100 Most Commonly Prescribed Drugs Flashcards
Acetlycystine
Use
Caution
SE
Dose
Precursor of glutathione, detoxifies metabolites of paracetamol
Use in paracetamol OD, look at the graph to determine if needed
Caution in asthma and atopy
SE: allergy - rash, bronchospasm, anaphylaxis if pushed too quick
Dose: if above treatment line at 4hrs or >8hrs post ingestion
Initially 150mg/kg in 200ml 5% glucose over 1 hr
Then 50mg/kg in 500ml over 4hrs
Then 100mg/ kg in 1L over 16hrs
Activated Charcoal
Use
Caution
Dose
Binds and decreases absorption of tablets and poisons
Used in ODs up to 1hr post ingestion (longer if antimuscarinic drugs)
Decreases GI motility so can cause obstruction.
Don’t use if low GCS unless have ET tube (risk of aspiration)
50g PO stat. Repeated doses 4hrly for barbiturates, carbamazepine, phenytoin, digoxin, dapsone, Paraguay, quinine, salicyates, theophylline.
Naloxone
Use
Caution
Dose
Opioid receptor antagonist for opiate reversal if OD to over Rx
Caution if pt has cardiovascular disease, if they are taking cardio toxic drugs or if they have a physical dependence on opioids.
Dose: 0.4-2 mg IV (s/c or IM).
Tramadol may need much larger doses. repeat after 2 mins if not response.
Very short half life so may been evert 2-3 mins, to max of 10mg. then r/v and consider IVI: 10mg with 40ml of %% dextrose, start at 60% of initial dose over 1hr.
Gaviscon
Use
Caution
Dose
Alginate raft-forming oral suspension for acid reflux
Ensure pts are well hydrated especially if elderly, have GI narrowing, or decreased GI motility
Dose: 5-10ml or 1-2 tablets after meals and at bedtime
NB:
- 3mmol Na and 1mmol K in 5ml
- 25mmol Na and 1mmol K in 1 tablet
Hyoscine Butlybromide (buscopan)
Use CI Caution SE Interactions Dose
Antimuscarinic: decreases GI motility (does not cross BBB)
Used to treat smooth muscle spasm - biliary colic, diverticulitis, IBS
CI: closed angle glaucoma, myasthenia gravis, megacolon, increased prostate
Caution in: GI obstruction, urinary retention, tachycardia
SE: antimuscarinic: decrease secretions, drowsiness, confusion
Interactions:
decreases effects of metaclopramide and sublingual nitrates.
increases tachycardic effect of B agonists
Dose: 20mg QDS PO or 20mg IM/IV. max 100mg/day
Hyoscine Hydrobromide
Use CI Caution SE Warnings Interactions Dose
Antimuscarinic - predominantly effects on CNS.
Decreases vestibular activity and respiratory/ oral secretions
Used in: motion sickness, terminal care and chronic bad swallow. unlicensed for hypersalivation secondary to antipsychotics
CI: closed angle glaucoma
Caution in: GI obstruction, urinary retention, CVD, porphyria, Downs syndrome, myasthenia gravis
SE: Antimuscarinic: decresed secretions, sedative
Warning: driving may be impaired
Interactions: decreases effect of sublingual nitrates
Dose: 300micrograms 6-hrly PO (max 3 doses) for motion sickness
0.6-2.4mg/ 24hr s/c infusion for secretions
300 micrograms BD PO with antipsychotics
Atropine
Use CI Caution SE Dose
Muscarinic antagnoist - blocks vagal SAN and AVN, bronchodilates, and decreases oropharyneal secretions
Used in severe bradycardia or heart block, organophosphate/ anticholinesterase OD
CI: closed angle glaucoma, myasthenia gravis, paralytic ileus, pyloric stenosis, bladder neck obstruction
Caution: down’s syndrome, GORD, diarrhoea, UC, acute MI, HTN, increased HR, pyrexia
SE: transient decrease in HR, antimuscarnic symptoms, N&V, confusion, dizziness
Dose: 0.3- 0.6 mg IV for bradycardia, 1-2mg IV every 10-30 mins to a max 100mg in 24hrs for poisoning.
Mebeverine
Use CI Caution SE Dose
Antispasmodic - direct action on GI muscle
Use: GI smooth muscle cramps
CI: ileus,
Caution: porphyria
SE: hypersensitivity, skin reactions
Dose: 135 - 150mg TDS, 20mins before food
Ranitidine
Use
Caution
SE
Dose
H2 antagonist - decreases H+ secretion from parietal cells
Used in peptic ulcer disease and reflux oseophagitis . Can be used along side long term NSAID use
Caution in acute porphyria and all the failures and pregnancy
Side effects are rare but include: GI upset (diarrhoea) dizziness, confusion, fatigue, blurred vision, headache, rash.
V rarely arrhythmias, hypersensitivity and blood disorders
Dose: 150mg BD PO initially (can have 300mg nocte) can increase to 600mg/day.
50mg TDS/QDS IV
Omeprazole
Use Caution SE Interactions Dose
Proton pump inhibitor - inhibits H+/K+ ATPase of parietal cells so decreases the acid secretion
Used in peptic ulcer disease and prevention if on NSAIDs, GORD, H.Plyori eradiction, Zollinger-Ellison syndrome
Caution - can mask symptoms of gastric malignancy,
Side effects include GI upset and headaches most commonly. Also dizziness, arthralgia, weakness and skin reactions.
Rarely hepatoxicity, blood disorders,
Interactions:
Decreases P450 - therefore increases levels of phenytoin, cilostazol, diazepam, raltegravir and digoxin.
Increases effects of warfarin
Dose: 20mg OD PO initially. Can increase to 40mg if severe disease, and decrease to 10mg OD if symptoms stable.
20mg BD for H.pylori eradication
max dose 20mg if liver failure
Can be used for acute GI bleeds.
Lansoprazole
PPI - same as omeprazole
fewer interactions
Dose: 15-30mg OD PO, can decrease to 15mg for maintenance
Loperamide
Use CI Caution SE Dose
Antimotility agent: synthetic opiod analogue. binds to receptors in the GI muscle so decreases peristalisis, increasing transit time and therefore resorption of water
Used in diarrhoea
CI: constipation, ileus, megacolon, bacterial enterocolitis secondary to salmonella, shigella, campylobacter, abdominal distension, active IBD, pseudomembranous colitis.
Caution in the young as can lead to fluid depletion.
SE: constipation, abdominal cramps, bloating, dizziness, drowsiness, fatigue.
Dose: 4mg initially, then 2mg after each loose stool (max 16mg/day for 5 days)
Sulfasalazine
Use CI SE Monitoring Dose
Aminosalicylate - combintation of the immune modulator 5-aminosalicylic acid (5-ASA) and the anti bacterial sulfapyridine
Used in RA, UC,
CI: hypersensitivity, renal failure
SE:GI upset (decreased appetite), hepatotoxicity, blood disorders, hypersensitivity, sezuires, lupus
LFTs, U&Es and FBC need monitoring
Dose: 500mg/day increaseing to a max of 3g/day
Mesalazine is similar but hasfewer side effects. the effects are decreased by lactulose. if used with NSAIDS and azathioprine nephrotoxicity may increase.
Fybogel
Use
CI
Dose
Bulking agent laxative - Ispaghula husk
Used for constipation including IBS
CI: decreased swallow, GI obstruction, faecal impaction, colonic atony
Dose: 1 sachet or 10ml BD after meals with water
Senna
USE CI Caution SE Dose
Stimulant laxative. Takes 8-12 hrs to work
Used for constipation
CI: GI obstruction
Caution in pregancy, try a bulk forming or osmotic first
SE: GI cramps, if used chronically: atonic non functioning colon, hypokalaemia.
Dose: 2 tablets nocte
Lactulose
Use CI Caution SE Dose
Osmotic laxative and decreases the growth of NH4 producing bacteria
Used in constipation and hepatic encephalopathy
CI: GI obstruction, glactosamia
Caution is pt lactose intolerant
SE: flatulence, distension, abdominal pains
Dose: 15ml OD/BD for constipation (can take 2 days to work) and 30-50ml TDS for HE
Movicol is also an osmotic laxative
Digoxin
Use CI Caution SE Monitor Interactions Dose
Cardiac glycoside. Decreases heart rate by slowing down AVN conduction and increasing vagal tone
Used in AF and heart failure
CI in heart block, VF, VT, HOCM, SVTs secondary to WPW
Caution in recent MI, hypokalaemia and hypothyroidism, in renal and liver failure decrease the dose
Side effects: mild unless toxicity (there is a small therapeutic window)
GI upset, arrhythmias, visual disturbances (blurred vision and yellow halos), fatigue, weakness, confusion, hallucinations, mood changes.
Rarely decreased platelets, rash, increased esinophils
Monitor U&Es, digoxin levels (6hrs post dose
Interactions: toxicity is increased by Ca2+ (especially verapamil), amiodarone, antimalarials, ciclosporin, St Johns wart, diuretics ( via K+ depletion), ACE inhibitors and sprionolactone.
Cholestyramine and antacids decrease absorption
Dose: non acute AF/SVT: load with 125-250 microgram bd PO and then maintain with 62.5-250 micrograms OD heart failure: 62.5 - 125 micrograms OD Decrease does in renal failure P
Bendroflumethiazide
Use CI Caution SE Interactions Dose
Thiazide Diuretic - decreases Na+ (and Cl-) reabsorption from the DCT so causes Na and H2O loss and stimulates K+ excretion
Used for Oedema (due to heart failure and low protein states) HTN (third line, it decreases fluid volume and CO in the short term and then decreases TPR in the long term)
Can also be used to prevent renal stones in hypercalcuria
CI: hypokalaemia, hyponatremia, hypercalcaemia, addisons disease, severe liver and renal failure.
Caution in porphyria, can worse gout, DM and SLE
SE: dehydration, hypokalaemia, GI upset, impotence, hyponatriumia, metabolic disturbance, pancreatitis
Interactions:
increases lithium levels, effect is decreased by NSAIDs, and oestrogens.
If causes hypokaleamia can increase the toxic effects of digoxin, NSAIDs, steroids, and antiarrhythmics.
There is an increased risk of hyponatraemia when use with carbamazepine.
Dose: 5mg -10 mg OD PO then decrease dose frequency if possible.
Indapamide
Use CI Caution SE Monitor Interactions Dose
Thiazide derivative diuretic - same as bendroflumethiazide
Used in HTN third line
CI: hx of sulphonamide derivative allergy, hypokalaemia, hyponatriumia, hypercalcaemia, severe liver or renal failure.
Caution hyperparathyroidism, gout, porphyria
SE: fewer metabolic disturbances than bendroflumethiazide.
dehydration, hypokalaemia, impotence
Monitor: U&Es and urate
Interactions: increases lithium levels and toxicity of digoxin
Dose: 2.5mg OD PO (in the morning)
Furosmide
Use CI Caution SE Interactions Monitor Dose
Loop diuretic - inhibits Na/K pump in the ascending loop of Henle. It decreases the resorption of Na and therefore H20.
Used in LVF, resistant hypertension, oliguria secondary to AKI ( only if volume has been replaced)
CI: hypokalaemia, hyponatriumia, Addisons, cirrhosis, renal failure.
Caution if hypotension, BPH, porphyria, diabetes
SE: hypotension, hypokalaemia, hyponatremia, other metabolic disturbances. Increased urate/ gout.
Rarely BM supression, renal failure, rash, pancreatitis.
Interactions: increases the toxicity of digoxin, flecanide, solatol, NSAIDs, vancomycin, gent, and lithium.
decreases the effect of antidiabetics
NSAIDs may decrease the diuretic response
Monitor: U&Es
Dose: 40mg po/iv/im in acute LVF
Sprionolactone
Use CI SE Monitor Interactions Dose
Potassium sparing duiretic.
Aldosterone antagonist at distal tube.
Potentiates loop and thaizide diuretics
Used in ascities, oedema, HF, nephrotic syndrome and primary aldosteronism
CI: hyperkalaemia, hyponatreamia, Addisons,
SE: hyperkalaemia, gynaecomasti, N&V, impotence,
Monitor: U&Es
Interactions: increases digoxin and lithium levels.
Increased risk of renal failure with NSAIDs
Dose: 100-400mg/ day PO.
25mg OD if for HF
Adenosine
Use CI Caution SE Warn Interactions Dose
Purine nucleoside. Slows AVN conduction, dilates coronary arteries
used in the treatment of SVT and the slowing down of SVT to see underlying rhythm.
CI: asthma, COPD, heart failure (can cause death), hyppotension, increased QTc, heart block
Caution: heart transplants, AF/ atrial flutter
SE: bronchospasm, decreased heart rate, asystole, angina, resp failure
Warn that can make you feel like you are going to die, sick, pain in chest, dyspnoea
Interactions: effects increased by dipyridamole: decrease initial dose to 0.5-1mg and watch for bleeding as adenosine also increases the anti-platelet effects of dipyridamole.
effect decreased by theophyllines and caffeine.
If used with digoxin can increase risk of VF
Dose: 6mg IV over 2sec, then 12mg IV after 1-2 x2. Cardiac monitor NEEDs to be attached, and needs to be given through large peripheral or central and then flushed.
t1/2 <10 sec
Amiodarone
Use CI Caution SE Monitor Warn Interactions Dose
Class III antiarrhythmic: increases refractory period of conducting system, useful as has a less negative inotropic effect than other drugs
Used in tachyarrhythmias especially SVT, AF, atrial flutter, nodal tachycardias, VT and VF
CI: sinus bradycardia, heart block, thyroid disease
Caution: hypokalaemia there is an increased risk of torsades
SE: Acute; nausea and vomiting, bradycardia, hypotension
Chronic: intersitial lung disease, changes to thyroid function, hepatotoxicity, conduction disturbances, malaise, fatigue, night glare, grey slate skin
Monitor: TFTs, LFTs, K+ and CXR
Warn: avoid sunlight and use sun cream
Interactions: increases the effects of phenytoin and digoxin.
Drugs that can cause an increase risk of VT: other antiarrhythmics, antipsychotics, TCAs, lithium, erythromycin
Drugs that can cause bradycardia and heart block: verapamil, diltiazem and B blockers
Increases effect of warfarin
Dose: PO load with 200mg TDS for 1/52, 200mg BD for 1/52 and then 200mg OD maintenance.
IV (in emergencies) 150-300mg in 10-20ml of 5% glucose over >3mins (see ALS guidelines)
Lidocaine
Use CI Caution SE Monitor Interactions Dose
Class Ib antiarrhythmic - decreases conduction in Purkinje and ventricular muscle fibres.
Local anaesthetic - blocks Na+ channels
Used in ventricular arrhythmias
CI: myocardial depression, heart block
Caution: epilepsy, hypoxia, hypovolaemia, bradycardia
SE: dizziness, drowiness, confusion, tinnitus, blurred vision. rarely resp depression, seizures, anaphylaxis
Monitor ECG when giving IV
Interactions: increased risk of arrhythmias with antipsychotics
increased myocardia depression with other antiarrhythmics and B blockers
levels increased by propranolol, ataza/ lopinavir and cimetidine.
Prolongs the action of suxamethonium
Dose (for ventricular arrhythmias): 50-100mg IV followed immediately by IVI as short t1/2.
Propranolol
Use CI Caution SE Interactions Dose
B blocker - non selective
B1 = decrease heart rate and contractility
B2 = vasodilation, bronchoconstriction, and glucose release from the liver
Blocks effects of catecholamines, decreases renin and slows SAN/AVN conduction
Used in hypertension, IHD, portal hypertension, essential tremor, symptom relief of anxiety and hyperthyroidism
CI: asthma, peripheral arterial disease, bradycardia, hypotension, heart block,
Caution: COPD, diabetes, mysthenia
SE: bradycardia, hypotension, peripheral vasoconstriction, fatigue, depression, sleep disturbances, hyperglycaemia, GI upset
Interactions: Verapamil ad diltiazem can cause heart block and death!!
Risk of hypotension and heart failure with nifedipine.
Increase risk of lidocaine toxicity.
Dose: variable depending on use.
HTN: 80-160mg PO
Post MI: 40mg QDS for 2-3 days then 80mgBD PO
dose needs to be decreased in liver and renal failure
Bisoprolol
Differences to Propranolol
Cardio selective B1 > B2
CI in heart failure, if SAN block and caution in poriasis
Dose: 10mg OD PO
Atenolol
Differences to Propranolol
Mildly cardioselective (B1 > B2), increased H2O soluble so less effects centrally, and increased renal secretion
Can be used within 12hrs of an MI
Causes less bronchospasm and less sleep disturbances
Dose: HTN 25-50 mg OD PO
Doxazonsin
Use CI Caution SE Interactions Dose
A1 blocker = systemic vasodilation and relaxation of internal urethral sphincter. Decreases TPR and increases bladder outflow.
Used in hypertension and BPH
CI; postural hypotension, anuria
Caution: micturition syncope
SE: postural hypotensin, dizziness, headache, urinary incontinence. Increases HDL ratio
Interactions: increases hypotensive effects of diuretics, B blockers, calcium channel blockers, general anaesthetics, and antidepressants
Dose: 1mg OD then increase to max 16mg/day in hypertension and 8mg/day in BPH
Ramipril
Use CI Caution SE Monitor Interactions Dose
ACE inhibitor
Used in hypertension, heart failure, post MI
CI: renovascular disease
Caution: sympotmatic aortic stenosis, hx of angioedema, if taking drugs that increase potassium
SE: hypotension, renal failure, dry cough, hyperkalaemia,
hypersensitivity, pancreatitis
Monitor: U&Es - baseline and then 2 weeks after starting
Interactions: effect decreased by NSAIDs (also increases renal failure),
Diuretics, TCAs, and antipsychotics increase the risk of hypotension.
Increases effects of lithium
Dose: 1.25mg OD increase to max 10mg OD
post MI: 2.5mg BD then increase to 5mg BD after 2 days and then maintain
- captopril is a short acting ACEi*
Lostartan
Use CI Caution SE Interactions Dose
Angiotensin II receptor antagonist - specifically blocks then renin- angiotensin system not anything to do with Bradykinin
Use: Hypertension, prevention of diabetic induced nephropathy if an ACEi not tolerated
CI: pregnancy and breast feeding
Caution: renal artery stenosis, HOCM, mitral or aortic stenosis, if taking drugs that increase potassium
SE: same as ramipril but not s dry cough
Interactions: can cause hyperkalaemia if used with drugs that increase potassium
Dose: 25-50mg OD increasing to a max of 100mg OD.
reduce dose in renal or liver failure
Glyceryl Trinitrate
Use CI Caution SE Interactions Warn Dose
Nitrate: coronary artery and systemic vein dilation = increased oxygen supply to the myocardium and decreased preload = decreased oxygen demand of the myocardium
Used in angina and LVF
CI; hypotension, anaemia, AS/MS, constrictive pericarditis, tamponade, HCOM, glaucoma, hypovolaemia, increased ICP
Caution: recent MI, hypothyrodism, head trauma, cerebral haemorrhage, malnutrition,
SE: hypotension, headache, dizziness, flushing, tachycardia
Interactions:
Sildenafil, tadalafil and vardenafil are CI due to +++ hypotension
reduced effect of heparins
Dose: 2 sprays or sublingual tabs PRN
in acute MI/ KVF 10-200micrograms/min IV
Isosorbide mononitrate = a nitrate but PO not sublingual - gives less of a headache than GTN.
10 - 40mg bd PO
Nicorandil
Use CI Caution SE Interactions Dose
Potassium channel activator - arterial dilation which decreases afterload with a nitrate component - venous dilatation decreasing preload
Used to treat angina which is unresponsive to other Rx
CI: hypotension, LVF with low filling pressures
Caution: hypovolaemia, acute pulmonary oedema, ACS with LVF,
SE: headache, flushing, dizziness, weakness, N+V, hypotension and tachycardia.
Rarely GI/ perianal ulcers
Interactions, risk of ++hypotension when used with sildenafil etc
Dose: 5-30mg BD
Adrenaline
Use Caution SE Interactions Dose
Sympathamimetric - powerful stimulation of alpha (vasoconstriction), beta 1 (increase HR, increase contractility) and beta 2 (vasodilation broncodilation, and uterine relaxation).
Also decreases mast cell cytokine release immediately
Used in CPR, anaphylaxis
Caution: cerebralvascular and heart disease
SE: tachycardia, hypertension, anxiety, sweats etc
Interactions: effect is increased by dopexamine, TCAs, ergotamine and oxytocin.
Risk of ++ hypertension and bradycardia with B blockers, TCAs, MAOIs.
Risk of arrhythmias with digoxin, quinidine, and volatile liquid anaesthetics
Dose:
CPR: 1mg IV (10mls of 1 in 10000) then flush with 20mls saline,
Anaphylaxis: 0.5mg im (0.5ml of 1 in 1000)
Enoxaparin
Use CI Caution SE Monitoring Interactions Dose
Low molecular weight heparin - anticoagulant. Potentiates protease inhibitor antithrombin III which inactivates thrombin.
Used in DVT/ PE treatment and prevention and in ACS
CI: haemorrhagic disorders (haemophilia), low platelets, severe hypertension, acute bacterial endocarditis, recent spinal (can give therapeutic doses)
Caution: hyperkalaemia, renal failure
SE: haemorrhage, low platelets, hypersensitivity, hyperkalaemia (inhibits aldosterone so increased risk if diabetic, chronic renal failure, acidosis or on potassium sparing drugs) osteoporosis
Monitor: FBC, U&E
Interactions: effect may be reduced by GTN ivi. increased bleeding risk with NSAIDs
Dose: subcut 1mg = 100 units DVT/ PE treatment = 1.5mg/kg OD ACS treatment = 1mg/kg BD Prophyalxis = 40mg OD (half for renal failure)
Warfarin
Use CI Caution SE Warn Dose
Vitamin K antagonist - blocks the synthesis of vitamin K dependent factors (II, VII, IX, X) and protein C and S
Used to prevent thrombo embolisms in AF, recurrent DVTs/PE, new heart valves
CI: severe hypertension, peptic ulcers, severe bleeding, haemorrhagic CVA, pregnancy
Caution: recent surgery, bacterial endocarditis, 48 hr post partum
SE: haemorrhage, rash, fever, diarrhoea, purple toe syndrome, skin necrosis, heptotoxicity
Warn: effects are increased by alcohol, cranberry juice,
Interactions: antibiotics and drugs that affect cytochrome P450
Dose: monitor INR - aim for 2.5 in most cases except for mechanic heart valve where 3.5 is needed.
Need to give a loading dose (10mg) and then check INR every day for 4 days and adjust dose accordingly and then continue to monitor in the community.
When starting need to give LMWH for 5 days as it is prothrombotic to start with.
Need to reduce doses for: >80yrs, liver failure, heart failure, post op, poor nutrition, or taking drugs that increase the effect of it.
Amlodipine
Use CI Caution SE Interactions Dose
Ca2+ channel blocker - cause vasodilatation and reduce the oxygen consumption of the myocardium.
Dihydropyridine - mainly peripheral vasodilators, and cause reflex tachycardia.
Used for hypertension, and angina.
CI: ACS, cardiogenic shock, clinically significant aortic stenosis
Caution in heart failure, BPH,
SE: flushing, headache, ankle oedema, dizziness, hypotension, palpitations, poly/nocturia, rash, GI upset, weakness, myalgia, gum hyperplasia,
Interactions: may increase the effect of theophyllines, care should be taken with inducers of cytochrome 3A4, decrease simvastatin dose to max 20mg OD
Dose: initially 5mg PO
Verapamil
Use CI Caution SE Interactions Dose
Calcium channel blocker - promotes vasodilatation and reduces myocardial oxygen consumption.
Non - dihydropyridines - slow conduction at the AV and SAN.
Used for hypertension, angina, arrhythmias
CI: hypotension, bradycardia, heart block, decreased LV function, AF,
Caution: ACS,
SE: Constipation, hear failure, hypotension, heart block, headache, dizziness, fatigue ankle oedma, hypersensitivity, skin reactions
Aspirin
Use CI Caution SE Interactions Dose
NSAID - inhibits COX1 and COX2 - decreases prostaglandin synthesis (anti-inflammatory and antipyrexial) and decreases thromboxane A2 (anti platelet aggregation)
Used for mild pain and as an anti platelet in IHD
CI in children <10ml/min
Caution in asthma,
SE: GI irritation, bleeding. rarely hypersensitivity, AKI, hepatotoxicity and ototoxic in OD
Interactions: increased GI bleeding when used with other anticoagulants, other NSAIDs, SSRIs and venlafaxine.
Increases the effect of warfarin.
Can increase the levels of methotrexate, increase the effects of anticonvulsants and decrease the effects of spironolactone.
Dose:
For analgesia: 300-900mg 4-6hrly, for IHD prevention 75mg OD, for treatment of ACS 300mg stat.
Clopidogrel
Use CI Caution SE Monitor Dose
Antiplatelet - ADP receptor antagonist (works with aspirin to have ++ anticoagulation as both on similar pathway)
Used post MI for 12months
CI: active bleeding,
Caution: increased bleeding risk, trauma, surgery.
effects decreased by omeprazole etc
SE: haemorrhage, GI upset, pancreatitis, headache, fatigue, dizziness etc
monitor FBC and signs of occult bleeding
Dose: 75mg OD - load with 300mg
