Based on the results of animal experiments drug overdose can cause severe gastrointestinal intolerance. Careful monitoring of the function of vital organs and hemostasis (bleeding time). In case of overdose recommended gastric lavage and the use of general supportive measures.
The interaction with other drugs
Some drugs anastrozole can interact with them through ticlopidine antiplatelet properties. This substance such as aspirin and non-steroidal anti-inflammatory drugs anastrozole men, clopidogrel, tirofiban, eptifibatide, abciximab and iloprost. The simultaneous use of several inhibiting platelet aggregation tools, as well as their combination with heparin, oral anticoagulants and thrombolytics can substantially increase the risk of bleeding, so should be subject to regular clinical and laboratory monitoring.
Combinations requiring special care:
Theophylline (base and salts) and aminophylline:
Increase in plasma theophylline levels with risk of overdosage (decrease in plasma clearance of theophylline). Clinical monitoring is required, as well as measurement of plasma levels of theophylline. The dosage of theophylline should be modified if necessary in the course of ticlopidine treatment and after its completion.
Increased phenytoin plasma levels with signs of overdose (inhibition of metabolism of phenytoin). Requires clinical monitoring and measuring plasma levels of phenytoin.
Concentrations of cyclosporin in the anastrozole men blood drop. Cyclosporin dose should increase its concentration in the control. After the abolition ticlopidine dose should be reduced.
Combined use of digoxin reduces by 15% the concentration of the latter in the blood plasma.
Antacids, reducing the absorption, reduces the concentration of ticlopidine in plasma by 18%; concomitant use with cimetidine may lead to slower elimination ticlopidine; mielotoksichsekie drugs increase the risk of suppression of bone marrow hematopoiesis.
Ticlopidine may cause hematologic or hemorrhagic side effects. (see. “Side effects”).
Hematologic disorders are mainly associated with white blood cells. In most cases, these side effects occur during the first three months of treatment. Sometimes there are severe cases (severe neutropenia, agranulocytosis), which can lead to death.
Severe hematologic outcomes or hemorrhagic side effects more likely to occur under the following conditions:
– Failure to comply with control measures, late diagnosis and inadequate therapeutic intervention;
– The combined use of anticoagulants or platelet aggregation inhibitors such as aspirin .
at the beginning of treatment should be carried out differential blood count (including platelet count), then it should be repeated every two weeks for the first three months of therapy. If treatment is discontinued during the first three months, within two weeks after discontinuation of treatment necessary to monitor neutrophils and platelets.
Control of hemostasis
Ticlopidine should be used with caution in risk of bleeding (see. “Interactions with other medicinal products”).
If the patient to surgery, in the case of undesirable effects of platelet suppression, treatment should be discontinued for at least ten days prior to surgery.
In the case of emergency surgery to reduce the risk of bleeding and bleeding time reduction can use three methods, individually or together:
1) administering 0.5-1.0 mg / kg methylprednisolone intravenously, which may be repeated;
2) administering desmopressin at a dose 0.2-0.4 mg / kg;
3) transfusion of fresh platelets in the platelet concentrate unit form.
All patients taking ticlopidine, should be made aware that the appearance of high temperature, sore throat, ulcers in the mouth, long or unusual bleeding, bruising, bloody vomit and stool (melena) requires the patient immediate treatment to the doctor .
The clinical diagnosis of thrombotic thrombocytopenic purpura anastrozole mencan be put in the presence of thrombocytopenia, hemolytic anemia and neurological symptoms, kidney dysfunction and high temperature.Home can be a surprise. Most cases were reported during the first eight weeks after initiation of therapy. Prognosis is very serious (known deaths from TTP).
The drug should be used with caution in patients with impaired liver function, and in the case of hepatitis or jaundice need to stop treatment.