Drug General Information (ID: DDIC3TMW60)
Drug Name			Anistreplase		Drug Info		Ticlopidine		Drug Info
Drug Type		Protein/peptide				Small molecule
Therapeutic Class		Thrombolytics				Fibrinolytic Agents

Mechanism of Anistreplase-Ticlopidine Interaction (Severity Level: Moderate)
Increased risk of bleeding Click to Show/Hide Mechanism Graph
Drug Name		Anistreplase				Ticlopidine
Mechanism		Risk of bleeding Thrombolytic agent				Risk of bleeding Antiplatelet
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 Anistreplase and Ticlopidine

Recommended Action
Management		Careful monitoring for signs of bleeding, particularly at arterial puncture wounds, is recommended when thrombolytics are used concurrently or sequentially with antiplatelet agents other than aspirin. Some authorities recommend avoiding the initiation of platelet aggregation inhibitors within the first 24 hours following thrombolysis treatment.

References
1	Harder S, Klinkhardt U "Thrombolytics: drug interactions of clinical significance." Drug Saf 23 (2000): 391-9. [PMID: 11085346]
2	Product Information. Abbokinase (urokinase). Abbott Pharmaceutical, Abbott Park, IL.
3	Product Information. TNKase (tenecteplase) Genentech, South San Francisco, CA.