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Pharmacologic class: Platelet adhesion inhibitor
Therapeutic class: Antiplatelet agent, diagnostic agent (coronary vasodilator)
Pregnancy risk category B
Unclear. May reduce platelet aggregation by inhibiting phosphodiesterase, adenosine uptake, or formation of thromboxane A2.
Tablets: 25 mg, 50 mg, 75 mg
Indications and dosages
➣ To prevent thromboembolism in patients with prosthetic heart valves
Adults: 75 to 100 mg P.O. q.i.d.
• Prevention of myocardial reinfarction (given with aspirin)
• Thrombotic thrombocytopenia purpura
• Hypersensitivity to drug
Use cautiously in:
• hypotension, hepatic insufficiency, severe coronary artery disease
• pregnant or breastfeeding patients
• children younger than age 12 (safety not established).
• Know that drug is usually given with warfarin when used to prevent thromboembolism.
• Give with a full glass of water at least 1 hour before or 2 hours after meals. If gastric distress occurs, give with food.
CNS: dizziness, headache
GI: abdominal distress
Hepatic: hepatic failure
Drug-drug. Adenosine: increased adenosine plasma level and CV effects
Cholinesterase inhibitors: counteracts activity of cholinesterase inhibitors
Drug-diagnostic tests. Hepatic enzymes: increased levels
Drug-behaviors. Alcohol use: increased risk of hypotension
• Monitor for therapeutic efficacy, including improved exercise tolerance and decreased need for nitrates.
• Assess platelet and coagulation studies regularly.
• Monitor ECG and vital signs, especially blood pressure.
• Monitor hepatic function tests regularly.
• Advise patient to take drug 1 hour before or 2 hours after meals for best absorption.
☞ Instruct patient to immediately report unusual tiredness, chest pain or other cardiac symptoms, upper right abdominal pain, yellowing of skin or eyes, or dark urine.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs and tests mentioned above.