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Anticoagulants and Anti-platelets

ANTIPLATELET DRUGS

All patients who have CHD should be on an antiplatelet drug unless intolerant (rare) or contraindicated.

Click here for the guideline on antiplatelet therapy.

Aspirin: drug of first choice is (aspirin dispersible 75mg daily).

Avoid increasing dose for simple analgesia.

Enteric coated aspirin formulations are expensive and no better tolerated.

Click here for further information on Aspirin formulations.

Clopidogrel: Think carefully before putting on repeat.

All patients receiving repeat prescriptions for clopidogrel should undergo medications review and if clopidogrel is used outside guidelines, consider switch to aspirin dispersible 75mg daily.

Refer to guideline.

Clopidogrel can react with Proton Pump Inhibitors such as Omeprazole or Lansoprazole

Click here for further information on PPIs.

Dipyridamole: If taking dipyridamole, ensure that the ONLY reason is because of a previous thrombotic stroke.

Use in CHD may also worsen angina.

Consider Warfarin if patient has Atrial Fibrillation (AF)

Novel Anticoagulant Drugs

Click here for more information on these drugs.

 WARFARIN

Click here for AF guideline.

Only prescribe warfarin AND aspirin on recommendation of an expert.