Aspirin Dispersible Tablets 75mg

Acute ischaemic stroke, Secondary prevention of cardiovascular disease, Following coronary artery bypass surgery, Management of ACS (Acute coronary syndrome) - as appropriate

Product can be purchased Over The Counter

Atherosclerotic events (Prevention)

MHRA Drug Safety Update -risk of acquired haemophilia
December 2013

STEMI, NSTEMI in combination with low dose aspirin (including stent placement following PCI) and Acute Coronary Syndrome.

For people who have had an ischaemic stroke or who have peripheral arterial disease or multivascular disease or for people who have had a myocardial infarction only if aspirin is contraindicated or not tolerated.

NICE TA 210
Clopidogrel and modified-release dipyridamole for the prevention of occlusive vascular events December 2010

* Concomitant use of clopidogrel and omeprazole or esomeprazole is to be discouraged unless considered essential
* Doctors should check whether patients who are taking clopidogrel are also buying over-the-counter omeprazole and consider whether other gastrointestinal therapies would be more suitable
* Pharmacists should check whether patients buying omeprazole are also taking clopidogrel
* Consider PPIs other than omeprazole or esomeprazole in patients who are taking clopidogrel. Other gastrointestinal therapy such as H2 blockers (except cimetidine) or antacids may be more suitable in some patients
* Discourage concomitant use of other known CYP2C19-inhibiting medicines with clopidogrel because these are expected to have a similar effect to omeprazole and esomeprazole (CYP2C19 inhibitors include fluvoxamine, fluoxetine, moclobemide, voriconazole, fluconazole, ticlopidine, ciprofloxacin, cimetidine, carbamazepine, oxcarbazepine, and chloramphenicol)

MHRA Drug Safety Update Volume 3 Issue 9 April 2010

Review Date: 01/01/2027

Ticagrelor Tablets

Prevention of atherothrombotic events in patients with acute coronary syndrome (including STEMI, NSTEMI and unstable angina)

Myocardial infarction (MI)-history of, with a high risk of developing an atherothrombotic event

Ticagrelor for preventing atherothrombotic events after myocardial infarction
December 2016

NICE NG185    Acute coronary syndromes

The 1st 28 days supply will be provided by the initiating Hospital
 Duration is for 12months post event and details should be added to the repeat prescription to ensure review occurs at this point.
Renal function should be checked 4 weeks after initiation - it is anticipated that the Primary Care prescriber will undertake this monitoring unless the patient attends a follow up Cardiology appointment within this time scale.
 Mild to moderate dyspnoea may occur in a very small number of patients - if this occurs contact Cardiology directly
The concomitant use of ticagrelor with doses of simvastatin greater than 40 mg is not recommended
Appropriate clinical and/or laboratory monitoring is recommended when giving digoxin or cyclosporin concomitantly with ticagrelor - contact Cardiology for further advice.

APC May 2012