Ticlopidine Methylprednisolone

Prolonged bleeding time is normalized within 2 hours after administration of 20 mg methylprednisolone IV. Platelet transfusions also may be used to reverse the effect of ticlopidine on bleeding. If possible, avoid platelet transfusions because they may accelerate thrombosis in patients with TTP on ticlopidine. 

Clinically important, potentially hazardous interactions with amprenavir, aprepitant, bedomethasone, buprenorphine, calcium, chloramphenicol, cimetidine, dobazam, clorazepate, cyclosporine, cyproterone, darunavir, dasatinib, delavirdine, dexamethasone, diazoxide, disulfiram, dopamine, fesoterodine, fluconazole, flunisolide, fluoxetine, fosamprenavir, ginkgo biloba, hydrocortisone, imatinib, indinavir, influenza vaccines, isoniazid, isradipine, itraconazole, lacosamide, lapatinib, lopinavir, meperidine, methylprednisolone, midazolam, mivacurium, nelfinavir, nilotinib, nilutamide, phenylbutazone, piracetam, posaconazole, prednisolone, prednisone, primrose, ritonavir, rivaroxaban, sage, saquinavir, solifenacin, St John s wort, sucralfate, telithromycin, temsirolimus, teniposide, ticlopidine, tizanidine, tolvaptan, triamcinolone, uracil/tegafur, vigabatrin... 

Ticlopidine-induced increases in bleeding times are opposed by methylprednisolone and prednisolone but its effects on platelet function are not affected. Ticlopidine decreases the clearance of phenazone (antipyrine), which suggests that it has mild enzyme-inhibiting effects. Beta blockers, calcium-channel blockers and diuretics are reported not to interact with ticlopidine. 

A study involving 14 healthy subjects found that a single 20-mg intravenous injection of methylprednisolone or oral prednisolone 15 mg twice daily for 7 days decreased the prolongation of bleeding times caused by ticlopidine 250 to 500 mg twice daily for 7 days. However, the antiplatelet effects of ticlopidine were not affected. The clinical importance of this interaction is uncertain. 

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