Secondary prevention

 

Antithrombotics

Recommendations 5.5.1

A. For patients with ischaemic stroke or TIA in sinus rhythm, clopidogrel should be the standard antithrombotic treatment:

• Clopidogrel should be used at a dose of 75mg daily
• For patients who are unable to tolerate clopidogrel, offer aspirin 75mg daily in combination with modified-release dipyridamole 200mg twice daily
• If both clopidogrel and modified-release dipyridamole are contraindicated or not tolerated, offer aspirin 75mg daily
• If both clopidogrel and aspirin are contraindicated or not tolerated offer modified-release dipyridamole 200mg twice daily
• The combination of aspirin and clopidogrel is not recommended for long-term prevention after TIA or stroke unless there is another indication such as acute coronary syndrome or recent coronary stent procedure

(for further recommendations see p68-69 of the 2012 guidelines or go to the Recommendations section of this module)