Drug interactions
Clopidogrel + Ticlopidine
Severity: Major
Clopidogrel 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
Both are thienopyridine antiplatelets, so combined use adds bleeding risk without clear benefit. Ticlopidine also inhibits CYP2C19 and may reduce clopidogrel activation, making the net effect unpredictable.
What this interaction means in plain words
Clopidogrel 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.
Clopidogrel belongs to Cardiovascular; Ticlopidine belongs to Cardiovascular.
Why it happens
Duplicate P2Y12 antagonism with additive bleeding risk, and CYP2C19 inhibition by ticlopidine reducing clopidogrel activation.
What to do
Avoid using the two together; use only one thienopyridine. Monitor for bleeding and hematologic toxicity if overlap occurs during a switch.
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 Clopidogrel
Other interactions of Ticlopidine
Frequently asked questions
Can I take Clopidogrel with Ticlopidine?
MediHelp rates the interaction as major. Clopidogrel 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. Both are thienopyridine antiplatelets, so combined use adds bleeding risk without clear benefit. Ticlopidine also inhibits CYP2C19 and may reduce clopidogrel activation, making the net effect unpredictable.
How serious is the interaction between Clopidogrel 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: Avoid using the two together; use only one thienopyridine. Monitor for bleeding and hematologic toxicity if overlap occurs during a switch.
What other medicines interact with Clopidogrel?
MediHelp also lists interactions of Clopidogrel with, for example, Ombitasvir / paritaprevir / ritonavir and dasabuvir, Abrocitinib, Acetylsalicylic acid. The full list is on the Clopidogrel page.
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