the product in the database has an inactive status
indications:
Reduction of the risk of ischemic stroke in patients after an episode of cerebral ischemia (ischemic stroke, transient ischemic attack (TIA)). Prevention of severe ischemic events, especially in the coronary arteries, in patients with obliterative atherosclerosis of the lower limbs in the intermittent claudication. Prevention of arteriovenathic fistula closure in patients undergoing hemodialysis. The drug should be used in patients with hypersensitivity to acetylsalicylic acid.
The drug inhibits platelet aggregation, prevents the formation of blood clots in the blood vessels, prolongs the bleeding time. The mechanism of action is to inhibit the ADP-dependent binding of fibrinogen to the platelet cell membrane. Ticlopidine does not inhibit cyclooxygenase. The antaggregative effect occurs within 2 days of the start of therapy, the maximum effect occurs after 5-8 days. After oral administration, it is rapidly absorbed from the gastrointestinal tract, almost 100%. The maximum concentration in the blood occurs approximately 2 hours after administration. The bioavailability of the drug is optimal when used immediately after a meal. Steady-state levels are achieved after 7-10 days of administration of 250 mg twice daily. Medium T0,5 at steady state is 30-50 h. The drug is metabolised in the liver. In 50-60% it is excreted in the urine, in 23-30% - with faeces.
Contraindications:
Hypersensitivity to ticlopidine or other ingredients of the preparation. Hemorrhagic diathesis. Diseases with an increased risk of bleeding, e.g. active gastric and / or duodenal ulcer or haemorrhagic cerebrovascular events in the acute phase. Disorders of hematopoietic system manifested by prolonged bleeding time. Leukopenia, thrombocytopenia or agranulocytosis. Children.
Precautions:
If neutropenia occurs during treatment (neutrophil count below 1500 / mm3) or thrombocytopenia (platelet count less than 100,000 / mm3) the drug should be discontinued. Special care should be taken in patients with an increased risk of bleeding; Do not use the product with medicines that increase the risk of hemorrhage, and if necessary, carefully monitor the patient. Administration of the drug should be discontinued at least 10 days before the planned surgery. In patients who undergo emergency surgery to reduce the risk of bleeding, 0.5-1 mg / kg may be used. methylprednisolone intravenously (administration may be repeated) or desmopressin 0.2-0.4 μg / kg. or roll the plate mass. The preparation should be used with caution in patients with hepatic impairment; in the event of hepatitis and / or jaundice, treatment should be discontinued.
Pregnancy and lactation:
The drug should not be used during pregnancy and breastfeeding, except when absolutely necessary.
Side effects:
Very common: diarrhea (mainly in the first 3 months of treatment), nausea. Common: neutropenia - 2.4%, including 0.8% - severe neutropenia (most cases of neutropenia or agranulocytosis occur in the first 3 months of using the drug), haemorrhagic complications (bruises, ecchymosis, epistaxis, intraoperative and postoperative bleeding), increase in liver enzymes, rash (especially maculopapular) or urticaria, pruritus (rash usually occurs in the first 3 months of treatment, on average after 11 days). Uncommon: isolated thrombocytopenia (<80,000 / mm3). Rare: bone marrow or pancytopenia, thrombotic thrombocytopenic purpura, thrombocytopenia with haemolytic anemia, hepatitis (cytolytic and cholestatic) during the first months of treatment (very rare cases with fatal outcome have been described). Very rare: severe diarrhea with colitis (including lymphocytic colitis), erythema multiforme, Stevens-Johnson syndrome, Lyell's syndrome, fever, immune reactions (allergic reactions, anaphylaxis, Quincke's edema, arthritis, vasculitis, lupus erythematosus) kidney, allergic changes in the lungs, eosinophilia). A slight increase in bilirubin may occur during treatment. During long-term therapy, there may be an increase in serum cholesterol and triglycerides - by 8-10% after 1-4 months.treatment; if continuation of treatment, no further increase in lipid concentration was observed; these changes do not affect the risk of cardiovascular complications. There have been cases of fulminant hepatitis.
Dosage:
Orally. Adults: 1 tabl. (250 mg) 2 times a day during a meal.
(C)
