ticlopidine induced neutropenia

• A case reported in April 1995 stating that a woman developed neutropenia (ANC 0.1 X 10⁹/l) two months after treatment with ticlopidine 250mg BD. 
• in March 1994, a patient developed neutropenia (ANC 0.04 X 10⁹/l) one month after started ticlopidine 250mg BD. 
• Another women developed neutropenia (ANC 0.112 X 10⁹/l) 6 weeks after ticlopidine 250mg once daily dose. 
• One final case happened on a man where neutropenia happened 7 weeks after the initiation of ticlopidine 250mg BD. 

Recommendation: 

• To summarize, ticlopidine-induced thrombocytopenia is estimated to occur within the first 3 months after initiation. Delayed onset of ticlopidine also been reported. 
• Therefore, haematological parameters should be monitored every other week for the first three months of ticlopidine therapy. 
• After withdrawal of Ticlopidine, the neutrophil count usually rises to >1200/mm3 within 1 to 3 weeks.

References:

1. http://pmj.bmj.com/content/74/868/126.full.pdf
2. http://www.jmedicalcasereports.com/content/4/1/269
3. http://www.drugs.com/sfx/ticlopidine-side-effects.html