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Summary of guidance relevant to general practice published in December 2010

  • Vascular disease - clopidogrel and dipyridamole
  • Chronic constipation - prucalopride

Vascular disease - clopidogrel and dipyridamole

Clopidogrel should be used for the prevention of vascular events in patients:

  • who have had a previous stroke or
  • have peripheral arterial disease,

and may be used as an option for patients who have:

  • multivascular disease or
  • peripheral arterial disease or
  • have had a heart attack if aspirin is contraindicated or not tolerated.

Dipyridamole plus aspirin may be used for patients who have had a transient ischaemic attack, or for those who have had an ischaemic stroke, but only if clopidogrel is contraindicated or not tolerated.

Dipyridamole can be given on its own if:

  • the patient has had an ischaemic stroke and treatment with aspirin and clopidogrel is contraindicated or not tolerated, or
  • if the patient has had a transient ischaemic attack and aspirin is contraindicated or not tolerated

GPs should start patients with the least costly licensed preparation of the drug.

For more information, see the Quick Reference Guide for TA210 Vascular disease - clopidogrel and dipyridamole

Support tools to help put this guidance into practice

We have prepared:

  • Audit support to help you to track progress in putting this guidance into practice
  • A costing template to help you to identify the costs and savings of putting this guideline into practice

Chronic constipation - prucalopride

GPs should only prescribe prucalopride to women who have tried at least two different types of laxatives from different classes (at the highest tolerated recommended doses) for at least 6 months, but have not had relief from constipation, and for whom invasive treatment is being considered.

Prucalopride should only be prescribed by a doctor with experience of treating chronic constipation, who has carefully reviewed the woman's previous course of laxatives.

If treatment with prucalopride is not effective after 4 weeks, the patient should be re-examined and the benefit of continuing treatment reconsidered.

The guidance ‘Prucalopride for the treatment of chronic constipation in women', including a version for patients, is available at www.nice.org.uk/guidance/TA211

Support tools to help put this guidance into practice

We have prepared:

  • Audit support to help you to track progress in putting this guidance into practice
  • A costing template to help you to identify the costs and savings of putting this guideline into practice

This page was last updated: 17 February 2011

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Accessibility | Cymraeg | Freedom of information | Vision Impaired | Contact Us | Glossary | Data protection | Copyright | Disclaimer | Terms and conditions

Copyright 2014 National Institute for Health and Care Excellence. All rights reserved.