Drug General Information (ID: DDI57BC8HI)
Drug Name			Ticlopidine		Drug Info		Tolmetin		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Fibrinolytic Agents				Antiinflammatory Agents
Structure

Mechanism of Ticlopidine-Tolmetin Interaction (Severity Level: Moderate)
Increased risk of bleeding Click to Show/Hide Mechanism Graph
Drug Name		Ticlopidine				Tolmetin
Mechanism		Risk of bleeding Antiplatelet				Risk of bleeding Antiplatelet effects
Key Mechanism Factor 1
		Factor Name		Bleeding
		Factor Description		Patients may be at risk for bleeding when the outcome of a disease or disease treatment confounds the standard mechanisms for maintaining hemostasis. Signs or symptoms of abnormal bleeding include: bleeding that takes a long time to stop (including nosebleeds, bleeding gums, bleeding from cuts and abrasions, and menstrual bleeding); severe unexplained bruising, or bruising that becomes larger; blood in the urine or stool, etc.
Mechanism Description		Increased risk of bleeding by the combination of Ticlopidine and Tolmetin

Recommended Action
Management		Patients should be monitored for signs and symptoms of bleeding, especially GI bleeding, if NSAIDs and ticlopidine are coadministered. They should be advised to promptly report any signs of bleeding to their physician, including abdominal pain, vomiting blood, red or black stools, swelling, headache, dizziness, weakness, prolonged bleeding from cuts, nosebleeds, bleeding of gums from brushing, red or brown urine, or other unusual bleeding or bruising. Patients should also be counseled to avoid any other over-the-counter NSAID products.

References
1	Product Information. Ticlid (ticlopidine). Syntex Laboratories Inc, Palo Alto, CA.