The Pharmaceutical Journal
Vol 274 No 7351 p641
28 May 2005

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NICE: Vascular disease - clopidogrel and dipyridamole

NICE restricts clopidogrel and dipyridamole

Patients who have experienced a stroke or heart attack, or who have symptomatic peripheral arterial disease, can be treated with the antiplatelet drug clopidogrel (Plavix) but only if they cannot tolerate aspirin, the National Institute for Health and Clinical Excellence announced this week.

NICE also recommends that modified-release dipyridamole can be used in combination with aspirin to prevent strokes and heart attacks. Such therapy is approved for a period of two years from a patient’s most recent vascular event. Thereafter, preventive therapy should revert to standard care.

A spokeswoman for the British Cardiac Patients Association said that the organisation was disappointed by the guidance, which, it said, placed too much emphasis on the use of aspirin to prevent heart attacks and strokes. This view was echoed in a statement issued by sanofi-aventis and Bristol-Myers Squibb, co-developers of Plavix in the UK.