Reduction of risk of thrombotic stroke in patients who have experienced stroke precursors and in patients who have had completed thrombotic stroke.
Reserved for patients intolerant to aspirin because of greater risk of adverse reactions.
Improved walking distance in intermittent claudication; vascular improvement in chronic arterial occlusion; reduced incidence of neurologic deficit in subarachnoid hemorrhage; reduced incidence of vascular occlusion in uremic patients with arteriovenous shunts or fistulas; control of platelet count in open heart surgery; decreased graft occlusion in coronary artery bypass grafts; reduced degree of proteinuria and hematuria in primary glomerulonephritis; reduced incidence, duration, and severity of infarctive crises in sickle cell disease.
Produces time- and dose-dependent inhibition of both platelet aggregation and release of platelet granule constituents as well as prolongation of bleeding time; interferes with platelet membrane function by inhibiting platelet-fibrinogen binding and subsequent platelet-platelet interactions.
Presence of hematopoietic disorders (eg, neutropenia, thrombocytopenia); history of thrombotic thrombocytopenic purpura (TTP); presence of hemostatic disorder or active pathologic bleeding (eg, bleeding, peptic ulcer, intracranial bleeding, hemophilia, other coagulation defects); severe liver impairment.
Life-threatening events including neutropenia, agranulocytosis, thrombotic thrombocytopenic purpura (TTP), and aplastic anemia. Severe hematological problems may occur within a few days after the start of therapy. Thus, monitor hematologically and clinically. Immediately discontinue therapy at any evidence of neutropenia or TTP. TTP incidence peaks at 3 to 4 wk posttherapy initiation. Neutropenia risk peaks at 4 to 6 wk posttherapy initiation. Aplastic anemia risk peaks at 4 to 8 wk posttherapy initiation. Perform CBC with ANC, platelet count, and appearance of the peripheral smear at baseline and every 2 wk during therapy for the first 3 month.