Department of Cardiology, Geisinger Medical Center, Danville, PA 17822-3003, USA.
Circ Cardiovasc Interv. 2009 Aug;2(4):348-51. doi: 10.1161/CIRCINTERVENTIONS.108.832964.108.832964. Epub 2009 Jul 22.
Clopidogrel and ticlopidine are structurally very similar. In patients with an allergic or hematologic adverse reaction to either one of these drugs, the likelihood that an allergic or hematologic adverse effect will develop to the other is unknown. It is also unknown whether a reaction to the second thienopyridine is likely to be life threatening.
Medical records from 2 academic institutions were reviewed to identify patients who had an allergic or hematologic adverse reaction to either of the 2 currently commercially available thienopyridines and who were subsequently prescribed the other thienopyridine. Patient demographics, details of the adverse reactions, and subsequent clinical course were reviewed. A total of 76 patients were identified with an allergic or hematologic adverse reaction to clopidogrel or ticlopidine who had also received the other thienopyridine. Fourteen (27%; 95% CI, 16 to 41) patients who had an allergic or hematologic adverse reactions to clopidogrel had a similar reaction to ticlopidine; none developed a life-threatening reaction. The most common reaction was a rash (93%).
In patients with an allergic or hematologic adverse reaction to one thienopyridine, there seems to be an increased frequency of such reactions to the other thienopyridine. However, no patient had a life-threatening reaction after exposure to the alternative thienopyridine.
氯吡格雷和噻氯匹定在结构上非常相似。对于对这两种药物之一有过敏或血液学不良反应的患者，对另一种药物发生过敏或血液学不良反应的可能性尚不清楚。也不知道对第二种噻吩吡啶的反应是否可能危及生命。
回顾了 2 所学术机构的病历，以确定对两种目前市售噻吩吡啶之一有过敏或血液学不良反应的患者，随后开了另一种噻吩吡啶。回顾了患者的人口统计学资料、不良反应的详细信息和随后的临床过程。共确定了 76 名对氯吡格雷或噻氯匹定有过敏或血液学不良反应的患者，他们也接受了另一种噻吩吡啶。在对氯吡格雷有过敏或血液学不良反应的 14 名患者（27%；95%CI，16 至 41）中，有类似的噻氯匹定反应；没有发生危及生命的反应。最常见的反应是皮疹（93%）。
在对一种噻吩吡啶有过敏或血液学不良反应的患者中，对另一种噻吩吡啶似乎更频繁地发生此类反应。然而，在接触替代噻吩吡啶后，没有患者发生危及生命的反应。
