Clopidogrel and Modified-Release Dipyridamole in the Prevention of Occlusive Vascular Events (TA210)

Technology Appraisal Guidance No. 210

Source: National Institute for Health and Care Excellence

1. Guidance

This guidance applies to people who have had an occlusive vascular event, or who have established peripheral arterial disease. For people who have had a myocardial infarction, this guidance follows on from the recommendations for clopidogrel in combination with low-dose aspirin in NICE clinical guidelines 48 and 94. This guidance does not apply to people who have had, or are at risk of, a stroke associated with atrial fibrillation, or who need treatment to prevent occlusive events after coronary revascularisation or carotid artery procedures.

1.1 Clopidogrel is recommended as an option to prevent occlusive vascular events:

  • 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

1.2 Modified-release dipyridamole in combination with aspirin is recommended as an option to prevent occlusive vascular events:

  • for people who have had a transient ischaemic attack or

  • for people who have had an ischaemic stroke only if clopidogrel is contraindicated or not tolerated


1.3 Modified-release dipyridamole alone is recommended as an option to prevent occlusive vascular events:

  • for people who have had an ischaemic stroke only if aspirin and clopidogrel are contraindicated or not tolerated or

  • for people who have had a transient ischaemic attack only if aspirin is contraindicated or not tolerated.

1.4 Treatment with clopidogrel to prevent occlusive vascular events should be started with the least costly licensed preparation.

1.5 People currently receiving clopidogrel or modified-release dipyridamole either with or without aspirin outside the criteria in 1.1, 1.2 and 1.3 should have the option to continue treatment until they and their clinicians consider it appropriate to stop.


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 http://www.nice.org.uk/guidance/index.jsp?action=byID&o=13285

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 N2394. It is also available on the Internet at http://guidance.nice.org.uk/TA210/QuickRefGuide/pdf/English

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 Care 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 Care Excellence, MidCity Place, 71 High Holborn, London WC1V 6NA. email: nice@nice.org.uk

Clopidogrel and Modified-Release Dipyridamole in the Prevention of Occlusive Vascular Events: Review of NICE Technology Appraisal Guidance 90.
Issue Date: December 2010
Review Date:


Have you registered with us yet?

Register now to enjoy more articles and free email bulletins

Register
Already registered?
Sign in

Register or Subscribe to MIMS

GPs can get MIMS print & online and GPonline for free when they register online – take 2 minutes, and make sure you get your free MIMS access! If you're not a GP, you can subscribe to MIMS for full access.

Register or subscribe

MIMS Dermatology

Read the latest issue online exclusively on MIMS Learning.

Read MIMS Dermatology

MIMS Adviser

Especially created for prescribing influencers.

Request free copy

Mobile apps

MIMS: access the full drug database and quick-reference tables on the go

MIMS Diagnosis and Management: concise information on signs and symptoms, investigations and diseases