10 known interactions • 4 major • 4 moderate • 2 minor
Always disclose all medications to your healthcare providers — prescription medicines, OTC medications, vitamins, and herbal supplements. This list may not include every possible interaction. Use our Medicine Interaction Checker to screen your complete medication list.
Potentially life-threatening or causing permanent damage. Avoid combination.
May worsen condition or require dose adjustment. Monitor closely.
Usually limited clinical effect. Manage with routine monitoring.
Aspirin
Ticlopidine potentiates the antiplatelet effect of aspirin on ADP-induced platelet aggregation, substantially increasing bleeding risk. Long-term concurrent use is generally not recommended except in the specific 30-day coronary stent indication where the combination is intended.
Warfarin
Combining ticlopidine with oral anticoagulants markedly increases the risk of serious and potentially life-threatening bleeding. Concomitant use should be avoided, and warfarin should generally be discontinued before starting ticlopidine.
Heparin
Co-administration with heparin compounds the risk of hemorrhage through additive effects on hemostasis; combined use requires careful risk-benefit assessment and close monitoring.
Clopidogrel
Both are thienopyridine P2Y12 inhibitors with overlapping mechanisms; using them together provides no additional benefit and significantly increases bleeding risk. They should not be combined.
Ibuprofen
NSAIDs add their own platelet-inhibiting and gastric-irritant effects to those of ticlopidine, increasing the risk of gastrointestinal and other bleeding.
Cimetidine
Chronic cimetidine reduces the clearance of a single dose of ticlopidine by about 50%, raising ticlopidine plasma concentrations and the potential for toxicity.
Theophylline
Ticlopidine reduces theophylline clearance and prolongs its elimination half-life (from roughly 8.6 to 12.2 hours), increasing the risk of theophylline toxicity; theophylline levels should be monitored and the dose adjusted.
Phenytoin
Case reports describe elevated phenytoin levels and toxicity (lethargy, confusion) when given with ticlopidine, likely through inhibition of phenytoin metabolism; monitor phenytoin concentrations.
Digoxin
Co-administration slightly decreases digoxin plasma levels (by about 15%), which is rarely clinically significant but may warrant attention in patients near the lower edge of the therapeutic range.
Antacids
Aluminum/magnesium antacids decrease ticlopidine plasma levels by about 18%; separating administration can avoid this modest reduction in absorption.
Always ask your pharmacist about potential interactions with food, alcohol, and supplements specific to Ticlopidine. Some medicines have significant interactions with grapefruit juice, high-fat meals, dairy products, or vitamin K-rich foods.