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Source: National Institute for Health and Clinical Excellence
1. Guidance
This
guidance applies to people who have had an occlusive vascular event, or
who have symptomatic peripheral arterial disease. This guidance does
not apply to people who have had, or are at risk of, a stroke
associated with atrial fibrillation, or who require treatment to
prevent occlusive events after coronary revascularisation or carotid
artery procedures.
1.1 As part of the prevention of occlusive vascular events:
1.1.1
the combination of modified-release (MR) dipyridamole and aspirin is
recommended for people who have had an ischaemic stroke or a transient
ischaemic attack for a period of 2 years from the most recent event.
Thereafter, or if MR dipyridamole is not tolerated, preventative
therapy should revert to standard care (including long-term treatment
with low-dose aspirin)
1.1.2 clopidogrel alone
(within its licensed indications) is recommended for people who are
intolerant of low-dose aspirin and either have experienced an occlusive
vascular event or have symptomatic peripheral arterial disease.
1.2 For the purposes of this guidance, aspirin intolerance is defined as either of the following:
- proven hypersensitivity to aspirin-containing medicines
- history of severe dyspepsia induced by low-dose aspirin.
The
guidance shown above constitutes Section 1 of the full document. A copy
of the full document and a summary of the evidence is available on the
Internet at www.nice.org.uk/page.aspx?o=259254
An
abridged version of this guidance (a 'quick reference guide') is also
available. Printed copies of the quick reference guide can be obtained
by contacting 0845 003 7783 or emailing publications@nice.org.uk and quoting reference number N0838. It is also available on the Internet at www.nice.org.uk/page.aspx?o=TA090quickrefguide
This
guidance represents the view of the Institute which was arrived at
after careful consideration of the available evidence. Health
professionals are expected to fully take it into account when
exercising their clinical judgement. This guidance does not, however,
override the individual responsibility of health professionals to make
appropriate decisions in the circumstances of the individual patient,
in consultation with the patient and/or guardian or carer.
©
Copyright National Institute for Health and Clinical Excellence. All
rights reserved. This material may be freely reproduced for educational
and not for profit purposes within the NHS. No reproduction by or for
commercial organisations is permitted without the express written
permission of the Institute.
Enquiries concerning the guidance
should be addressed to: National Institute for Health and Clinical
Excellence, MidCity Place, 71 High Holborn, London WC1V 6NA. email: nice@nice.nhs.uk
Clopidogrel and Modified-Release Dipyridamole in the Prevention of Occlusive Vascular Events.
Issue Date: May 2005
Review Date: April 2008
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