The usefulness of ticlopidine in preventing re-stenosis (stent thrombosis) after percutaneous coronary intervention (PCI) is being evaluated but it has been reported that ticlopidine causes adverse effects, such as thrombotic thrombocytopenic purpure, granulocytopenia and liver failure. In July 2002, the 2 nd Emergency Safety Information Notice (Dear Dr. Letter), which gives prescribing rules and stresses the importance of blood tests, was distributed. However, since the stipulations in it have not been fully observed, in consultation with doctors, we made our own rules for patients taking ticlopidine PCI which are : 1. Ensure that blood tests are carried out during hospitalization, 2. Reduce administration period after PCI from four weeks to two weeks, 3. Have pharmacists provide information on adverse effects and drug information on ticlopidine. We investigated the number of prescription days, extent of conducting blood tests and manifestation of adverse effects at the time of discharge from hospital for before (n=27) and after (n=42) implementing the rules and compared the findings. We also investigated re-stenosis rates and from this determined whether there was any disadvantage in treatment with ticlopidine for before and after implementing the rules (n=23) and after (n=20).
As our findings, the frequency of carrying out blood tests improved and there was no significant rise in re-stenosis rates. These results suggest that there are no problems with treatment using ticlopidine. Furthermore, we consider our efforts to have ticlopidine used properly have been useful from the points of both safety and efficacy.