Drug interactions
Acetylsalicylic acid + Ticlopidine
Severity: Major
Acetylsalicylic acid and Ticlopidine: major interaction.
Last updated Sources: UK SmPC
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Combining aspirin with ticlopidine increases the risk of bleeding because both impair platelet function through different pathways. The pair is sometimes used deliberately, for example after coronary stenting, but ticlopidine carries additional hematologic toxicity and has largely been replaced by other agents.
What this interaction means in plain words
Acetylsalicylic acid and Ticlopidine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Acetylsalicylic acid belongs to Musculoskeletal; Ticlopidine belongs to Cardiovascular.
Why it happens
Additive antiplatelet effects from irreversible COX-1 inhibition by aspirin and P2Y12 receptor blockade by ticlopidine.
What to do
Use only when dual antiplatelet therapy is clearly indicated, and prefer clopidogrel or another P2Y12 inhibitor instead of ticlopidine. Monitor for bleeding and follow blood counts regularly.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
Other interactions of Acetylsalicylic acid
- Acetylsalicylic acid + Ketorolac Contraindicated
- Acetylsalicylic acid + Ketorolac intranasal Contraindicated
- Abciximab + Acetylsalicylic acid Major
- Acemetacin + Acetylsalicylic acid Major
- Acetazolamide + Acetylsalicylic acid Major
- Acetylsalicylic acid + Alteplase Major
Other interactions of Ticlopidine
- Mavacamten + Ticlopidine Contraindicated
- Abrocitinib + Ticlopidine Major
- Apixaban + Ticlopidine Major
- Aspirin / citric acid / sodium bicarbonate + Ticlopidine Major
- Aspirin rectal + Ticlopidine Major
Frequently asked questions
Can I take Acetylsalicylic acid with Ticlopidine?
MediHelp rates the interaction as major. Acetylsalicylic acid and Ticlopidine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Combining aspirin with ticlopidine increases the risk of bleeding because both impair platelet function through different pathways. The pair is sometimes used deliberately, for example after coronary stenting, but ticlopidine carries additional hematologic toxicity and has largely been replaced by other agents.
How serious is the interaction between Acetylsalicylic acid and Ticlopidine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use only when dual antiplatelet therapy is clearly indicated, and prefer clopidogrel or another P2Y12 inhibitor instead of ticlopidine. Monitor for bleeding and follow blood counts regularly.
What other medicines interact with Acetylsalicylic acid?
MediHelp also lists interactions of Acetylsalicylic acid with, for example, Ketorolac, Ketorolac intranasal, Abciximab. The full list is on the Acetylsalicylic acid page.
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