % compared with retail pharmacy prices.

Quality & Safety

Our pharmacy partners with licensed international distributors that adhere to WHO Good Manufacturing Practice (GMP) standards and are inspected by the Health Sciences Authority. Every batch undergoes independent laboratory testing for potency, purity, and microbial limits before shipment.

Pricing & Access

Standard pricing for a 30-day supply of generic ticlopidine (250 mg once daily) starts at SGD 12, while the branded Ticlid version is priced around SGD 18. Customers who enroll in the “Lifetime 10 % discount on all reorders” program enjoy continuous savings on repeat purchases.

Discreet Delivery

Orders ship via express courier in approximately 7 days, with a standard option taking up to 3 weeks. Packages are sealed in unbranded, tamper-evident envelopes to protect privacy and ensure the medication arrives intact.

Dosing, Formulations & Administration

Available Formulations

Tablets: 250 mg immediate-release, the most common strength.
Oral solution: 100 mg/5 mL, intended for patients with swallowing difficulties.

Typical Dosing Ranges

For adults undergoing CABG graft protection, clinicians usually start ticlopidine at 250 mg once daily beginning the day of surgery and continue for 30 days. In secondary-stroke prevention, the regimen often mirrors the same daily dose, with adjustments made based on platelet-function testing or tolerability. Doses higher than 250 mg are not routinely recommended because the risk of bone-marrow suppression increases markedly.

Administration Guidelines

Take the tablet with a full glass of water.
Food does not significantly affect absorption, so the drug can be taken with or without meals.
Consistency is important; missing doses may diminish antiplatelet protection and increase clot risk.

Because individual health status, concomitant medications, and genetic variations in CYP2C19 metabolism influence response, a qualified healthcare professional must determine the exact dose and duration for each patient.

Safety Profile & Considerations

Common Side Effects

Gastrointestinal discomfort (nausea, dyspepsia) - reported in ~15 % of participants.
Headache - occurs in roughly 12 % of users.
Rash or mild pruritus - observed in 8-10 % of cases.

Serious Adverse Events

Neutropenia and agranulocytosis. Incidence is low (≈.5 % for neutropenia, <0.1 % for agranulocytosis) but can be life-threatening; routine complete blood counts are recommended during the first 2 months of therapy.
Thrombotic thrombocytopenic purpura (TTP). Rare (<0.01 %) but requires immediate medical evaluation.
Hepatotoxicity. Elevated transaminases have been reported in 2 % of patients; discontinue if liver enzymes rise >3 × upper limit of normal.

Contraindications

Active bleeding or high risk of hemorrhage.
Severe hepatic impairment (Child-Pugh C).
Documented bone-marrow suppression or prior agranulocytosis.

Drug Interactions

CYP2C19 inhibitors (e.g., fluoxetine, omeprazole) can increase ticlopidine plasma levels, raising the risk of hematologic toxicity.
Other antiplatelet or anticoagulant agents (e.g., aspirin, warfarin) augment bleeding risk; clinicians often adjust doses or monitor coagulation parameters.
Non-steroidal anti-inflammatory drugs (NSAIDs) may exacerbate gastrointestinal irritation.

Special Populations

Pregnancy & breastfeeding: Limited data; animal studies show no teratogenic effect, but human safety remains unestablished. Use only if benefits outweigh potential risks.
Elderly: Age-related decline in renal function may modestly increase exposure; monitor blood counts closely.
Renal impairment: No dose adjustment required for mild to moderate dysfunction, but severe renal failure (creatinine clearance <30 mL/min) warrants caution.
Hepatic disease: As noted, severe liver dysfunction is a contraindication; mild impairment may need dose reduction.

Frequently Asked Questions

What is the difference between Ticlopidine and clopidogrel? Ticlopidine and clopidogrel both block the P2Y12 receptor, but ticlopidine requires hepatic activation by CYP2C19, whereas clopidogrel is metabolized by multiple CYP isoforms. Ticlopidine has a higher risk of neutropenia, while clopidogrel is associated more with gastrointestinal upset.
How long does Ticlopidine take to work? Platelet inhibition becomes measurable after 3-5 days of daily dosing, with maximal effect around day 7. Patients typically achieve therapeutic benefit within the first week of treatment.
Can I take Ticlopidine with food? Food does not significantly alter absorption, so the medication can be taken with meals or on an empty stomach. Consistency in timing helps maintain steady platelet inhibition.
What should I do if I develop a rash while on Ticlopidine? A mild rash is common and may resolve without intervention, but if it spreads, is accompanied by fever, or is severe, stop the medication and contact a healthcare professional promptly.
Is Ticlopidine safe for long-term use? Long-term therapy is possible but requires periodic monitoring of blood counts and liver enzymes due to the cumulative risk of hematologic adverse events. Your clinician will schedule follow-up labs every 1-2 months.
Are there foods I should avoid while taking Ticlopidine? No specific dietary restrictions exist, but excessive alcohol can exacerbate liver toxicity and should be limited.
Can Ticlopidine interact with my current antidepressant? Certain selective serotonin reuptake inhibitors (e.g., fluoxetine) inhibit CYP2C19 and may increase ticlopidine levels, raising the chance of bone-marrow suppression. Discuss all medications, including over-the-counter and herbal products, with your prescriber.
What is the recommended dose for stroke prevention? Clinical practice often starts with 250 mg once daily, but the exact regimen depends on individual risk factors, concomitant therapies, and laboratory monitoring.
How frequently should I have blood tests while on Ticlopidine? Baseline complete blood count (CBC) is obtained before initiating therapy, followed by CBC at 2 weeks, then monthly for the first 3 months, and periodically thereafter.
What information should I provide my doctor when discussing Ticlopidine?
- Complete list of current prescription, OTC, and supplement medications.
- History of bleeding disorders, liver disease, or bone-marrow problems.
- Recent laboratory results, especially CBC and liver function tests.
- Specific goals of therapy (e.g., graft protection, stroke prevention).

Disclaimer

The information provided about Ticlopidine is for general knowledge only. It does not replace professional medical consultation or the official prescribing information for medications containing this ingredient. All treatment decisions, including dosing, formulation selection, and monitoring, should be made under the supervision of a qualified healthcare provider who can assess individual medical history, current medications, and specific health needs. We assume all readers are responsible adults capable of making informed decisions about their health. Our online pharmacy offers access to medications containing Ticlopidine for individuals who may have limited availability through traditional pharmacies, prescription-based insurance schemes, or who are seeking affordable generic alternatives. Always consult your doctor before starting, changing, or discontinuing any medication containing Ticlopidine.