Abstract
Ticlopidine (TCP)1has a wide spectrum of platelet anti-aggregating activity in man(1).This compound is known to inhibit the metabolism of several drugs (2). Recent case reports have shown that ticlopidine inhibits phenytoin clearance, which results in acute toxicity (3–6). Phenytoin is metabolized by CYP 2C9 and 2C19 (7) but ticlopidine does not affect CYP 2C9 activity (8) and decreased the in vivo activity of CYP 2C19 as measured by omeprazole metabolism (9) an indication of inhibition in vivo of CYP 2C19 activity by ticlopidine. In vitro such inhibitory effects on bufuralol hydroxylation(10)and on S-mephenytoin 4-hydroxylation (11) have been shown on recombinant CYP 2C19.
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