In line with guidance from the Royal College of Physicians’, the Nottinghamshire Area Prescribing Committee recommends that clopidogrel at a dose of 75mg daily (following initial 300mg loading dose) is used for stroke and TIA patients in sinus rhythm. See link below
Occasionally on advice from a stroke consultant, clopidogrel may be used in combination with 75mg aspirin for up to 3 weeks following minor stroke or TIA before the maintenance dose of clopidogrel 75mg alone is continued. The duration of DAPT should be documented and communicated on discharge.
25mg/5ml unlicensed liquid special available for paediatric use at NUH only.
If needed tablets can be dispersed in water (unlicensed). More Info
For use in patients that meet NICE criteria. Specify duration of therapy on discharge.
Treatment should be stopped when clinically indicated or at a maximum of 3 years post MI as per NICE TA 420
Orodispersible tablets can be dispersed in water for nasogastric tube (CH8 or greater) administration. It is important to flush the nasogastric tube through with water after administration of the mixture.
Each capsule contains 200mg dipyridamole MR and 25 mg aspirin
Discontinued July 2020
No formal submission
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Non Formulary section
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Grey / Non-Formulary: Medicines, which the Nottinghamshire APC has actively reviewed and does not recommend for use at present due to limited clinical and/or cost effective data. Grey / Non-Formulary (undergoing assessment): Work is ongoing and will be reviewed at a future APC meeting. Grey / Non-Formulary (no formal assessment): APC has not formally reviewed this medicine or indication because it had never been requested for formulary inclusion. Often used for drugs new to market.
Medicines which should normally be prescribed by specialists only. eg hospital only.
For patients already receiving prescriptions in primary care - continue. No new patients to receive prescriptions in primary care.
Medicines that should be initiated by a specialist and prescribed by primary care prescribers only under a shared care protocol, once the patient has been stabilised.
Prior agreement must be obtained by the specialist from the primary care provider before prescribing responsibility is transferred. The shared care protocol must have been agreed by the relevant secondary care trust Drugs and Therapeutics Committee(s) (DTC) and approved by the Nottinghamshire APC.
Medicines suitable to be prescribed in primary care / general practice after specialist* recommendation or initiation.
A supporting prescribing guideline may be requested which must have been agreed by the relevant secondary care trust DTCs and approved by the Nottinghamshire APC.
*Specialist is defined by the APC as a clinician who has undertaken an appropriate formal qualification or recognised training programme within the described area of practice
Primary care/ non specialist may initiate as per APC guideline.
The supporting prescribing guideline must have been agreed by the relevant secondary care trust D&TC(s) and approved by the Nottinghamshire APC.
Medicines suitable for routine use within primary care.
Can be initiated within primary care within their licensed indication, in accordance with nationally recognised formularies, for example the BNF, BNF for Children, Medicines for Children or Palliative Care Formulary. Primary care prescribers take full responsibility for prescribing.