Why is clopidogrel preferred over ticlopidine?

Ans. is 'a' i.e., Lower incidence of neutropenia and thrombocytopenia Clopidogrel* This newer congener of ticlopidine has similar mechanism of action, ability to inhibit platelet function and therapeutic efficacy, but appears to be safer and better tolerated (CLASSICS study).* Clopidogrel is safer than ticlopidine as it is less associated with hematological dyscrasias than use of ticlopidine. A lower frequency of neutropenia, thrombocytopenia and other bone marrow toxicity compared to ticlopidine has been recorded.* The clopidogrel as aspirin in patients at risk of ischaemic events (CAPRIE) trial has found clopidogrel recipients to have a slightly lower annual risk of primary ischaemic events than aspirin recipients.* The most important adverse effect is bleeding.* Addition of aspirin to clopidogrel has been found to double the incidence of serious bleeding among high risk stroke patients (MATCH study).* A lower frequency of neutropenia, thrombocytopenia and other bone marrow toxicity compared to ticlopidine has been recorded.* Side effects are diarrhoea, epigastric pain and rashes.* Clopidogrel + aspirin is as effective in stented patients as ticlopidine + aspirin. Clopidogrel is 50% absorbed orally and like ticlopidine, it is a prodrug; action lasts for upto 7 days.