Ticlopidine

Identification

Summary

Ticlopidine is a platelet aggregation inhibitor used in the prevention of conditions associated with thrombi, such as stroke and transient ischemic attacks (TIA).

Generic Name
Ticlopidine
DrugBank Accession Number
DB00208
Background

Ticlopidine is an effective inhibitor of platelet aggregation. It is a prodrug that is metabolised to an active form, which blocks the ADP receptor that is involved in GPIIb/IIIa receptor activation leading to platelet aggregation. Ticlopidine is marketed under the brand name Ticlid and is indicated for patients who cannot take aspirin or in whom aspirin has not worked to prevent a thrombotic stroke. The FDA label includes a black-box warning of neutropenia, aplastic anemia, thrombotic thrombocytopenia purpura, and agranulocytosis, so it is necessary to monitor patients' WBC and platelets when they are taking ticlopidine.

Type
Small Molecule
Groups
Approved
Structure
Weight
Average: 263.786
Monoisotopic: 263.05354785
Chemical Formula
C14H14ClNS
Synonyms
  • Ticlopidina
  • Ticlopidine
  • Ticlopidinum

Pharmacology

Indication

Used in patients, who have had a stroke or stroke precursors and who cannot take aspirin or aspirin has not worked, to try to prevent another thrombotic stroke.

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Associated Conditions
Indication TypeIndicationCombined Product DetailsApproval LevelAge GroupPatient CharacteristicsDose Form
Adjunct therapy in prevention ofStent thrombosis••••••••••••
Prevention ofStroke••••••••••••
Prevention ofThrombotic stroke•••••••••••••••••••••• •• •• •••••••••• •• •••••••• •••••••• ••••••••••••
Prevention ofThrombotic stroke••••••••••••••••••••••• •••••• ••••••••••• •••••••••• •• •• •••••••••• •• •••••••••••••
Adjunct therapy in prevention ofSubacute stent thrombosis•••••••••••••••••••• ••••• ••••••••••••••••••
Contraindications & Blackbox Warnings
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Pharmacodynamics

Ticlopidine is a prodrug that is metabolised to an as yet undetermined metabolite that acts as a platelet aggregation inhibitor. Inhibition of platelet aggregation causes a prolongation of bleeding time. In its prodrug form, ticlopidine has no significant in vitro activity at the concentrations attained in vivo.

Mechanism of action

The active metabolite of ticlopidine prevents binding of adenosine diphosphate (ADP) to its platelet receptor, impairing the ADP-mediated activation of the glycoprotein GPIIb/IIIa complex. It is proposed that the inhibition involves a defect in the mobilization from the storage sites of the platelet granules to the outer membrane. No direct interference occurs with the GPIIb/IIIa receptor. As the glycoprotein GPIIb/IIIa complex is the major receptor for fibrinogen, its impaired activation prevents fibrinogen binding to platelets and inhibits platelet aggregation. By blocking the amplification of platelet activation by released ADP, platelet aggregation induced by agonists other than ADP is also inhibited by the active metabolite of ticlopidine.

TargetActionsOrganism
APlatelet-activating factor receptor
modulator
Humans
AP2Y purinoceptor 12
antagonist
Humans
Absorption

Absorption is greater than 80%. Food increases absorption by approximately 20%.

Volume of distribution

The volume of distribution was not quantified.

Protein binding

Binds reversibly (98%) to plasma proteins, mainly to serum albumin and lipoproteins. The binding to albumin and lipoproteins is nonsaturable over a wide concentration range. Ticlopidine also binds to alpha-1 acid glycoprotein (about 15% or less).

Metabolism

Ticlopidine is metabolized extensively by the liver with only trace amounts of intact drug detected. At least 20 metabolites have been identified.

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Route of elimination

Ticlopidine is eliminated mostly in the urine (60%) and somewhat in the feces (23%).

Half-life

Half-life following a single 250-mg dose is approximately 7.9 hours in subjects 20 to 43 years of age and 12.6 hours in subjects 65 to 76 years of age. With repeated dosing (250 mg twice a day), half-life is about 4 days in subjects 20 to 43 years of age and about 5 days in subjects 65 to 76 years of age.

Clearance

Ticlopidine clearance was not quantified, but clearance decreases with age.

Adverse Effects
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Toxicity

Single oral doses of ticlopidine at 1600 mg/kg and 500 mg/kg were lethal to rats and mice, respectively. Symptoms of acute toxicity were GI hemorrhage, convulsions, hypothermia, dyspnea, loss of equilibrium and abnormal gait. The FDA label includes a black-box warning of neutropenia, aplastic anemia, thrombotic thrombocytopenia purpura, and agranulocytosis, so it is necessary to monitor patients' WBC and platelets when they are taking ticlopidine.

Pathways
PathwayCategory
Ticlopidine Action PathwayDrug action
Ticlopidine Metabolism PathwayDrug metabolism
Pharmacogenomic Effects/ADRs
Not Available

Interactions

Drug Interactions
This information should not be interpreted without the help of a healthcare provider. If you believe you are experiencing an interaction, contact a healthcare provider immediately. The absence of an interaction does not necessarily mean no interactions exist.
DrugInteraction
AbacavirTiclopidine may decrease the excretion rate of Abacavir which could result in a higher serum level.
AbataceptThe metabolism of Ticlopidine can be increased when combined with Abatacept.
AbciximabThe risk or severity of bleeding can be increased when Ticlopidine is combined with Abciximab.
AbirateroneThe metabolism of Ticlopidine can be decreased when combined with Abiraterone.
AbrocitinibThe risk or severity of bleeding and thrombocytopenia can be increased when Ticlopidine is combined with Abrocitinib.
Food Interactions
  • Take with a high fat meal. High fat meals will increase ticlopidine absorption.
  • Take with food. Food can help ticlopidine-induced stomach upset.

Products

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Product Ingredients
IngredientUNIICASInChI Key
Ticlopidine hydrochlorideA1L4914FMF53885-35-1MTKNGOHFNXIVOS-UHFFFAOYSA-N
Product Images
Brand Name Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing EndRegionImage
TiclidTablet, film coated250 mg/1OralPhysicians Total Care, Inc.1996-06-052001-06-30US flag
TiclidTablet, film coated250 mg/1OralGenentech, Inc.1991-10-312011-07-18US flag
Ticlid 250mg TabletsTablet250 mgOralHoffmann La Roche1995-12-312006-07-25Canada flag
Ticlid Tab 250mgTablet250 mg / tabOralSyntex Inc.1992-12-311996-09-30Canada flag
TiclopidineTablet250 mgOralSanis Health Inc2010-02-162014-08-01Canada flag
Generic Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing EndRegionImage
Alti-ticlopidine - Tab 250mgTablet250 mgOralAltimed Pharma Inc.1996-12-312005-05-27Canada flag
Dom-ticlopidineTablet250 mgOralDominion Pharmacal2001-05-232016-10-25Canada flag
Mylan-ticlopidineTablet250 mgOralMylan Pharmaceuticals Inc.1999-03-042017-01-09Canada flag
PMS-ticlopidineTablet250 mgOralPharmascience Inc2001-02-232016-10-28Canada flag
Sandoz TiclopidineTablet250 mgOralSandoz S.P.A.2001-05-142011-10-21Canada flag

Categories

ATC Codes
B01AC05 — Ticlopidine
Drug Categories
Chemical TaxonomyProvided by Classyfire
Description
This compound belongs to the class of organic compounds known as thienopyridines. These are heterocyclic compounds containing a thiophene ring fused to a pyridine ring. Thiophene is 5-membered ring consisting of four carbon atoms and one sulfur atom. Pyridine is a 6-membered ring consisting of five carbon atoms and one nitrogen center.
Kingdom
Organic compounds
Super Class
Organoheterocyclic compounds
Class
Thienopyridines
Sub Class
Not Available
Direct Parent
Thienopyridines
Alternative Parents
Phenylmethylamines / Benzylamines / Chlorobenzenes / Aralkylamines / Pyridines and derivatives / Aryl chlorides / Thiophenes / Heteroaromatic compounds / Trialkylamines / Azacyclic compounds
show 3 more
Substituents
Amine / Aralkylamine / Aromatic heteropolycyclic compound / Aryl chloride / Aryl halide / Azacycle / Benzenoid / Benzylamine / Chlorobenzene / Halobenzene
show 14 more
Molecular Framework
Aromatic heteropolycyclic compounds
External Descriptors
monochlorobenzenes, thienopyridine (CHEBI:9588)
Affected organisms
  • Humans and other mammals

Chemical Identifiers

UNII
OM90ZUW7M1
CAS number
55142-85-3
InChI Key
PHWBOXQYWZNQIN-UHFFFAOYSA-N
InChI
InChI=1S/C14H14ClNS/c15-13-4-2-1-3-11(13)9-16-7-5-14-12(10-16)6-8-17-14/h1-4,6,8H,5,7,9-10H2
IUPAC Name
5-[(2-chlorophenyl)methyl]-4H,5H,6H,7H-thieno[3,2-c]pyridine
SMILES
ClC1=CC=CC=C1CN1CCC2=C(C1)C=CS2

References

General References
  1. FDA Approved Drug Products: TICLID (ticlopidine hydrochloride) tablets [Link]
Human Metabolome Database
HMDB0014353
KEGG Drug
D08594
KEGG Compound
C07140
PubChem Compound
5472
PubChem Substance
46504438
ChemSpider
5273
BindingDB
85509
RxNav
10594
ChEBI
9588
ChEMBL
CHEMBL833
ZINC
ZINC000019594599
Therapeutic Targets Database
DAP000723
PharmGKB
PA451686
PDBe Ligand
TIC
RxList
RxList Drug Page
Drugs.com
Drugs.com Drug Page
Wikipedia
Ticlopidine
PDB Entries
3kw4
FDA label
Download (916 KB)
MSDS
Download (106 KB)

Clinical Trials

Clinical Trials
Clinical Trial & Rare Diseases Add-on Data Package
Explore 4,000+ rare diseases, orphan drugs & condition pairs, clinical trial why stopped data, & more. Preview package
PhaseStatusPurposeConditionsCountStart DateWhy Stopped100+ additional columns
4CompletedBasic SciencePharmacodynamics / Pharmacokinetics1somestatusstop reasonjust information to hide
4CompletedPreventionInfarction Cerebral / Stroke1somestatusstop reasonjust information to hide
4CompletedTreatmentCoronary Artery Disease (CAD)1somestatusstop reasonjust information to hide
3CompletedPreventionMyocardial Infarction / Stable Angina (SA)1somestatusstop reasonjust information to hide
3CompletedPreventionPeripheral Arterial Disease (PAD)1somestatusstop reasonjust information to hide

Pharmacoeconomics

Manufacturers
  • Roche palo alto llc
  • Actavis elizabeth llc
  • Apotex inc
  • Caraco pharmaceutical laboratories ltd
  • Genpharm inc
  • Mylan pharmaceuticals inc
  • Sandoz inc
  • Teva pharmaceuticals usa inc
  • Watson laboratories inc
Packagers
  • Apotex Inc.
  • AQ Pharmaceuticals Inc.
  • Caraco Pharmaceutical Labs
  • Eon Labs
  • F Hoffmann-La Roche Ltd.
  • Major Pharmaceuticals
  • Mylan
  • Physicians Total Care Inc.
  • Resource Optimization and Innovation LLC
  • Sandhills Packaging Inc.
  • Teva Pharmaceutical Industries Ltd.
  • Torpharm Inc.
Dosage Forms
FormRouteStrength
TabletOral
Pill250 MG
Tablet, sugar coatedOral250 mg
Tablet, film coatedOral
Tablet, film coatedOral250 mg/1
TabletOral250 mg
TabletOral250 mg / tab
Pill
Tablet, coatedOral
Tablet, film coatedOral250 MG
Tablet, coatedOral250 mg/1
Tablet, film coatedOral250 mg/tablet
Tablet, coatedOral250 mg
Capsule250 mg
Prices
Unit descriptionCostUnit
Ticlid 30 250 mg tablet Bottle87.36USD bottle
Ticlid 250 mg tablet2.61USD tablet
Ticlopidine HCl 250 mg tablet2.1USD tablet
Ticlopidine 250 mg tablet1.86USD tablet
Apo-Ticlopidine 250 mg Tablet0.72USD tablet
Mylan-Ticlopidine 250 mg Tablet0.72USD tablet
Novo-Ticlopidine 250 mg Tablet0.72USD tablet
Nu-Ticlopidine 250 mg Tablet0.72USD tablet
Sandoz Ticlopidine 250 mg Tablet0.72USD tablet
Ticlopidine 250 mg Tablet0.72USD tablet
DrugBank does not sell nor buy drugs. Pricing information is supplied for informational purposes only.
Patents
Not Available

Properties

State
Solid
Experimental Properties
PropertyValueSource
melting point (°C)approx. 1 189°CFrom Remington: The Science and Practice of Pharmacy
water solubilityFreely solubleFrom Remington: The Science and Practice of Pharmacy
logP2.9Not Available
Predicted Properties
PropertyValueSource
Water Solubility0.0219 mg/mLALOGPS
logP4.25ALOGPS
logP4.2Chemaxon
logS-4.1ALOGPS
pKa (Strongest Basic)6.94Chemaxon
Physiological Charge0Chemaxon
Hydrogen Acceptor Count1Chemaxon
Hydrogen Donor Count0Chemaxon
Polar Surface Area3.24 Å2Chemaxon
Rotatable Bond Count2Chemaxon
Refractivity74.33 m3·mol-1Chemaxon
Polarizability27.99 Å3Chemaxon
Number of Rings3Chemaxon
Bioavailability1Chemaxon
Rule of FiveYesChemaxon
Ghose FilterYesChemaxon
Veber's RuleYesChemaxon
MDDR-like RuleNoChemaxon
Predicted ADMET Features
PropertyValueProbability
Human Intestinal Absorption+0.9902
Blood Brain Barrier+0.9906
Caco-2 permeable+0.6062
P-glycoprotein substrateSubstrate0.6111
P-glycoprotein inhibitor IInhibitor0.8
P-glycoprotein inhibitor IIInhibitor0.8513
Renal organic cation transporterInhibitor0.8152
CYP450 2C9 substrateNon-substrate0.8234
CYP450 2D6 substrateNon-substrate0.9115
CYP450 3A4 substrateNon-substrate0.5155
CYP450 1A2 substrateInhibitor0.9107
CYP450 2C9 inhibitorNon-inhibitor0.907
CYP450 2D6 inhibitorInhibitor0.9209
CYP450 2C19 inhibitorInhibitor0.8994
CYP450 3A4 inhibitorNon-inhibitor0.8808
CYP450 inhibitory promiscuityHigh CYP Inhibitory Promiscuity0.9666
Ames testNon AMES toxic0.6773
CarcinogenicityNon-carcinogens0.9414
BiodegradationNot ready biodegradable0.9959
Rat acute toxicity2.2022 LD50, mol/kg Not applicable
hERG inhibition (predictor I)Strong inhibitor0.6392
hERG inhibition (predictor II)Inhibitor0.6333
ADMET data is predicted using admetSAR, a free tool for evaluating chemical ADMET properties. (23092397)

Spectra

Mass Spec (NIST)
Not Available
Spectra
SpectrumSpectrum TypeSplash Key
Predicted GC-MS Spectrum - GC-MSPredicted GC-MSsplash10-01t9-3920000000-df8dae54de62053653e7
LC-MS/MS Spectrum - LC-ESI-QFT , negativeLC-MS/MSsplash10-001i-0920000000-c7636201a8e44462782b
LC-MS/MS Spectrum - LC-ESI-QFT , negativeLC-MS/MSsplash10-001i-0910000000-b3c5107441452553bbfd
LC-MS/MS Spectrum - LC-ESI-QFT , negativeLC-MS/MSsplash10-001i-0900000000-7c7761f0b2d5d40ea37b
LC-MS/MS Spectrum - LC-ESI-QFT , positiveLC-MS/MSsplash10-03di-0490000000-735d41d20acd9ef61b19
LC-MS/MS Spectrum - LC-ESI-QFT , positiveLC-MS/MSsplash10-0udi-0920000000-763ff4372c7d534b9aef
LC-MS/MS Spectrum - LC-ESI-QFT , positiveLC-MS/MSsplash10-0fb9-0900000000-fdcbf528f5121fd88009
LC-MS/MS Spectrum - LC-ESI-QFT , positiveLC-MS/MSsplash10-004i-0900000000-73f90678ec6b04c031d4
LC-MS/MS Spectrum - LC-ESI-QFT , positiveLC-MS/MSsplash10-004i-0900000000-76105662a3b90ad51ec0
LC-MS/MS Spectrum - LC-ESI-QFT , positiveLC-MS/MSsplash10-004i-0900000000-43073273096ebea8675e
MS/MS Spectrum - , positiveLC-MS/MSsplash10-0imi-0960000000-88ccc8c382cb1c0eaed1
Predicted MS/MS Spectrum - 10V, Positive (Annotated)Predicted LC-MS/MSsplash10-03di-0090000000-e11b1e31b494fe51f243
Predicted MS/MS Spectrum - 10V, Negative (Annotated)Predicted LC-MS/MSsplash10-03di-4090000000-23d0f19ab26bde620481
Predicted MS/MS Spectrum - 20V, Negative (Annotated)Predicted LC-MS/MSsplash10-001i-9010000000-d8f3dc9f20b572a682b1
Predicted MS/MS Spectrum - 20V, Positive (Annotated)Predicted LC-MS/MSsplash10-03di-0290000000-7eb09dc28026ee0e58f1
Predicted MS/MS Spectrum - 40V, Negative (Annotated)Predicted LC-MS/MSsplash10-001i-9000000000-6fcaf85ee207ae71aba7
Predicted MS/MS Spectrum - 40V, Positive (Annotated)Predicted LC-MS/MSsplash10-02dl-3910000000-b9de27fb8bc64577038e
Predicted 1H NMR Spectrum1D NMRNot Applicable
Predicted 13C NMR Spectrum1D NMRNot Applicable
Chromatographic Properties
Collision Cross Sections (CCS)
AdductCCS Value (Å2)Source typeSource
[M-H]-157.8419929
predicted
DarkChem Lite v0.1.0
[M-H]-150.90477
predicted
DeepCCS 1.0 (2019)
[M+H]+158.4948929
predicted
DarkChem Lite v0.1.0
[M+H]+153.26277
predicted
DeepCCS 1.0 (2019)
[M+Na]+158.0462929
predicted
DarkChem Lite v0.1.0
[M+Na]+159.64182
predicted
DeepCCS 1.0 (2019)

Targets

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insights and accelerate drug research.
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Kind
Protein
Organism
Humans
Pharmacological action
Yes
Actions
Modulator
General Function
Receptor for platelet activating factor, a chemotactic phospholipid mediator that possesses potent inflammatory, smooth-muscle contractile and hypotensive activity. Seems to mediate its action via a G protein that activates a phosphatidylinositol-calcium second messenger system
Specific Function
G protein-coupled purinergic nucleotide receptor activity
Gene Name
PTAFR
Uniprot ID
P25105
Uniprot Name
Platelet-activating factor receptor
Molecular Weight
39203.075 Da
References
  1. Zhou Y, Zhang Y, Zhao D, Yu X, Shen X, Zhou Y, Wang S, Qiu Y, Chen Y, Zhu F: TTD: Therapeutic Target Database describing target druggability information. Nucleic Acids Res. 2024 Jan 5;52(D1):D1465-D1477. doi: 10.1093/nar/gkad751. [Article]
Kind
Protein
Organism
Humans
Pharmacological action
Yes
Actions
Antagonist
General Function
Receptor for ADP and ATP coupled to G-proteins that inhibit the adenylyl cyclase second messenger system. Not activated by UDP and UTP. Required for normal platelet aggregation and blood coagulation
Specific Function
G protein-coupled adenosine receptor activity
Gene Name
P2RY12
Uniprot ID
Q9H244
Uniprot Name
P2Y purinoceptor 12
Molecular Weight
39438.355 Da
References
  1. Storey RF: The P2Y12 receptor as a therapeutic target in cardiovascular disease. Platelets. 2001 Jun;12(4):197-209. [Article]
  2. Boeynaems JM, van Giezen H, Savi P, Herbert JM: P2Y receptor antagonists in thrombosis. Curr Opin Investig Drugs. 2005 Mar;6(3):275-82. [Article]
  3. Gachet C: The platelet P2 receptors as molecular targets for old and new antiplatelet drugs. Pharmacol Ther. 2005 Nov;108(2):180-92. Epub 2005 Jun 13. [Article]
  4. Zhan C, Yang J, Dong XC, Wang YL: Molecular modeling of purinergic receptor P2Y12 and interaction with its antagonists. J Mol Graph Model. 2007 Jul;26(1):20-31. Epub 2006 Sep 26. [Article]
  5. Chen X, Ji ZL, Chen YZ: TTD: Therapeutic Target Database. Nucleic Acids Res. 2002 Jan 1;30(1):412-5. [Article]

Enzymes

Details
1. Cytochrome P450 2C19
Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Substrate
Inhibitor
Curator comments
Moderate to strong inhibition of 2C19.
General Function
A cytochrome P450 monooxygenase involved in the metabolism of polyunsaturated fatty acids (PUFA) (PubMed:18577768, PubMed:19965576, PubMed:20972997). Mechanistically, uses molecular oxygen inserting one oxygen atom into a substrate, and reducing the second into a water molecule, with two electrons provided by NADPH via cytochrome P450 reductase (NADPH--hemoprotein reductase) (PubMed:18577768, PubMed:19965576, PubMed:20972997). Catalyzes the hydroxylation of carbon-hydrogen bonds. Hydroxylates PUFA specifically at the omega-1 position (PubMed:18577768). Catalyzes the epoxidation of double bonds of PUFA (PubMed:19965576, PubMed:20972997). Also metabolizes plant monoterpenes such as limonene. Oxygenates (R)- and (S)-limonene to produce carveol and perillyl alcohol (PubMed:11950794). Responsible for the metabolism of a number of therapeutic agents such as the anticonvulsant drug S-mephenytoin, omeprazole, proguanil, certain barbiturates, diazepam, propranolol, citalopram and imipramine. Hydroxylates fenbendazole at the 4' position (PubMed:23959307)
Specific Function
(R)-limonene 6-monooxygenase activity
Gene Name
CYP2C19
Uniprot ID
P33261
Uniprot Name
Cytochrome P450 2C19
Molecular Weight
55944.565 Da
References
  1. Zhou SF, Zhou ZW, Yang LP, Cai JP: Substrates, inducers, inhibitors and structure-activity relationships of human Cytochrome P450 2C9 and implications in drug development. Curr Med Chem. 2009;16(27):3480-675. Epub 2009 Sep 1. [Article]
  2. Richter T, Murdter TE, Heinkele G, Pleiss J, Tatzel S, Schwab M, Eichelbaum M, Zanger UM: Potent mechanism-based inhibition of human CYP2B6 by clopidogrel and ticlopidine. J Pharmacol Exp Ther. 2004 Jan;308(1):189-97. doi: 10.1124/jpet.103.056127. Epub 2003 Oct 16. [Article]
  3. Donahue SR, Flockhart DA, Abernethy DR, Ko JW: Ticlopidine inhibition of phenytoin metabolism mediated by potent inhibition of CYP2C19. Clin Pharmacol Ther. 1997 Nov;62(5):572-7. doi: 10.1016/S0009-9236(97)90054-0. [Article]
  4. Donahue S, Flockhart DA, Abernethy DR: Ticlopidine inhibits phenytoin clearance. Clin Pharmacol Ther. 1999 Dec;66(6):563-8. doi: 10.1053/cp.1999.v66.103277001. [Article]
  5. Giancarlo GM, Venkatakrishnan K, Granda BW, von Moltke LL, Greenblatt DJ: Relative contributions of CYP2C9 and 2C19 to phenytoin 4-hydroxylation in vitro: inhibition by sulfaphenazole, omeprazole, and ticlopidine. Eur J Clin Pharmacol. 2001 Apr;57(1):31-6. [Article]
  6. Tateishi T, Kumai T, Watanabe M, Nakura H, Tanaka M, Kobayashi S: Ticlopidine decreases the in vivo activity of CYP2C19 as measured by omeprazole metabolism. Br J Clin Pharmacol. 1999 Apr;47(4):454-7. doi: 10.1046/j.1365-2125.1999.00914.x. [Article]
  7. Talakad JC, Shah MB, Walker GS, Xiang C, Halpert JR, Dalvie D: Comparison of in vitro metabolism of ticlopidine by human cytochrome P450 2B6 and rabbit cytochrome P450 2B4. Drug Metab Dispos. 2011 Mar;39(3):539-50. doi: 10.1124/dmd.110.037101. Epub 2010 Dec 14. [Article]
  8. Flockhart Table of Drug Interactions [Link]
  9. Drug Interactions & Labeling - FDA [Link]
  10. Ticlopidine Hydrochloride - Drug Summary - PDR [Link]
Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Substrate
Inhibitor
Curator comments
Moderate to strong inhibition of 2D6.
General Function
A cytochrome P450 monooxygenase involved in the metabolism of fatty acids, steroids and retinoids (PubMed:18698000, PubMed:19965576, PubMed:20972997, PubMed:21289075, PubMed:21576599). Mechanistically, uses molecular oxygen inserting one oxygen atom into a substrate, and reducing the second into a water molecule, with two electrons provided by NADPH via cytochrome P450 reductase (NADPH--hemoprotein reductase) (PubMed:18698000, PubMed:19965576, PubMed:20972997, PubMed:21289075, PubMed:21576599). Catalyzes the epoxidation of double bonds of polyunsaturated fatty acids (PUFA) (PubMed:19965576, PubMed:20972997). Metabolizes endocannabinoid arachidonoylethanolamide (anandamide) to 20-hydroxyeicosatetraenoic acid ethanolamide (20-HETE-EA) and 8,9-, 11,12-, and 14,15-epoxyeicosatrienoic acid ethanolamides (EpETrE-EAs), potentially modulating endocannabinoid system signaling (PubMed:18698000, PubMed:21289075). Catalyzes the hydroxylation of carbon-hydrogen bonds. Metabolizes cholesterol toward 25-hydroxycholesterol, a physiological regulator of cellular cholesterol homeostasis (PubMed:21576599). Catalyzes the oxidative transformations of all-trans retinol to all-trans retinal, a precursor for the active form all-trans-retinoic acid (PubMed:10681376). Also involved in the oxidative metabolism of drugs such as antiarrhythmics, adrenoceptor antagonists, and tricyclic antidepressants
Specific Function
anandamide 11,12 epoxidase activity
Gene Name
CYP2D6
Uniprot ID
P10635
Uniprot Name
Cytochrome P450 2D6
Molecular Weight
55768.94 Da
References
  1. Zhou SF, Zhou ZW, Yang LP, Cai JP: Substrates, inducers, inhibitors and structure-activity relationships of human Cytochrome P450 2C9 and implications in drug development. Curr Med Chem. 2009;16(27):3480-675. Epub 2009 Sep 1. [Article]
  2. Ko JW, Desta Z, Soukhova NV, Tracy T, Flockhart DA: In vitro inhibition of the cytochrome P450 (CYP450) system by the antiplatelet drug ticlopidine: potent effect on CYP2C19 and CYP2D6. Br J Clin Pharmacol. 2000 Apr;49(4):343-51. doi: 10.1046/j.1365-2125.2000.00175.x. [Article]
  3. Sasaki T, Sato Y, Kumagai T, Yoshinari K, Nagata K: Effect of health foods on cytochrome P450-mediated drug metabolism. J Pharm Health Care Sci. 2017 May 10;3:14. doi: 10.1186/s40780-017-0083-x. eCollection 2017. [Article]
  4. Flockhart Table of Drug Interactions [Link]
Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Substrate
General Function
Part of the host defense system of polymorphonuclear leukocytes. It is responsible for microbicidal activity against a wide range of organisms. In the stimulated PMN, MPO catalyzes the production of hypohalous acids, primarily hypochlorous acid in physiologic situations, and other toxic intermediates that greatly enhance PMN microbicidal activity (PubMed:9922160). Mediates the proteolytic cleavage of alpha-1-microglobulin to form t-alpha-1-microglobulin, which potently inhibits oxidation of low-density lipoprotein particles and limits vascular damage (PubMed:25698971)
Specific Function
chromatin binding
Gene Name
MPO
Uniprot ID
P05164
Uniprot Name
Myeloperoxidase
Molecular Weight
83867.71 Da
References
  1. Zhou SF, Zhou ZW, Yang LP, Cai JP: Substrates, inducers, inhibitors and structure-activity relationships of human Cytochrome P450 2C9 and implications in drug development. Curr Med Chem. 2009;16(27):3480-675. Epub 2009 Sep 1. [Article]
Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Inhibitor
General Function
A cytochrome P450 monooxygenase involved in the metabolism of various endogenous substrates, including fatty acids and steroids (PubMed:12865317, PubMed:15766564, PubMed:19965576, PubMed:21576599, PubMed:7574697, PubMed:9435160, PubMed:9866708). Mechanistically, uses molecular oxygen inserting one oxygen atom into a substrate, and reducing the second into a water molecule, with two electrons provided by NADPH via cytochrome P450 reductase (NADPH--hemoprotein reductase) (PubMed:12865317, PubMed:15766564, PubMed:19965576, PubMed:21576599, PubMed:7574697, PubMed:9435160, PubMed:9866708). Catalyzes the epoxidation of double bonds of polyunsaturated fatty acids (PUFA) (PubMed:15766564, PubMed:19965576, PubMed:7574697, PubMed:9866708). Catalyzes the hydroxylation of carbon-hydrogen bonds. Metabolizes cholesterol toward 25-hydroxycholesterol, a physiological regulator of cellular cholesterol homeostasis (PubMed:21576599). Exhibits low catalytic activity for the formation of catechol estrogens from 17beta-estradiol (E2) and estrone (E1), namely 2-hydroxy E1 and E2 (PubMed:12865317). Catalyzes bisallylic hydroxylation and hydroxylation with double-bond migration of polyunsaturated fatty acids (PUFA) (PubMed:9435160, PubMed:9866708). Also metabolizes plant monoterpenes such as limonene. Oxygenates (R)- and (S)-limonene to produce carveol and perillyl alcohol (PubMed:11950794). Contributes to the wide pharmacokinetics variability of the metabolism of drugs such as S-warfarin, diclofenac, phenytoin, tolbutamide and losartan (PubMed:25994031)
Specific Function
(R)-limonene 6-monooxygenase activity
Gene Name
CYP2C9
Uniprot ID
P11712
Uniprot Name
Cytochrome P450 2C9
Molecular Weight
55627.365 Da
References
  1. Giancarlo GM, Venkatakrishnan K, Granda BW, von Moltke LL, Greenblatt DJ: Relative contributions of CYP2C9 and 2C19 to phenytoin 4-hydroxylation in vitro: inhibition by sulfaphenazole, omeprazole, and ticlopidine. Eur J Clin Pharmacol. 2001 Apr;57(1):31-6. [Article]
  2. Donahue SR, Flockhart DA, Abernethy DR, Ko JW: Ticlopidine inhibition of phenytoin metabolism mediated by potent inhibition of CYP2C19. Clin Pharmacol Ther. 1997 Nov;62(5):572-7. doi: 10.1016/S0009-9236(97)90054-0. [Article]
  3. Yang SH, Cho YA, Choi JS: Effects of ticlopidine on pharmacokinetics of losartan and its main metabolite EXP-3174 in rats. Acta Pharmacol Sin. 2011 Jul;32(7):967-72. doi: 10.1038/aps.2011.32. Epub 2011 Jun 13. [Article]
Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Inhibitor
General Function
A cytochrome P450 monooxygenase involved in the metabolism of various endogenous substrates, including fatty acids, steroid hormones and vitamins (PubMed:11093772, PubMed:14559847, PubMed:15766564, PubMed:19965576, PubMed:7574697). Mechanistically, uses molecular oxygen inserting one oxygen atom into a substrate, and reducing the second into a water molecule, with two electrons provided by NADPH via cytochrome P450 reductase (NADPH--hemoprotein reductase) (PubMed:11093772, PubMed:14559847, PubMed:15766564, PubMed:19965576, PubMed:7574697). Primarily catalyzes the epoxidation of double bonds of polyunsaturated fatty acids (PUFA) with a preference for the last double bond (PubMed:15766564, PubMed:19965576, PubMed:7574697). Catalyzes the hydroxylation of carbon-hydrogen bonds. Metabolizes all trans-retinoic acid toward its 4-hydroxylated form (PubMed:11093772). Displays 16-alpha hydroxylase activity toward estrogen steroid hormones, 17beta-estradiol (E2) and estrone (E1) (PubMed:14559847). Plays a role in the oxidative metabolism of xenobiotics. It is the principal enzyme responsible for the metabolism of the anti-cancer drug paclitaxel (taxol) (PubMed:26427316)
Specific Function
arachidonic acid epoxygenase activity
Gene Name
CYP2C8
Uniprot ID
P10632
Uniprot Name
Cytochrome P450 2C8
Molecular Weight
55824.275 Da
References
  1. Backman JT, Filppula AM, Niemi M, Neuvonen PJ: Role of Cytochrome P450 2C8 in Drug Metabolism and Interactions. Pharmacol Rev. 2016 Jan;68(1):168-241. doi: 10.1124/pr.115.011411. [Article]
Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Inhibitor
General Function
A cytochrome P450 monooxygenase involved in the metabolism of various endogenous substrates, including fatty acids, steroid hormones and vitamins (PubMed:10681376, PubMed:11555828, PubMed:12865317, PubMed:19965576, PubMed:9435160). Mechanistically, uses molecular oxygen inserting one oxygen atom into a substrate, and reducing the second into a water molecule, with two electrons provided by NADPH via cytochrome P450 reductase (NADPH--hemoprotein reductase) (PubMed:10681376, PubMed:11555828, PubMed:12865317, PubMed:19965576, PubMed:9435160). Catalyzes the hydroxylation of carbon-hydrogen bonds (PubMed:11555828, PubMed:12865317). Exhibits high catalytic activity for the formation of hydroxyestrogens from estrone (E1) and 17beta-estradiol (E2), namely 2-hydroxy E1 and E2 (PubMed:11555828, PubMed:12865317). Metabolizes cholesterol toward 25-hydroxycholesterol, a physiological regulator of cellular cholesterol homeostasis (PubMed:21576599). May act as a major enzyme for all-trans retinoic acid biosynthesis in the liver. Catalyzes two successive oxidative transformation of all-trans retinol to all-trans retinal and then to the active form all-trans retinoic acid (PubMed:10681376). Primarily catalyzes stereoselective epoxidation of the last double bond of polyunsaturated fatty acids (PUFA), displaying a strong preference for the (R,S) stereoisomer (PubMed:19965576). Catalyzes bisallylic hydroxylation and omega-1 hydroxylation of PUFA (PubMed:9435160). May also participate in eicosanoids metabolism by converting hydroperoxide species into oxo metabolites (lipoxygenase-like reaction, NADPH-independent) (PubMed:21068195). Plays a role in the oxidative metabolism of xenobiotics. Catalyzes the N-hydroxylation of heterocyclic amines and the O-deethylation of phenacetin (PubMed:14725854). Metabolizes caffeine via N3-demethylation (Probable)
Specific Function
aromatase activity
Gene Name
CYP1A2
Uniprot ID
P05177
Uniprot Name
Cytochrome P450 1A2
Molecular Weight
58406.915 Da
References
  1. Richter T, Murdter TE, Heinkele G, Pleiss J, Tatzel S, Schwab M, Eichelbaum M, Zanger UM: Potent mechanism-based inhibition of human CYP2B6 by clopidogrel and ticlopidine. J Pharmacol Exp Ther. 2004 Jan;308(1):189-97. doi: 10.1124/jpet.103.056127. Epub 2003 Oct 16. [Article]
  2. Aleil B, Rochoux G, Monassier JP, Cazenave JP, Gachet C: Ticlopidine could be an alternative therapy in the case of pharmacological resistance to clopidogrel: a report of three cases. J Thromb Haemost. 2007 Apr;5(4):879-81. doi: 10.1111/j.1538-7836.2007.02338.x. [Article]
  3. Rendic S: Summary of information on human CYP enzymes: human P450 metabolism data. Drug Metab Rev. 2002 Feb-May;34(1-2):83-448. [Article]
  4. Ko JW, Desta Z, Soukhova NV, Tracy T, Flockhart DA: In vitro inhibition of the cytochrome P450 (CYP450) system by the antiplatelet drug ticlopidine: potent effect on CYP2C19 and CYP2D6. Br J Clin Pharmacol. 2000 Apr;49(4):343-51. doi: 10.1046/j.1365-2125.2000.00175.x. [Article]
  5. Flockhart Table of Drug Interactions [Link]
  6. Ticlopidine Hydrochloride - Drug Summary - PDR [Link]
Details
7. Cytochrome P450 2B6
Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Inhibitor
General Function
A cytochrome P450 monooxygenase involved in the metabolism of endocannabinoids and steroids (PubMed:12865317, PubMed:21289075). Mechanistically, uses molecular oxygen inserting one oxygen atom into a substrate, and reducing the second into a water molecule, with two electrons provided by NADPH via cytochrome P450 reductase (NADPH--hemoprotein reductase). Catalyzes the epoxidation of double bonds of arachidonoylethanolamide (anandamide) to 8,9-, 11,12-, and 14,15-epoxyeicosatrienoic acid ethanolamides (EpETrE-EAs), potentially modulating endocannabinoid system signaling (PubMed:21289075). Hydroxylates steroid hormones, including testosterone at C-16 and estrogens at C-2 (PubMed:12865317, PubMed:21289075). Plays a role in the oxidative metabolism of xenobiotics, including plant lipids and drugs (PubMed:11695850, PubMed:22909231). Acts as a 1,4-cineole 2-exo-monooxygenase (PubMed:11695850)
Specific Function
anandamide 11,12 epoxidase activity
Gene Name
CYP2B6
Uniprot ID
P20813
Uniprot Name
Cytochrome P450 2B6
Molecular Weight
56277.81 Da
References
  1. Walsky RL, Astuccio AV, Obach RS: Evaluation of 227 drugs for in vitro inhibition of cytochrome P450 2B6. J Clin Pharmacol. 2006 Dec;46(12):1426-38. [Article]
  2. Richter T, Murdter TE, Heinkele G, Pleiss J, Tatzel S, Schwab M, Eichelbaum M, Zanger UM: Potent mechanism-based inhibition of human CYP2B6 by clopidogrel and ticlopidine. J Pharmacol Exp Ther. 2004 Jan;308(1):189-97. doi: 10.1124/jpet.103.056127. Epub 2003 Oct 16. [Article]
  3. Flockhart Table of Drug Interactions [Link]
  4. Ticlopidine Hydrochloride - Drug Summary - PDR [Link]
Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Inhibitor
General Function
A cytochrome P450 monooxygenase involved in the metabolism of fatty acids (PubMed:10553002, PubMed:18577768). Mechanistically, uses molecular oxygen inserting one oxygen atom into a substrate, and reducing the second into a water molecule, with two electrons provided by NADPH via cytochrome P450 reductase (NADPH--hemoprotein reductase) (PubMed:10553002, PubMed:18577768). Catalyzes the hydroxylation of carbon-hydrogen bonds. Hydroxylates fatty acids specifically at the omega-1 position displaying the highest catalytic activity for saturated fatty acids (PubMed:10553002, PubMed:18577768). May be involved in the oxidative metabolism of xenobiotics (Probable)
Specific Function
4-nitrophenol 2-monooxygenase activity
Gene Name
CYP2E1
Uniprot ID
P05181
Uniprot Name
Cytochrome P450 2E1
Molecular Weight
56848.42 Da
References
  1. Ko JW, Desta Z, Soukhova NV, Tracy T, Flockhart DA: In vitro inhibition of the cytochrome P450 (CYP450) system by the antiplatelet drug ticlopidine: potent effect on CYP2C19 and CYP2D6. Br J Clin Pharmacol. 2000 Apr;49(4):343-51. doi: 10.1046/j.1365-2125.2000.00175.x. [Article]

Drug created at June 13, 2005 13:24 / Updated at October 17, 2024 13:59