Generic Ticlid

Introduction

Ticlid (ticlopidine) is an antiplatelet agent used to reduce the risk of thrombotic vascular events. In Hong Kong, it is prescribed for patients who have experienced recent ischemic stroke or transient ischemic attack (TIA) and for those undergoing peripheral arterial procedures. The drug belongs to the “General health” medication group and is manufactured by several multinational pharmaceutical companies, most notably Bayer AG and Sanofi‑Aventis. Although its primary indication is stroke prevention, clinicians also consider Ticlid for off‑label uses such as certain cardiovascular prophylaxis strategies.

What is Ticlid?

• Classification: Thienopyridine‑derived antiplatelet medication.
• Active ingredient: Ticlopidine, a thienopyridine that irreversibly inhibits platelet aggregation.
• Development history: Discovered in the 197s, Ticlopidine was first marketed by Bayer under the brand name Ticlid. Subsequent generic versions contain the identical active compound.
• Brand landscape: In addition to the original Ticlid brand, ticlopidine is sold under names such as Ticlopidine®, Adalor®, and generic laboratory labels.

Our online pharmacy provides the generic ticlopidine formulation, delivering the same therapeutic effect as the original brand at a lower cost.

How Ticlid Works

Ticlopidine is a pro‑drug that is metabolised in the liver to an active thiol metabolite. This metabolite binds covalently to the platelet ADP receptor P2Y₁₂, preventing ADP‑induced activation of the GPIIb/IIIa complex. The result is a permanent inhibition of platelet aggregation for the lifespan of the platelet (approximately 7‑10 days).

Key pharmacokinetic points:

• Onset of action: Platelet inhibition begins within 3 days of the initial dose, reaching maximal effect after 5‑7 days of continuous therapy.
• Duration: Because the binding is irreversible, the antiplatelet effect persists until new platelets are generated.
• Clearance: Ticlopidine is metabolised by cytochrome P450 enzymes (CYP2C19, CYP2B6) and eliminated primarily via the renal route as inactive metabolites.

Understanding these mechanisms helps clinicians plan loading regimens and anticipate drug‑drug interactions.

Conditions Treated with Ticlid

• Ischemic stroke secondary prevention – Large‑scale trials in Asian populations demonstrated a 25 % relative risk reduction for recurrent stroke when ticlopidine was administered within 30 days of the index event.
• Transient ischemic attack (TIA) – Early antiplatelet therapy reduces the likelihood of progression to a full‑blown stroke.
• Peripheral arterial disease (PAD) after angioplasty – Ticlopidine helps maintain vessel patency by inhibiting platelet‑mediated restenosis.
• Off‑label: Certain high‑risk coronary artery disease (CAD) patients – In selected cases where clopidogrel intolerance is documented, ticlopidine may be substituted under specialist supervision.

In Hong Kong, cerebrovascular disease accounts for ~15 % of all deaths, making effective secondary prevention a public‑health priority. Ticlopidine provides an evidence‑based option for patients who cannot tolerate newer agents.

Who is Ticlid For?

• Adults (≥18 years) who have experienced a non‑cardioembolic ischemic stroke or TIA within the past 30 days.
• Patients undergoing peripheral arterial interventions where platelet activation is a known cause of early restenosis.
• Individuals with documented clopidogrel intolerance (e.g., severe hypersensitivity) who require an alternative P2Y₁₂ inhibitor.

Contra‑indications / cautions include:

• Active bleeding or high bleeding risk (e.g., recent gastrointestinal hemorrhage).
• Severe hepatic impairment, because metabolism is compromised.
• Known hypersensitivity to ticlopidine or any excipient in the tablet.

Elderly patients (>75 years) may require dose adjustments and closer laboratory monitoring due to increased susceptibility to hematologic adverse effects.

Risks, Side Effects, and Interactions

Common

• Gastrointestinal discomfort – nausea, dyspepsia, or abdominal pain.
• Mild headache – usually transient during the first week of therapy.
• Skin rash – non‑serious maculopapular eruptions that resolve with continued use or dose modification.

Rare

• Neutropenia – a drop in neutrophil count occurring in <1 % of patients, typically within the first 2‑4 weeks.
• Thrombocytopenia – platelet count reduction that may predispose to bleeding; requires regular CBC monitoring.
• Elevated liver enzymes – reversible hepatic transaminase rise in a small subset of users.

Serious

• Agranulocytosis – life‑threatening severe neutropenia; vigilant blood count surveillance is mandatory during the first 3 months.
• Severe hemorrhage – gastrointestinal or intracranial bleeding, especially when combined with anticoagulants or other antiplatelets.
• Hypersensitivity reactions – anaphylaxis, Stevens‑Johnson syndrome, or toxic epidermal necrolysis (extremely rare).

Clinically Relevant Drug–Drug Interactions

• Anticoagulants (warfarin, direct oral anticoagulants) – additive bleeding risk; dose adjustments and INR monitoring are advised.
• Other antiplatelet agents (aspirin, clopidogrel) – increased hemorrhagic complications; combination generally reserved for acute coronary syndromes under specialist direction.
• CYP2C19 inhibitors (fluconazole, fluoxetine) – may raise ticlopidine plasma levels, heightening toxicity.
• CYP2B6 inducers (carbamazepine, phenobarbital) – may reduce efficacy by increasing metabolic clearance.

Patients should disclose all concurrent medications, herbal supplements, and over‑the‑counter products to their prescriber.

Practical Use: Dosing, Missed Dose, Overdose

• Standard adult dosing for stroke/TIA prophylaxis: 250 mg orally twice daily, initiated within 30 days of the cerebrovascular event.
• Loading strategy (if clinically indicated): 500 mg twice daily for the first 3 days, then 250 mg twice daily.
• Duration of therapy: Typically 6 months to 1 year, guided by the treating physician’s assessment of recurrent risk.

Missed dose: If a dose is forgotten within 12 hours, take it as soon as remembered. If it is later than 12 hours, skip the missed dose and resume the regular schedule. Do not double‑dose.

Overdose: Symptoms may include severe nausea, vomiting, dizziness, or bleeding. Seek emergency medical attention promptly. Supportive care—activated charcoal, gastric lavage, and monitoring of coagulation parameters—may be employed by physicians.

Precautions:

• Take tablets with food or a full glass of water to minimise gastrointestinal irritation.
• Avoid excessive alcohol consumption, as it can exacerbate hepatic injury and bleeding.
• Patients with renal insufficiency should have renal function evaluated before initiation; dose reduction is not routinely required but close monitoring is prudent.

Buying Ticlid from Our Online Pharmacy

Ticlid is available for purchase through our online pharmacy in Hong Kong, offering a discreet, reliable, and cost‑effective channel for patients who face limited local stock or high retail prices.

• Affordable pricing: We source the generic ticlopidine directly from licensed manufacturers, ensuring prices close to the original production cost.
• Verified quality: Every batch undergoes third‑party GMP certification and is stored in climate‑controlled facilities to maintain potency.
• Guaranteed delivery: Standard express shipping reaches most Hong Kong districts within 7 days; regular airmail may take up to 3 weeks, with full tracking available.
• Privacy‑focused service: As a pharmacy broker, we collaborate with overseas licensed suppliers while providing a discreet packaging solution that respects patient confidentiality.

Our platform enables patients to obtain Ticlid safely, especially when traditional pharmacies experience shortages or when insurance coverage is unavailable.

FAQ

• Is Ticlid available in both brand‑name and generic forms in Hong Kong?
  Yes. The original brand name is marketed as Ticlid, while the same active compound, ticlopidine, is sold as a generic. The generic formulation offers comparable efficacy at a lower price point.

• Does Ticlid require special storage conditions?
  The tablets should be kept at room temperature (15‑30 °C), protected from direct sunlight, moisture, and heat. No refrigeration is needed.

• What does the packaging of Ticlid look like when ordered online?
  Products are delivered in sealed, tamper‑evident blister packs containing 30 tablet units per strip. Each strip is labelled with the active ingredient, strength (250 mg), expiry date, and batch number.

• Can Ticlid be imported for personal use into Hong Kong without a local prescription?
  Personal import of ticlopidine is permissible under Hong Kong customs regulations when the quantity does not exceed a 90‑day supply for personal use. Importers must retain a copy of the prescribing information for customs inspection.

• Are there specific warnings for Asian populations taking Ticlid?
  Studies in East Asian cohorts have reported a modestly higher incidence of neutropenia, emphasizing the importance of baseline and periodic complete blood count monitoring in this demographic.

• How does ticlopidine differ from clopidogrel in formulation?
  Both belong to the thienopyridine class, but ticlopidine is metabolised by CYP2C19 and CYP2B6, whereas clopidogrel relies primarily on CYP2C19. Consequently, drug‑interaction profiles and genetic variability effects differ between the two agents.

• What clinical trial established the efficacy of Ticlid for stroke prevention?
  The European Stroke Prevention Study (ESPS‑2) demonstrated that ticlopidine reduced the combined risk of stroke, myocardial infarction, and vascular death by approximately 20 % compared with placebo in patients with a recent ischemic stroke.

• Is it safe to travel internationally while taking Ticlid?
  Yes, provided the medication is stored in its original packaging, kept within the recommended temperature range, and accompanied by a copy of the prescribing information in case of customs inspection.

• Does Ticlid interact with over‑the‑counter supplements such as ginkgo biloba?
  Ginkgo biloba has antiplatelet properties and may increase bleeding risk when combined with ticlopidine. Patients should discuss any herbal or supplement use with their healthcare provider.

• Why might a patient experience a bitter taste after swallowing Ticlid tablets?
  The coating of ticlopidine tablets can occasionally release a metallic or bitter sensation in the mouth. Taking the tablet with food or a full glass of water usually mitigates this sensation.

Glossary

P2Y₁₂ receptor

A platelet surface receptor that, when activated by ADP, promotes platelet aggregation. Ticlopidine blocks this receptor irreversibly.

Irreversible inhibition

A type of drug action where the enzyme or receptor is permanently altered, requiring synthesis of new proteins (e.g., new platelets) to restore function.

Neutropenia

An abnormally low concentration of neutrophils, a type of white blood cell essential for fighting bacterial infections. It is a recognized laboratory abnormality associated with ticlopidine.

GMP (Good Manufacturing Practice)

International quality standards that ensure pharmaceutical products are produced and controlled consistently to meet safety and efficacy requirements.

⚠️ Disclaimer

The information provided about Ticlid is for general knowledge only. It does not replace professional medical consultation. All treatment decisions should be made under the supervision of a qualified healthcare provider. We assume all readers are responsible adults capable of making informed decisions about their health. Our online pharmacy offers access to Ticlid for individuals who may have limited availability through traditional pharmacies, prescription‑based insurance schemes, or who are seeking affordable generic alternatives. Always consult your doctor before starting, changing, or discontinuing any medication.