National Antiplatelet Guidance Published
Clopidogrel (Plavix) is being used much more as time passes as an alternative when patients cannot tolerate Aspirin as an antiplatelet follwing a cardiovascular event, such as a heart attack or stroke.
NICE recently published a Technology Appraisal in respect of Clopidogrel and Dypridamole (Persantin) in occlusive vascular events. It has also been summarised by the NPC in a recent MeReC Bulletin.
In summary:
For Secondary Prevention
- Low dose Aspirin (75mg daily) is first line and should be prescribed indefinitely
- Dypridamole (prescribed as Asasantin) is of additional benefit for the first two years after a stroke
- Clopidogrel is a suitable alternative to aspirin where aspirin is contraindicated or not tolerated
For Primary Prevention
- Low dose Aspirin (75mg daily) is first line and should be considered for all patients over the age of 50 at higfh risk of CVD, provided hypertension is controlled
- Clopidogrel and Dypridamole are neither indicated nor licensed for Primary Prevention
Action: Ensure you are using antiplatelets appropriately to ensure greatest benefit to the patient in terms of effect and safety.
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