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 Formulary Chapter 2: Cardiovascular system - Full Chapter
Notes:

Chapter complete - updated July 18

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02.09  Expand sub section  Antiplatelet drugs
 note 

Antiplatelet drugs decrease platelet aggregation and inhibit thrombus formation in the arterial circulation, because in faster-flowing vessels, thrombi are composed maily of platelets with little fibrin.

Use of aspirin in primary prevention of cardiovascular events, in patients with or without diabetes, is of unproven benefit. Long-term use of aspirin is of benefit in established cardiovascular disease (secondary prevention); unduly high blood pressure must be controlled before aspirin is given. If the patient is at high risk of gastro-intestinal bleeding, a proton pump inhibitor can be added.

Prescribing for secondary prevention should be in line with GEH guidelines.

Aspirin
(antiplatelet)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
  • Available as:
    • Dispersable tablets 75mg (preferred) £/28
    • Enteric coated 75mg £/56
    • Suppositories 150mg ££/10
 
Link  UKMI Q&A: Can a person with low dose aspirin take gingko?
Link  UKMI Q&A: Is there evidence to support the use of EC coated aspirin to reduce GI side effects?
   
Clopidogrel
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Formulary
  • Available as tablets £/28
 
Link  NICE TA80: Acute coronary syndromes - clopidogrel
Link  NICE TA210: Clopidogrel and modified-release dipyridamole for the prevention of occlusive vascular events
   
Dipyridamole
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Formulary
  • Available as 200mg MR capsules ££/60
 
   
Prasugrel (Efient)
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Restricted Drug Restricted
Green SI
  • Available as tablets ££/28
  • For initiation by cardiology team
 
Link  NICE TA182: Acute coronary syndrome - prasugrel
Link  NICE TA317: Prasugrel with percutaneous coronary intervention for treating acute coronary syndromes (review of technology appraisal guidance 182)
   
Ticagrelor (Brilique)
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Restricted Drug Restricted
Green SI
  • Available as tablets £££/56
  • For initiation by cardiology team
 
Link  NICE TA236: Ticagrelor for the treatment of acute coronary syndromes
Link  NICE TA420: Ticagrelor for preventing atherothrombotic events after myocardial infarction
   
 ....
Key
note Notes
Section Title Section Title (top level)
Section Title Section Title (sub level)
First Choice Item First Choice item
Non Formulary Item Non Formulary section
Restricted Drug
Restricted Drug
Unlicensed Drug
Unlicensed
Track Changes
Display tracking information
click to search medicines.org.uk
Link to adult BNF
click to search medicines.org.uk
Link to children's BNF
click to search medicines.org.uk
Link to SPCs
SMC
Scottish Medicines Consortium
Cytotoxic Drug
Cytotoxic Drug
CD
Controlled Drug
High Cost Medicine
High Cost Medicine
Cancer Drugs Fund
Cancer Drugs Fund
NHSE
NHS England
Homecare
Homecare
CCG
CCG

Traffic Light Status Information

Status Description

Red SO

SPECIALIST ONLY - These drugs are deemed to be not appropriate for prescribing by GPs. Specialists should not ask GPs to prescribe these drugs.   

Green SI

SPECIALIST INITIATED - These drugs must be initiated, i.e. the first dose prescribed, by the specialist and then may be continued when appropriate by the patients GP following communication from the specialist.   

Green SA

SPECIALIST ADVISED Specialists may simply advise a patients GP to initiate these drugs themselves after they have made an initial assessment.   

Amber SC

SHARED CARE - Responsibility for prescribing may be transferred from secondary to primary care with the agreement of an individual GP and when agreed shared care arrangements have been established. The specialist MUST stabilize the patient before asking for care to be transferred. Only specialists should initiate these drugs. Prescribing should be transferred to GPs according to an Shared Care Agreement [SCA]   

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