Vascular disease - clopidogrel and dipyridamole

Summary

Guidance currently being reviewed: See review

NICE has recommended that:

• the combination of MR dipyridamole and aspirin is used as part of the prevention of occlusive vascular events in people who have had an ischaemic stroke or a transient ischaemic attack for a period of 2 years from the most recent event. After this period of time, or if MR dipyridamole causes adverse effects, the person should receive standard care which includes long-term treatment with low-dose aspirin
• clopidogrel alone (within its licensed indications) is used as part of prevention of occlusive vascular events in people who are intolerant of low-dose aspirin and either have experienced an occlusive vascular event or have symptomatic peripheral arterial disease.

In these recommendations, NICE has defined aspirin intolerance as either:

• a proven hypersensitivity to aspirin or
• a history of severe indigestion caused by low-dose aspirin.

Documents

For healthcare professionals

• TA90 Vascular disease - clopidogrel and dipyridamole: Guidance
• TA90 Vascular disease - clopidogrel and dipyridamole: Guidance (Word version)
• TA90 Vascular disease - clopidogrel and dipyridamole: Quick reference guide

For patients, carers and the public

• TA90 Vascular disease - clopidogrel and dipyridamole: Information for the public

Background information

• Review Decision - August 2008
• Review Decision - August 2008: Table of comments
• Assessment report
• 2005/010 NICE issues guidance on the use of "clot-busters" in the prevention of heart attacks and strokes
• TA090 Distribution list - Clopidogrel and modified-release dipyridamole for the prevention of occlusive vascular events
• Review Proposal - April 2008
• Review Proposal - May 2008: provisional matrix of consultees and commentators

Implementing this guidance

Any further information NICE has produced to help the NHS implement this guideline locally is linked to below:

• None found