Pharmacokinetic and pharmacological interactions between ticlopidine hydrochloride and Kangen-Karyu - Chinese traditional herbal medicine.

Kangen-Karyu (KGK), containing peony root, cnidium rhizome, saf flower, cyperus rhizome, saussurea root and Salvia miltiorrhiza root, is a Chinese traditional medicine formula to invigorate the 'blood' and dispel 'blood stasis', arising from poor blood circulation. The present study evaluated the pharmacokinetic and pharmacological interactions between KGK and ticlopidine hydrochloride. Ticlopidine was administered orally or intravenously to KGK-treated rats, and its plasma concentrations were measured. KGK did not significantly affect the pharmacokinetic parameters of ticlopidine in rats treated with both oral and intravenous administration. Ticlopidine alone significantly prolonged the mouse tail-bleeding time and adenosine 5'-diphosphate-induced ex vivo platelet aggregation, which was slightly augmented by KGK. It is suggested that the combined therapy of ticlopidine and KGK may augment the antithrombotic effects, and that the dosage of ticlopidine should be reduced to prevent thrombotic thrombocytopenic purpura, a severe adverse effect of ticlopidine.