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ACUTE EXPOSURE INFORMATION

  1. WITH THERAPEUTIC USE
    1. SEVERE: Life-threatening hematologic adverse events can develop suddenly within the first few days to weeks of therapy and may include neutropenia/agranulocytosis, thrombotic thrombocytopenic purpura (TTP), and aplastic anemia. The incidence of TTP usually peaks after 3 to 4 weeks of therapy, neutropenia generally peaks at 4 to 6 weeks, and aplastic anemia peaks at 4 to 8 weeks. Other hematologic events may also include bone-marrow suppression and an increased risk of bleeding including gastrointestinal bleeding. Intracerebral bleeding is rare. COMMON: Gastrointestinal symptoms including diarrhea (12.5%) nausea (7%), dyspepsia (7%), GI pain (3.7%) and vomiting (1.9%). Other clinical effects may include maculopapular or urticarial rash, cholestatic jaundice, and elevated liver enzymes. INFREQUENT: Urticaria, headache, asthenia, pain, epistaxis and tinnitus.
  1. WITH POISONING/EXPOSURE
    1. Case reports of ticlopidine overdoses are rare. Agitation, tachycardia, hypotension, hypoxia, metabolic acidosis, and bleeding were described in a 69-year-old male following an intentional ingestion of 10 grams of ticlopidine. Following a single 6 gram dose a 38-year-old developed an increased bleeding time and ALT, but no clinical symptoms developed.
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