Ticlopidine contraindications

The following patient categories were excluded from the study patients with ostial and bifurcation lesions, left ventricular ejection fraction <30%, known hypersensitivity or contraindication to aspirin or stainless steel, or a sensitivity to contrast dye, allergy to heparin or ticlopidine,... 

Antiplatelet therapy plays a key role in the treatment of ACS, such as Ml. Aspirin has been shown to decrease overall mortality and reinfarction and is recommended for all patients in this setting unless contraindicated. Aspirin should be given at the lowest effective dose, to ensure efficacy and to limit adverse reactions. If aspirin is contraindicated or not tolerated, thienopyridines (clopidogrel or ticlopidine) may be used. Comparisons of oral antiplatelet agents are summarized in Thumbnail. 

More recently, Tran and Anand conducted a systematic review of the literature in an effort to summarize the best evidence for oral antiplatelet therapy in patients with cerebrovascular disease, CAD, and PAD. This review included 111 trials (42 of which included patients with PAD, n = 9214) and concluded that patients with PAD should use ASA (160 to 325 mg/day) or clopidogrel (75 mg/day) when ASA is not tolerated or contraindicated. This is in concordance with the recommendations of the Seventh American College of Chest Physicians (ACCP) Conference on Antithrombotic and Thrombolytic Therapy which recommends lifelong ASA (75 to 325 mg/day) over clopidogrel, ticlopidine, and no antithrombotic therapy in patients with PAD. Unfortunately, no data are currently avaUable from large, clinical, randomized trials that ASA, or any other antiplatelet therapies, can actually prevent or delay the progression of PAD. ... 

Caution must be employed when eptifibatide is used with other drugs that affect haemostasis, including clopidogrel, ticlopidine, dipyridamole, oral anticoagulants or thrombolytics and concurrent or planned use of another glycoprotein Ilb/IIIa inhibitor is contraindicated. ... 

Are there contraindications to concomitant drug use For instance, tizanidine is contraindicated in patients with concomitant use of CYP450 1A2 inhibitors such as fluvoxamine, amiodarone, mexiletine, propafenone, cimetidine, fluoroquinolones (ciprofloxacin, norfloxacin), rofecoxib, oral contraceptives, and ticlopidine [27]. 

---