• FCMS
  • Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust
  • Rotherham Doncaster and South Humber NHS Foundation Trust
  • Nottingham and Nottinghamshire
  • South Yorkshire ICB

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

Pack Price
28 tablet £0.69

Atherosclerotic events (Prevention)

MHRA Drug Safety Update -risk of acquired haemophilia
December 2013

Pack Price
28 tablet £1.05

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

 

Pack Price
28 tablet £1.05

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

Pack Price
56 tablet £54.60

Aspirin Dispersible Tablets 300mg

Acute ischaemic stroke, Following coronary artery bypass surgery, Management of ACS (Acute coronary syndrome)

 

Pack Price
32 tablet £1.01

Dipyridamole 200mg MR Capsules

Dipyridamole is now rarely used in practice. It is used only in those patients with ischaemic stroke or TIA who are intolerant to clopidogrel where the MR capsule should be used in conjunction with aspirin. In patients intolerant to both clopidogrel and aspirin, dipyridamole m/r can be used as a sole agent.
Dose:
Dipyridamole 200mg MR capsules – one twice daily

Special Container pack of 60 capsules 

Acute ischaemic stroke, Management of ACS (Acute coronary syndrome) - As appropriate

 

Pack Price
10 suppository £55.68

Review Date: 01/01/2025

Prasugrel Tablets

Prevention of atherothrombotic events in patients with acute coronary syndrome

NICE TA317 Prasugrel with percutaneous coronary intervention for treating acute coronary syndromes

1.1 Prasugrel 10 mg in combination with aspirin is recommended as an option within its marketing authorisation, that is, for preventing atherothrombotic events in adults with acute coronary syndrome (unstable angina [UA], non-ST segment elevation myocardial infarction [NSTEMI] or ST segment elevation myocardial infarction [STEMI]) having primary or delayed percutaneous coronary intervention.

MHRA Drug Safety Update Incresed risk of bleeding - information on timing of loading dose when used in the acute management of patients experiencing unstable angina or NSTEMI and undergoing coronary angiography within 48hours of admission.

Yorkshire & the Humber Cardiovascular Strategic Clinical Network (South) Guidance can be found here
February 2014


NICE CG172 Myocardial infarction: cardiac rehabilitation and prevention of further cardiovascular disease

Treatment with Prasugrel should be initiated in secondary care. It is then appropriate for continued prescribing in primary care. The duration of treament should be specified by secondary care in the original communication.

Prasugrel may be suitable for a limited number of patients (e.g. patients who require immediate percutaneous coronary intervention or patients who have experienced stent thrombosis despite previous clopidogrel treatment). However, for each individual, the potential benefits of prasugrel must be carefully balanced against the risk of bleeding.

Prasugrel is not recommended for patients over the age of 75 years or patients weighing less then 60kg because these patients have a high risk of bleeding.

It is contraindicated in patients with a history of stroke or transient ischaemic attack.

Prasugrel (Efient) for acute coronary syndrome managed with percutaneous coronary intervention
MTRAC Verdict & Summary February 2010

Pack Price
28 tablet £5.01
Pack Price
28 tablet £33.68

Review Date: 01/01/2024

Acute Coronary Syndrome (ACS) - Moderate and high-risk

Rationale: 1,2,4

*Hospital Use only*